---

Public Accounts

I am afraid that the answer is extremely hard to find. The Government will say that value for money has been obtained precisely because the original contract required that suppliers were not to be paid until they had delivered, but the position is not quite as simple as that. In some instances suppliers have been paid by the back door in respect of other programmes, and it is therefore difficult to see where they have made money and where they have lost it. I have little doubt that suppliers have lost a lot of money, but I would much rather see them offer the NHS something that it wants and be paid a reasonable profit in return than see patients kept waiting, hospital waiting lists in a complete mess, and hospitals unable to tell whether they have sent cancer patients messages with the results of their oncology tests. I would much rather see something that actually worked and produced value for money. Our recommendation 6 states:""Unless the position on care records system deployments improves appreciably in the very near future"," the Department of Health should allow hospital trusts to seek central funding. We think that rather than funds going to local service providers that have not delivered, trusts should be able to look to the Department for those same funds, in order to spend them on systems that they actually want and which stand a chance of delivering something. That is the way in which to achieve value for money. We have already lost a great deal that we are not going to get back. What I want to hear from the Exchequer Secretary is how she thinks we can start making some sense of this mess, and how she thinks we can start receiving sensible answers to some of the questions that a number of us have been asking for a very long time.