House of Commons - Public Accounts

Select Committee on Public Accounts Sixty-Third Report

1 Delivering high quality public services for all

1. Almost all of us use public services every day of our lives. We do so as we drive our cars on publicly funded roads and have our rubbish taken away by the local council. Millions of us benefit from services provided by our hospitals, schools, colleges and universities, as well as our police force and other front-line services. Public services are there for emergencies - for example, at times of illness; and for everyday use - for example, if we are looking for a job or need advice on taxes or benefits.

2. Our public services can be excellent. Many people remember when they were well cared for in hospital or look back with gratitude on the assistance received from well trained teachers. Over the years, the Committee of Public Accounts has taken evidence regarding numerous successful public services provided by highly dedicated staff working throughout the public sector. At other times, however, we have heard how public services can be difficult to use, particularly where customers have not fitted with the requirements of those running the services. As Members of Parliament we see letters from citizens describing situations where public organisations have failed to provide an adequate service.

3. People want public services that work (Figure 2). They want them to be easy to find out about, simple to use and responsive to their needs. They want them to deal with their requirements, preferably in one go. If they cannot do this, they want to know by when they will be dealt with. They do not want to be passed between different offices or handled by staff who know little or nothing about them. In particular, they want to be treated as individuals.

Figure 2: What customers like and dislike about public services

Citizens like services which are…
well organised and efficiently run
accountable and fair
aware of the needs of all
swift to respond
reliable
consistent and clear
easy to use
delivered by knowledgeable staff
and which ...
treat people as individuals

Citizens do not like services which…

are complex and bureaucratic
have staff who are unhelpful
don't explain what is happening with their case
fail to ring back or allow phones to go unanswered
are inflexible
produce incomprehensible leaflets and letters
are badly linked up with other services

What governments have done to improve the quality of public services

4. Providing high quality and cost-effective public services is not easy. It involves creating organisations with the right approaches and ethos, establishing clear ways of delivering services and putting the right people in place to respond to the needs of customers. It also requires a combination of good policy development, successful implementation, a good understanding of customer needs, sound technology, appropriate resources, a responsive organisational culture and well trained staff.

5. Over the last 20 years, successive governments have introduced measures designed to help provide better services to the public. They have done this by:

introducing explicit published standards for what people can expect from public services;

publishing performance information so that people can see how, for example, schools or trains in their locality are performing;

recognising the potential of innovation, 'thinking outside the box', and providing services in different ways - for example, electronically or through contact centres;

establishing organisations to deal specifically with particular groups of people, such as The Pension Service;

training staff to think more about customers and their needs;

working in partnership with other organisations in the voluntary or private sectors;

using the private sector to deliver some services; and

establishing stronger means by which people can complain about poor services.

6. The Committee of Public Accounts have examined many of these developments. We have seen many successful improvements in public services over the last two decades, such as those described in Figure 3. For example, many Jobcentres have been transformed from the grim social security offices of the past, it is now much easier to obtain a passport or a driving licence, and information about a wide range of public services is much more readily available via many government websites.

Figure 3: Examples of successful improvements in public service delivery

Transformed services: Since 2002, Jobcentre Plus has been introducing new offices which have transformed the service for those looking for work.[1] This initiative has succeeded in providing a far more pleasant environment than the traditional social security offices, which were often old, poorly maintained and shabbily furnished. Jobcentre Plus has also made available details of job vacancies on-line so that they can be easily searched by thousands of people every day.

More accessible services: The development of call centres has successfully allowed public bodies to provide a wide range of services at times of the day when public offices were often closed in the past.[2] For many people this is more convenient than travelling to an office to discuss their affairs or having them dealt with by letter.

Safer services: The Public Guardianship Office was established in 2001 to protect the financial interests of people who lose mental incapacity. This followed criticism from the Committee that the Public Trust Office (its predecessor) had failed to ensure, through its visits programme, that patients' funds were being used for their benefit.[3]

Innovative services: HM Revenue and Customs has established an e-programme to help it offer 100% of its services electronically by 2005 and to achieve 50% take-up by March 2006. The e-programme involves developing new ways of working and integrated IT systems including a new website, to deliver a wider range of services electronically.[4]

7. Such cases illustrate the transformation of some public services in recent years for the good of citizens. The rest of this Report draws together examples of good and bad quality of service across government. In particular, it highlights our view that successful public services are those that are:

easy to access;
delivered promptly;
responsive to reasonable customer needs;
communicated clearly and consistently;
delivered to high standards; and
delivered in cost effective ways.

High quality public services need to be easy to access

8. Some groups of people, through no fault of their own, face barriers to using, and making the most of, public services. Where a person lives can have an impact on their opportunity to access public services. We want to see local discretion, which allows good managers to innovate and develop services in their own area, but we have often highlighted the development of a 'postcode lottery' that sees different levels of public service provision across the country for no good reason. For example, in 2004-05, we identified about two million people who would like to register with an NHS dentist but were unable to do so. In areas of high levels of deprivation there were relatively few dentists, and in more affluent areas many adults experienced difficulties in registering for NHS treatment.[5] In response, the Department pointed to the new local commissioning arrangements that aim to give Primary Care Trusts (PCTs) greater influence over where new dental services are established, and the application of new guidelines by the National Institute for Clinical Excellence (NICE), designed to generate capacity that can be used to improve access to NHS dental services.

9. People from ethnic minorities often do not get the most from public services. Our 2005 omnibus Report into public services for older people noted that older people from ethnic minorities had specific needs and may face additional barriers to using public services. Understanding of the need to provide services which meet linguistic, cultural and religious needs is in its infancy, and we recommended specific research and consultation to help develop services.[6] On a more positive note, our Report into adult literacy and numeracy highlighted an increasing proportion of the Skills for Life budget was devoted to English for foreign language speakers and highlighted progress in reaching those with language needs.[7]

10. The Committee has called on the Government to tackle problems experienced by disabled people. Our Report into medical assessments for determining eligibility for incapacity and disability benefits highlighted that people with mental health problems experienced greater than average difficulties in attending examinations, being assessed and getting a fair hearing, and that consequently doctors should be specially trained to recognise and deal with such customers.[8] The Department noted in reply that in 2004 all new Medical Services doctors were provided with specific training on interacting with people with mental health problems. Providing special assistance - including advice to disabled people - has helped the Department for Work and Pensions to be on course to meet its target for increasing the employment rate for disabled people. The National Audit Office reported that many participants on training and work programmes were very satisfied with their experience.[9]

11. The Committee has shown that a person's age can act as a barrier to accessing public services. Our Report on improving services for older people noted that new technology could improve the lives of older people but warned that careful planning was needed. We reported, in particular, that government websites were often not accessible to many older people, especially those with disabilities, because of a failure to apply widely recognised design standards. We recommended that innovative approaches to service delivery should be tested on older people and more should be done to encourage take-up of technology, including via UK online centres. In its response, the Government pointed to the creation of 6,000 UK on-line centres providing free or low-cost access to the internet and email, many of which are located in places convenient to older people such as libraries and Age Concern offices.

12. Access can be affected by complexity in the way services are delivered. For example, people can be deterred from claiming benefits if the process is seen as too complicated.[10] We pointed to the quadrupling in size of the Child Poverty Action Group's guide to welfare benefits since 1990-91, the requirement for Disability Living Allowance applicants to complete a long application form, and the difficulties many people have in getting through to contact centres. We also discovered that some people are unaware of where to go for advice. This highlights the importance of being proactive in approaching the hard to reach. The Comptroller and Auditor General noted that some groups were unlikely to take up services such as UK online centres. He recommended promoting awareness and use of the centres by visiting older people with laptops to demonstrate the benefits of computers along the lines of work already carried out by Age Concern.[11]

13. To deliver services successfully, public bodies need to:

Avoid a 'postcode lottery', whereby the quality of service received depends on where someone lives, by compiling information on the full extent of the problem and using resources to try to overcome it.
Investigate why some social groups feel inhibited from using particular services and tackle barriers to use through better communication and by introducing measures to encourage participation.
Identify the needs and rights of disabled people, older people and people from ethnic minorities, and develop services that take into account their particular needs and circumstances.
Be proactive in approaching hard to reach groups, for example, by linking up with voluntary bodies and others doing outreach work.

Successful public services are delivered promptly

14. Some people are made to wait a long time to use public services. This can cause inconvenience and hardship, be disruptive and, at its most serious, put people's lives at risk. The Committee has commented many times on the slow speed of delivery of many basic public services.

15. Benefits can only be delivered effectively when initial decision making is both speedy and accurate. In our Report on the quality of benefit decision making we commented on the importance of the philosophy of 'getting it right first time'. Despite this, the Disability Living Allowance error rate was nearly 50% in 2003-04. Nearly a quarter of cases then went to appeal and half were overturned at this stage in the customer's favour. This can lead to customer stress, is wasteful in terms of staff having to reconsider cases, and delays a decision even further.[12] Responding to our concerns, the Department outlined plans to establish the Effective Case Management Framework to support improved benefit accuracy by improving guidance, addressing common errors, identifying and reducing variation and providing improved support products and IT.

16. Identifying blockages in processes is crucial. In 2003, we noted improvements in the timely discharge of patients ready to leave hospital thanks in part to the introduction since 1999 in many NHS Trusts of discharge co-ordinators to help overcome internal obstacles to discharge, Despite this progress, we still highlighted seven typical problems, with poor co-ordination and planning, failure to find a care home or delays in the availability of public funding occurring frequently. We highlighted a series of ways in which blockages could be avoided or dealt with, including earlier planning and assessment of patient needs, better involvement of key groups such as hospital pharmacies and transport departments, and improved identification of where often simple blockages occur.[13]

17. Providers are better able to deliver public services quickly if the relevant administrative and management systems are suitably designed, streamlined and straightforward. In its examination of the Social Fund, the Committee highlighted the complex nature of some eligibility rules and the inability of staff to access the information they need to make assessments due to poor computer systems as factors that led to delays in making benefit payments.[14] New technology, when it works, offers the opportunity to speed up many processes but service providers may need to provide incentives. E-filing of tax self assessment forms is cheaper and more accurate, but we recommended that to encourage take-up HM Revenue and Customs pre-completed parts of the form with data it already held.[15] The Department subsequently noted it could pre-complete online tax returns with names, addresses and reference numbers, and declared its longer-term aim to include details of income and tax deducted as well.

18. Public bodies also need to consider how the structure of organisations can affect the planning and delivery of services. The public sector becomes more complex as it grows in size, as the commissioning of new projects and services leads to overlap between departments. For example, if a new agency is created to tackle childhood obesity, headed by a government-appointed 'tsar' and equipped with a small office staff, its powers and field of responsibility will overlap with those of other departments, such as the Department of Health, local education and strategic health authorities. As the agency becomes embedded within the overall government framework, its interaction with these other departments will evolve to 'iron out' overlapping provision, but there will nevertheless be a time period in which less-efficient practices occur. The more rapidly the Government decides to expand the public sector the more likely this is to occur. Political pressure to establish or expand the public provision of a service as quickly as possible will increase the likelihood of such projects being ill-defined and poorly planned, wasting public money in the process and possibly slowing down improvements.

19. Public services can be delivered quickly when providers possess the necessary capacity, in terms of facilities and staff. The Committee applauded University College London NHS Hospital Trust's acquisition of the Heart Hospital which enabled the Trust to reduce its maximum waiting times for cardiac treatment from 12 months in September 2001 to below 6 months by July 2002.[16] On the back of this progress, the Committee urged the Trust to help reduce waiting lists elsewhere, for example, by marketing the hospital to out-of-area general practitioners as a potential treatment site for their patients. The Trust held a number of open days for clinicians and managers, targeting those Primary Care Trusts and other NHS Trusts with the longest waits. This was with the aim of raising awareness of available capacity and demonstrating the Trust's competitiveness with other providers.

20. We also reported progress in reducing waiting times in accident and emergency (A&E) thanks to the Department's proactive management of NHS trust performance.[17] The percentage of patients being discharged or admitted from A&E in under four hours rose from 77% in September 2002 to 94.6% in September 2004. However, the proportion of older and vulnerable patients who spend longer than four hours in A&E remained disproportionately high. To combat this we called on the Department to make data available to all emergency care providers to enable them to benchmark their performance and monitor their processes in ensuring patients spend no more time in A&E than is clinically necessary. The Department accepted the importance of ensuring patients experience as little non-clinical delay as possible and introduced an analytical tool enabling providers to pinpoint the reasons for unnecessary delays and plan corrective action.

21. Successful public services:

Have a philosophy of 'getting it right first time' so as to reduce the delays and wasted resources caused by having to re-examine a case.
Gather complete and accurate information at the start of a contact, even if it delays initial progress.
Identify and tackle blockages to effective public service delivery.
Design streamlined and straightforward administrative and management systems.
Undertake careful forecasting of demand and use innovative ways of increasing the ability to deliver, including altering roles and purchasing additional capacity.

High quality public services respond to users reasonable needs

22. As people become used to the private sector providing goods and services tailored to their needs, so they will increasingly demand the same from their public services. However, if public service providers fail to sufficiently take into account what people want and need, this can result in unsuitable services that cause inconvenience, dissatisfaction and sometimes hardship for users.

23. Services for the public can only be effective if they are designed around the needs of the user, instead of the convenience of the provider. The Committee's Report into light rail identified poor integration with other public transport, poor provision of supporting facilities like 'park and ride', and poor route planning, with lines often not connecting shopping and business areas with where people live.[18] The failure on the part of some light rail providers to look beyond their own convenience and deliver services that fit in with the lives of their customers led to lower than expected passenger numbers and a loss of money for some operators. In its response, the Department for Transport said local authorities had sufficient powers to deliver integrated transport strategies and would not approve light rail services in the future unless they demonstrated an integrated approach.

24. As a positive example of providers attempting to deliver public services in the manner most convenient for users, we reported on the NHS Walk-in Centres designed to provide people with quick and convenient access to a range of NHS services.[19] In particular, the Report highlighted Personal Medical Service pilots which were providing dedicated health services according to the specific needs of vulnerable people, such as rough sleepers.

25. It is important that public services are delivered in a way that takes into account the particular conditions of a local area. The Report into the pilot New Deal for Communities (NDC), designed to give local communities influence over neighbourhood renewal, recognised the importance of local knowledge as a means of delivering responsive and suitable services.[20] However, the Committee's comments were mixed. In particular, the Committee called for NDC partnerships to do more to bring businesses and wealth into deprived areas, for example, by identifying skills shortages in local businesses and targeting training in the community to meet these needs, and by highlighting the barriers to businesses moving into areas and working with relevant agencies to overcome them.

26. Carrying out reliable research on user views is an important way of developing high quality services. Our Report on Energywatch and Postwatch - two organisations whose job it is to represent the views of consumers and provide them with advice and information - noted that understanding consumers lay at the core of their work, for which they drew on an analysis of complaints and queries received from consumers, along with research into their attitudes and concerns. Although this information is valuable, we noted that as not all consumers have the ability or motivation to complain, this research gave an incorrect picture of consumer views. Our Report encouraged greater attention to the views of more vulnerable consumers.[21]

27. To be successful, public bodies should:

Make sure their services are designed and delivered around the needs of users, not their own convenience.
Where possible, take account of the particular conditions in local areas when designing services.
Undertake reliable research on user needs and try to understand the characteristics of those people who are eligible but do not use the services so as to better target efforts to encourage use.

Information about public services needs to be clear and consistent

28. Ultimately public services will fall short of expectations if users and providers fail to communicate effectively with each other. Customers need to know what services are available and whether they are eligible to use them. Providers need to have simple and effective ways of explaining their requirements, gathering information to assess entitlement and allowing people to state their preferences.

29. Departments and providers must be able to communicate easily with users but, as the Committee has noted, too often basic systems are weak. For example, our predecessors highlighted the poor quality of address records made it difficult for the Department for Work and Pensions to contact its customers and advise them of changes to schemes.[22] The Department accepted the need to improve the quality of its address data where it was cost-effective to do so. Shortcomings in communications between Energywatch, Postwatch and the public were also highlighted by the Committee.[23] With recognition levels of just 2%, Energywatch and Postwatch were asked to do more to identify consumer needs and difficulties, especially those of older people and low income families.

30. The move to increased use of call centres raises new challenges. Call centres offer opportunities to deliver services more quickly and at times more convenient to people, but we have also found that some call centres find it hard to cope with demand and consequently frustrate their customers. In 2004-05, for example, the Department for Work and Pensions' centres failed to answer 21 million calls.[24] Ensuring staff provide appropriate advice is essential. Our Report on tax self-assessment reported that telephone helpline staff often lack the detailed knowledge to respond consistently and accurately to enquiries. Staff needed improved training and customers also needed access to specialist advice for more complex enquiries.[25] In response, HM Revenue and Customs pointed to the introduction of more targeted training for its call centre staff.

31. The literature organisations send to their customers needs to be easy to obtain and understand. On a number of occasions we have urged departments to improve the standard of their written communications, using simple language and well laid out text.[26] We are also keen to see innovative approaches to providing information. Our Report on Inheritance Tax recommended that the Inland Revenue, with others, develop a 'bereavement journey' website in order to provide in one place all the information and advice people need to deal with the death of a relative. We recommended the Inland Revenue makes it easier for people to obtain guidance on Inheritance Tax from its website and leaflets. In particular, more information could be provided on the acceptability or otherwise of the more common types of avoidance schemes and attention could be drawn to websites which representatives can use without the expense of professional valuations.[27] HM Revenue and Customs responded that it is increasing and improving the amount of guidance available on its website, and is looking to identify other Government websites that would assist people in arriving at accurate valuations of land and property, and promote greater awareness of Inheritance Tax rules and requirements.

32. Departments need to devise simple and straightforward ways of capturing information they need. The Committee has urged Departments to make sure their forms are quick and easy for people to fill in, calling for regular reviews of forms and the introduction of simple guidance notes.[28] Our Report on Inheritance Tax, however, found that the form remained difficult for lay representatives to complete and there was scope to improve the layout and language.[29] But we have commended others for reducing the length of their forms - for example, the Department for Work and Pensions reduced the length of the form for Attendance Allowance and Pension Credit.[30]

33. Consulting with customers is vital. Involving patients and their relatives and carers in discharge decisions is crucial for patient satisfaction as well as timely discharge.[31] However, although almost all acute trusts considered they involved patients, relatives and carers, many of these people do not see it that way. The Committee called on all NHS Trusts to ensure their practices meet reasonable expectations, with discussions including full information on options available and the provision of a discharge plan.

34. It is also important to find ways of consulting with those who do not currently use services. The Committee reported that the Veterans Agency was unlikely to reach veterans who have not kept in touch with the ex-service organisations, through which the Agency channels much of its promotional activity. We recommended that they undertake surveys of pensioners in general to clarify awareness of the Agency and determine whether some groups of veterans were under-represented and thus not heard.[32]

35. To communicate successfully with customers, public bodies should:

Maintain accurate and complete customer information.
Understand and manage the particular risks of communicating with customers via new technology or contact centres.
Review their literature on services regularly to ensure that it is easy to understand and obtain, as well as accurate and complete.
Look for innovative ways of communicating with customers and joining up disparate sources of information.
Develop ways of reaching those people who are eligible but are currently non-users.
Make sure customer and providers perceptions of whether suitable communication has taken place are the same.

Public bodies need to find ways of establishing and driving up standards

36. Public organisations need to find ways of establishing, maintaining and driving up high standards. Standards go beyond simple delivery of a service since public bodies must also be seen as fair and accountable, particularly if things go wrong. The Committee has commented on a range of measures to drive up standards and quality in public services.

37. People need to have confidence in the fairness of public services. Our Report on Tax Credits commented that the effectiveness of the Inland Revenue in assessing and collecting taxes largely depended on its reputation for accuracy, fairness and proper handling of taxpayer affairs. We concluded that the problems with the administration of Tax Credits had affected the public's perception of the Department.[33] It has also caused considerable distress; recovery of overpayments of Tax Credits does not automatically take individual circumstances into account and many people face severe difficulties in trying to repay the money.[34]

38. Incentives and targets are often introduced as mechanisms to improve the quality of public services. The original franchises awarded on the privatisation of the railways failed to put sufficient emphasis on improving station facilities. We recommended greater use be made of financial penalties to drive up standards.[35] We also suggested that the Department should consider employing a points system to rate stations, publishing the results periodically to encourage train operating companies to enhance station quality.

39. The Committee has looked at a number of ways of providing users with choice designed to improve the quality of public services. We commented favourably on the Department of Health's plans to provide patients with information on the performance of NHS trusts and waiting times, and give patients and their GPs choice over where to go for examination and treatment.[36] Additionally, the Committee called for more flexible commissioning arrangements to provide all patients with greater local choice.

40. Service providers can drive up quality and standards by 'thinking the unthinkable', innovating and adopting new approaches to delivery. The Committee has reported on some such initiatives. For example, we examined the Invest to Save Budget, designed to support projects intended to foster changes in departments' methods of working so as to promote successful innovation and deliver better public services.[37] The Committee said that ways of rewarding those at the front line of service delivery who make a real difference, whether through innovation, well managed risk taking, or good performance should be developed to encourage others to do so. And the Committee called on departments to work together more to establish a nucleus of projects tackling similar issues with most potential to benefit from innovation.

41. The Committee looked at innovations designed to improve school attendance.[38] Amongst its findings was evidence that schools in the first wave of the Behaviour Improvement Programme - which funded measures to support schools facing the greatest behaviour and attendance challenges - collectively achieved improvements in attendance at twice the rate for all schools. Examples of innovations included multi-agency teams, learning mentors, learning support units and police in schools.

42. Effective public services also need to acknowledge that sometimes things go wrong and they may need to provide redress and compensation. The Comptroller and Auditor General reported that 1.4 million cases are received through redress systems in central government each year.[39] These are systems for getting things right, remedying grievances, securing a second view or applying against a disputed decision.

43. Successful public bodies:

Use appropriate incentives and targets to drive up standards in public services.
Design ways of giving customers reasonable choice and provide appropriate information about these choices.
Recognise that poor performance in delivery can undermine confidence in the fairness of the service as a whole.
Encourage innovation and creative thinking, especially amongst front-line staff, to develop ways of improving the quality of public services.
Establish and maintain effective redress and compensation mechanisms.

How much people have to pay is an important element of their satisfaction with a service

44. People want public services to be cost-effective: getting the greatest 'bang for the buck'. Even if standards are world class, people will not be happy if services cost what they consider too much. However, as the Committee has highlighted, people may not know how much they will pay when contacting a public service, particularly, for example, via the telephone. And too often public services do not control their finances properly, leading to, amongst many other things, user dissatisfaction.

45. Users of services need to know about costs they will incur to be able to make decisions. The Committee has examined the effectiveness of the regulation of various utilities. Competition in the telecommunications market is well established and has brought a wide range of choice for consumers. Whether this is an informed choice depends on whether they can make meaningful comparisons between companies. Our 2004 Report noted that many telephone bills do not provide enough information to allow customers to determine the best tariff and discount options. We encouraged Ofcom, the regulator, to disseminate guidance on how consumers could identify the best supplier, using a series of typical bills as case studies, and recommended it undertake an education campaign to ensure that consumers knew more about the costs of renting handsets.[40] We also encouraged Ofgem to ensure that suppliers provide accurate bills to consumers rather than inaccurate estimates, which can lead to the build-up of debt.

46. Citizens expect services to be efficiently run and dislike seeing wasteful services. Some money never makes it to a programme's frontline because it is swallowed up by management costs. For example, the Committee found the running costs of the Vocational Training Scheme - which funds vocational training for people involved in forestry and farming - were 46% of the cost of the overall scheme.[41] The Rural Enterprise Scheme - which provides assistance for projects to develop more sustainable, diversified and enterprising rural economies and communities - had running costs of 31% as a proportion of scheme costs. However, the Committee anticipated that the introduction of more modern IT support would reduce scheme running costs by around 40%. Our predecessors further recommended that the Department rationalise the number of support schemes available to farm and rural businesses, simplify the application processes and streamline its administration of schemes, to reduce costs and make more funds available for frontline support.

47. The Committee stressed the importance of high productivity in public services as a means of containing costs and raising standards.[42] For example, Departments should be satisfied that expenditure on higher salary levels is genuinely needed to attract more skilled or highly qualified staff, because otherwise additional resources for service improvement can leak away into higher pay without matching productivity improvements. And departments should establish direct links between funding and the specific improvements in service quality they expect the resources to deliver. By aligning increased funding to specific objectives and targets for improved service quality more closely, departments will be in a stronger position to gauge whether resources are being used effectively.

48. To deliver cost-effective services, public bodies need to:

Take steps to reduce the cost of compliance, for example, by minimising information demands on customers.
Maximise resources directed to the frontline by minimising unnecessary bureaucracy at management level.
Reduce duplication of activities to prevent wasted effort and resources.
Establish mechanisms linking inputs with outputs to ensure productive use of resources.
And, wherever possible, they should advise customers of the costs they are likely to incur in using their services.

Annex: Organisations participating in discussions about service quality

This Report is based on a review of past Reports by the Committee of Public Accounts. In addition, the National Audit Office consulted with representatives of a number of organisations with an interest in high quality public services. The Committee is grateful to the following for their assistance.

Organisation Representative Mission/Activity

Age Concern England Andrew Harrop, Policy Manager "to promote the well-being of all older people and to help make later life a fulfilling and enjoyable experience"

Child Poverty Action Group Paul Dornan, Head of Policy & Research "the abolition of poverty among children and young people in the UK and the improvement of the lives of low-income families"

Disability Alliance Vanessa Stanislas, Chief Executive "to improve the living standards of disabled people by breaking the link between poverty and disability"

Institute for Public Policy Research James Morris, Research Fellow "we play a vital role in maintaining the momentum of progressive thought"

National Association of Citizens Advice Bureaux Dan Vale, Head of Social Policy "helps people resolve their legal, money and other problems by providing free information and advice from nearly 3,400 locations, and by influencing policymakers"

National Consumer Council Abena Dadze-Arthur, Senior Policy Officer "we help everyone get a better deal by making the consumer voice heard"

Royal National Institute of the Blind Julianne Marriott, Senior Campaigns Officer "we are the UK's leading charity offering information, support and advice to over two million people with sight problems"