Select Committee on Public Accounts Minutes of Evidence

Examination of Witnesses (Questions 220 - 224)



  220. The specialist centres we have been hearing about, will they also be—
  (Mr Crisp) Specialist centres, not necessarily. For example, one that is being looked at which is being developed in the Middlesex in London is looking at just what is the best way to do it and what is the best way to use facilities.

  221. Looking at page 22, Sir John, you indicated that some trusts inappropriately adjusted their waiting list figures, I presume that means they cooked the books in some way or another, such as Redbridge, Guy's, St Thomas's, University College London Hospital, Plymouth, South Warwickshire and Stoke Mandeville, when do you hope to be able to produce your report on what has been happening there and what they are doing to put things right?
  (Sir John Bourn) In December.

  222. Public in December?
  (Sir John Bourn) Yes.

  Mr Williams: That is very good, I cannot wait.

Mr Bacon

  223. A very quick question, Mr Crisp, you mentioned NHS Direct as one of new things you are taking forward which prompted a thought in my mind, I read a few months ago from memory expenditure of £87 million from NHS Direct resulted in two per cent of GP appointments being avoided. I was wondering whether you can comment on the effect that is having? Secondly, I have been told that the call centre has people sitting there doing PHDs in NHS time because of low utilisation levels. I wonder if you can comment on that.
  (Mr Crisp) The first one, I cannot remember the figure, what we are seeing on NHS Direct is, it is increasing demand to some extent because it was always bound to increase demand, you are making a service available and it is having some effect. That effect is both in sending more people to hospital who might not have gone as well as some reduction, it may be, it is too early to say, related to the fact that A&E attendance is down. There is a preliminary evaluation round that. The second point, I am not aware of these PHD students you are referring to, but I would happily follow it up if you want to give me the information on that. But NHS Direct has got further to go. We have got it in parts of this country linking into GP out of hours services, so there is one phone call you can make to get to your GP as well as to get information and advice from a nurse. We are looking at extending that so it becomes a much more ordinary way for us as members of the public to go to NHS Direct. We are also linking it with 999 calls, because you will be aware that a lot of the ambulance service calls are "inappropriate", in that we are using big vehicles for a small issue. So perhaps we can use NHS Direct to screen those out. So if there is spare capacity, I am delighted to know that because we will be able to do those extensions more cheaply and more effectively.

Geraint Davies

  224. This Committee is about value for money and the efficient use of resources, what do you think about the idea of prioritising working people in the waiting list over non-working people, the logic being that this would actually generate an enormous amount of extra tax revenue which in theory at least could be hypothecated back into the system so everybody would have to wait less time.
  (Mr Crisp) I am not sure what I think of it. I am not sure it is being looked at within the Department or not.

  Geraint Davies: Perhaps you could have a think about it and, who knows?

  Chairman: Thank you very much, Mr Crisp. You have done extremely well. You will remember you promised Mr Williams a list of part-time and full-time consultants. It has been a very useful session, it is obviously politically controversial but we have managed to shed some light on these matters. Thank you for your patience in being with us so long.

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