In one of the most strongly worded reports published by a cross-party group of MPs, the Public Accounts Committee severely criticised executives at the Wessex Regional Health Authority for spending pounds 43m on an information system that was eventually abandoned. Questions about the scheme were first raised by the Independent and Computer Weekly.
MPs said it was a 'a matter of grave concern that, by the management executive's own admission, at least pounds 20m was wasted' between 1984, when the plan started, and 1990, when it was scrapped. 'This money should have been spent on health care for sick people.'
The 210-page report presents a litany of bungling, incompetence and possible deceit. In 24 sharply phrased conclusions, the committee repeatedly voices its 'concern' and 'dismay' at the behaviour of the Wessex RHA management.
Apart from embarrassment that its much-vaunted health service reforms should have gone so spectacularly off the rails in this instance, the Government also comes in for direct criticism. It was 'unacceptable', the committee said, that 'although a series of auditors' reports were presented to the management executive and the Secretary of State between February 1987 and August 1989, detailing what had gone wrong in the implementation of the project, it was not abandoned by the Regional Health Authority until 1990'. Successive Secretaries of State for Health during that period were Norman Fowler, John Moore and Kenneth Clarke.
Even if much of the blame could be attached to John Hoare, the Wessex regional general manager, the committee said 'fundamental changes are needed in the management and accountability arrangements at regional health authorities'.
Not only did the RHA management dispute the auditors' findings, but they were able to conceal vital details from members of the authority and management executive. MPs criticised both bodies for 'allowing themselves to be kept at arm's length for three-and-a- half years over the mismanagement of this project'. This was 'a serious failure on the part of the regional health authority to secure accountability from the then regional general manager, and a failure on the part of the management executive to act with sufficient urgency'.
Some of the key criticisms centre on the role of Andersen Consulting, the firm that advised on the software at the same time as it was bidding to supply the core computer system. Andersen was awarded the consultancy at an inquorate meeting of the RHA. The firm's contract contained no quality provisions and no maximum price.
Andersen's belief that there was not a conflict of interest is dismissed. 'It is clearly wrong for somebody who is tendering for NHS business also to be advising the NHS as their consultant.'
The dangers posed by the NHS's increasing use of consultants are also vividly highlighted. At Wessex, they were not adequately controlled, and their advisory contracts were not put out to tender.
Wessex Integrated Systems, the company that won the right to operate the health authority's computer services, had a contract guaranteeing 15 per cent profits, regardless of performance, and minus any controls. Also, if the company failed, the RHA was to step in - something the MPs describe as a failure to protect the public interest.
Measures taken by the RHA did not reflect the seriousness of what occurred or prevent it from happening again. Mr Hoare should have been disciplined - 'indeed, we have to say that we regard it as unsatisfactory and surprising that none of the main parties involved in the waste of pounds 20m has suffered any significant form of disciplinary measure'.
In future, non-executive members of RHAs must be of 'sufficient calibre and experience to bring independent judgements to bear on key decisions'. What was needed was 'clearer lines of accountability and control'.
It was also important, concluded the MPs, that 'all health service staff respect the fundamental principles of public business in this country, and are judged, in their own performance, by the standards of honesty, openness and fair dealing that are expected in public life'.
The MPs said concern for those standards must play a large part in staff recruitment and training at all levels.