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Mr. Heath: I do not dispute what the Minister has just said, but he must realise that there are a number of hospital trusts dotted around the country that have gone through the process of getting their management in order and are trailing, as it were, in surplus, but are nevertheless saddled with insurmountable debts from previous management failures, which are proving an impossible burden for them and causing detriment to the patients in their area through no fault of the present management.

Mike Penning (Hemel Hempstead) (Con): Further to that point of order, Mr. Deputy Speaker.

Mr. Deputy Speaker (Sir Michael Lord): Order. First, that was not a point of order. Secondly, it is necessary to allow the Minister to respond to one intervention before he takes another.

John Healey: The task is not impossible, because the vast majority of our NHS organisations are succeeding. What my right hon. Friend the Secretary of State announced was ways of making sure that the proper support is available for those that are struggling.

Mike Penning rose—

Greg Clark rose—

John Healey: I am reluctant to give way to the hon. Member for Hemel Hempstead (Mike Penning). He has been in the Chamber off and on during the afternoon, but he has not contributed to the debate, so if he does not mind, I shall give way to the hon. Member for Tunbridge Wells, who is a member of the PAC and made a contribution earlier. Then I shall conclude my remarks, as I am anxious to let the Chairman of the PAC have the final word, as is traditional.

Greg Clark: I am grateful to the Minister for giving way. He is right that more money is being spent on the NHS, and I whole-heartedly welcome that, but my point was about value for money. It does not make sense from the point of view of value for money not to perform operations when people are ready, willing and able to conduct them but to have to defer them to a date after 31 March when they might have to work overtime to do so. It is not about the volume of money; it is about the systems that are resulting in a lack of value for money.

John Healey: The hon. Gentleman and his colleagues on the Public Accounts Committee may want to look at
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the question of financial management and control and value for money in that context. If they do so, I look forward to the conclusions that they draw.

I noted the mention made again by my hon. Friend the Member for Burnley (Kitty Ussher) of her ten-minute Bill. I hope that the hon. Member for South Norfolk is a sponsor, because he is clearly in favour of her proposals. She stressed the attention that the PAC can give to economic policy, especially in the regions, and I certainly welcome that interest.

I hope that the hon. Member for Basingstoke (Mrs. Miller) sees the fact that 93 per cent. of the PAC's recent recommendations have been adopted and put into practice by the Government as confirmation, which she encouraged, of how seriously we take the Committee's work, although we do not quite see the Committee as somehow our in-house management consultancy, as she suggested. She talked about the importance of child care to both the social and economic future of this country. I welcome her strong, albeit reasonably questioning, support for the policies that we are pursuing. She is right to say that we want every pound invested in child care to work hard.

In closing, I want to touch on two vital general areas for the Government in which the PAC also has an active interest: first, the efficiency programme following the Gershon review, which the hon. Member for Gainsborough mentioned, as did my hon. Friend the Member for Burnley; and, secondly, the comprehensive spending review.

The Government are committed to improving public sector efficiency following both the Gershon and the Lyons reviews. Departments own their efficiency plans, however, and it is their responsibility to report on their own progress. They do that in the autumn performance reports and the annual departmental reports. The Chancellor also provided an update on the aggregate progress, both at the Budget last year and in the pre-Budget report, and the Treasury reports on overall progress on efficiency as part of reporting on our spending review 2004 target 9. The efficiency programme is delivering results, as the Chancellor showed in his recent update: £4.7 billion on efficiency gains released back to the front line. In addition to the monetary figure, a total head-count reduction of 31,000 was confirmed and the relocation of a total of 6,300 staff was completed.

Those aggregate gains are based on departmental returns that are reported against a very robust measurement framework on a quarterly basis. Every pound reported can be traced to individual delivery programmes. Those returns are scrutinised and checked for consistency quarter on quarter. However, we will not consider them final until they have been subject to a full verification, which is of course carried out after the end of each financial year.

The comprehensive spending review sets an important context in which we can consider and incorporate recommendations received from the PAC. A decade on from the first CSR, the 2007 comprehensive spending review will represent a long-term and fundamental review of Government expenditure, and it will cover departmental allocations for three years,
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beginning in 2008–09. Since 1997, the Government have shown that we can deliver for Britain a strong economy and sound public finances at the same time as sustained and sustainable growth in investment in public services. But what we need now is an assessment of the long-term challenges facing our country and our public services, focusing on the major global and domestic long-term trends to which public spending and public services need to respond over the next decade. That assessment must also focus on the conclusions of the long-term reviews that are already under way into the future of transport, skills, pensions and local services.

Britain faces a rapid increase in the old-age dependency ratio. We also face an intensification of cross-border economic competition, an acceleration in the pace of innovation and technology, continued global uncertainty and threats, as well as increasing pressure on our natural resources and global climate. These challenges will have fundamental and far-reaching implications for our public services and they will require innovative policy responses, co-ordination of activity across Departments, and sustained investment in key areas.

The comprehensive spending review will be tough and challenging. It will take a zero-base approach to assessing the effectiveness of Departments' existing spending in delivering the outputs to which they are committed. The review will also look at how the public expenditure framework can best embed and extend ongoing efficiency improvements and support the long-term investments needed to meet these challenges. The CSR therefore offers an important opportunity for the Government to take stock of what we have achieved and to prepare for the challenges ahead—one to which I am sure the PAC will make an important contribution.

Perhaps I can end where the PAC's 17th report began. It stated:

We in the Government and in the House, as well as the public at large and the civil service, owe a debt of gratitude to the Committee for its work. The report went on to say:

With the PAC's advice, we will continue to do just that.

7.12 pm

Mr. Leigh: With your permission, Mr. Deputy Speaker, I shall say a few words to sum up. May I thank everyone who has contributed to the debate? First, I thank the hon. Member for Dagenham (Jon Cruddas), who is valued former member of the Committee. I will raise with the Comptroller and Auditor General the matter of our producing a report on how demographic factors can influence public policy. The hon. Gentleman made his point extremely well.

I also thank the hon. Member for Somerton and Frome (Mr. Heath) for speaking so eloquently in our debate. He suggested that the National Audit Office should be involved in the debate on identity cards. There is a slight problem there, because the NAO is very keen
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to stay out of current political issues. However, I agree that that issue is one that we need to keep careful tabs on.

I am very grateful to the hon. Member for Bishop Auckland (Helen Goodman) for her contribution. She is a highly valued new member of the Committee, and she uses her Treasury experience to good effect. She made a very good point about the problem relating to our reports being produced so long after the event. I sometimes feel that we are kicking a corpse that has been dead for a long time, as happened several times in relation to the dome. I have raised this issue again with the Comptroller and Auditor General and he has promised me that we can try to produce much shorter reports that hon. Members can actually read. If they were about 20 pages long and written in narrative form, they would be easily understood. That would enable us to drive the oversight process forward much more quickly.

I am grateful to my hon. Friend the Member for South Norfolk (Mr. Bacon) for his contribution today and for being a sterling member of the Committee throughout my chairmanship. With the right hon. Member for Swansea, West (Mr. Williams), we alone on the Committee have said that, if someone becomes an Opposition spokesman, they must leave the Committee. We have maintained the purity of the Committee in that regard. My hon. Friend the Member for South Norfolk has chosen to stay on the Committee and not to become an Opposition spokesman, as his abilities merit. I am grateful to him for that.

I thank the hon. Member for Portsmouth, North (Sarah McCarthy-Fry) for her contribution and for the valuable experience in risk management and project management that she has brought to the Committee. I am also grateful to my hon. Friend the Member for Tunbridge Wells (Greg Clark) for his powerful remarks about our work in controlling the para-state, as he put it, and those parts of the state that are not as accountable as they should be.

I am grateful for what the hon. Member for Burnley (Kitty Ussher) said about smart procurement. I say this to my hon. Friend the Member for Basingstoke (Mrs. Miller): it is true that we view ourselves, in our capacity as allies of the Treasury, as low-paid management consultants—paid much less than those employed by the Financial Secretary—but we do our best.

My hon. Friend the Member for Chipping Barnet (Mrs. Villiers) experienced her first outing on the Front Bench. Yesterday we had before us a permanent secretary with another 14 years to serve. I have no doubt that my hon. Friend will serve for at least 14 years with great distinction, in and out of Government. She spoke of delivering a 1 per cent. efficiency improvement—£14 billion of gains. That is a lot of money to play with.

Of course I also thank the Financial Secretary for what he said. I am very proud of our work. In an era of rapid increases in public expenditure we do not question what is being done, but I believe that we can make a difference. This is one part of Parliament that is doing a superb job.
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I thank all who have contributed to this excellent debate.


7.15 pm

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