Category Archives: cost reduction

Central buying of IT and other services is a bit of a shambles – just what Sir Humphrey wants?

By Tony Collins

Cabinet Office entrance

Cabinet Office entrance

Like the Government Digital Service, the Crown Commercial Service was set up as a laudable attempt to cut the huge costs of running central government.

The Cabinet Office under Francis Maude set up the Crown Commercial Service [CCS] in 2014 to cut the costs of buying common products and services for Whitehall and the wider public sector including the NHS and police.

It has a mandate to buy commodity IT, other products and services and whatever can be bought in bulk. It has had some success – for example with negotiating lower prices for software licences needed across Whitehall. The skills and knowledge of its civil servants are well regarded.

But, like the Government Digital Service, CCS has had limited support from permanent secretaries and other senior officials who’d prefer to protect their autonomy.

It has also been hindered by unachievable promises of billions of pounds in savings. Even CCS’s own managers at the time regarded the Cabinet Office’s plans for huge savings as over-optimistic.

Yesterday [13 December 2016] the National Audit Office published a report that questioned whether CCS has paid its way, let alone cut public sector costs beyond what civil and public servants could have achieved without it.

CCS employed 790 full-time equivalent staff in 2015/16 and had operating costs in one year alone of £66.3m

This was the National Audit Office’s conclusion:

“CCS has not achieved value for money. The Cabinet Office underestimated the difficulty of implementing joint buying for government. With no business case or implementation plan CCS ran into difficulties. Net benefits have not been tracked so it cannot be shown that CCS has achieved more than the former Government Procurement Service would have.

“However, the strategic argument for joint buying remains strong and CCS is making significant changes to improve future services.”

Some of the NAO’s detailed findings:

  • The public sector spends £2.5bn directly with CCS – £8bn less than originally forecast.
  • Seven departments buy directly through CCS – 10 fewer than originally forecast
  • The forecast of £3.3bn net benefits from the creation of CCS over the four years to 2017-18 are  unlikely to materialise.
  • The National Audit Office says the actual net benefits of CCS to date are “unknown”.
  • The Cabinet Office did not track the overall benefits of creating CCS.
  • Most of the planned transfers of procurement staff from central departments and the wider public sector to CCS haven’t happened.
  • Where some of the workforce has transferred, some departments have rehired staff to replace those who transferred.
  • Departments continue to manage their own procurement teams, although they use CCS’s frameworks.
  • CCS was set up with the power to force central departments to use its bulk buying services. But that power wasn’t enforced.
  • The National Audit Office says it is “no longer clear whether CCS has a clear mandate that requires all departments to use it for direct buying… it no longer has a clear timetable or expectation that further departments will transfer staff or buying functions to CCS”.

It’s all a far cry from the expectations set by a Cabinet Office announcement in 2013 which said that CCS will “ensure maximum value for the taxpayer is extracted from every commercial relationship”.

The then Cabinet Office minister Francis Maude said at the time,

“The new Crown Commercial Service will ensure a step change in our commercial capability, giving government a much tighter grip on all aspects of its commercial performance, from market engagement through to contract management.”

Comment

Why CCS has failed so far to make much difference to Whitehall’s costs is not clear. It seems to have been hit by a combination of poor management at the outset, a high turnover of senior officials and ludicrously high expectations, combined with a civil service reluctance in central departments and the wider public sector to cede control over procurement to CCS –  even when it comes to common products and services.

The NAO report is a reminder of a fundamental flaw in the way government works: central departments can’t in practice be forced to do anything. They are a power unto themselves. The Cabinet Office has powers to mandate a change of practice and behaviour in central departments – to which Sir Humphrey can shrug his shoulders and change nothing

Even the Prime Minister is, in practice, powerless to force departments to do something they don’t want to do (except in the case of the miscarriage of justice that involved two Chinook pilots who were eventually cleared of gross negligence because the then defence secretary Liam Fox, through a series of manoeuvres, forced the MoD to set the finding aside).

The CCS may be doomed to failure unless the Cabinet Office rigorously enforces its mandate to make government departments use its buying services.

If the Cabinet Office does not enforce its power, Sir Humphrey will always protect his turf by arguing that the products and services his officials buy – including IT in general – are specific and are usually tailored to the department’s unique and complex needs.

Much to the relief of Sir Humphrey, Francis Maude, the battle-hardened enforcer at the Cabinet Office, has left the House of Commons. He has no comparable replacement.

Are all central initiatives aimed at making  a real dent in the costs of running Whitehall now doomed to failure?

Sir Humphrey knows the answer to that; and he’s wearing a knowing grin.

Crown Commercial Service – National Audit Office report

 

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A great speech in praise of the Public Accounts Committee

By Tony Collins

Margaret Hodge spoke incisively this week about her five years as chairman of the 160 year-old Public Accounts Committee.

It’s assumed that civil servants answer to ministers who are then accountable to Parliament when things go wrong. Hodge mentioned failed IT projects several times.

But she painted a picture of senior officialdom as a force independent and sometimes opposed to Parliament. She said some senior officials had a “fundamental lack of respect for Parliament”. She had come up against an opposition that was “akin to a freemasonry”.

She said:

“With accountability comes responsibility. I can’t think how often we ask whether those responsible for dreadfully poor implementation are held to account for their failures.

“It rarely happens. People rarely lose their job. Those responsible for monumental failures all too often show up again in another lucrative job paid for by the taxpayer…”

Some excerpts from Hodge’s “Speaker’s Lecture” are worth quoting at length …

“… I have been truly shocked by the extent of the waste we have encountered. This is not a party political point. It’s not that this Conservative- Lib-Dem Coalition is worse or better than the previous Labour Government.

“It’s not that the private sector is more efficient than the public sector.

“It’s not about questioning the dedication of hundreds of thousands of public sector workers wanting to do their best… for me personally, sitting on the left of the political spectrum, I passionately believe in the power of public spending and public services to transform and equalise life chances.

“Yet if I am to ask other people to give up their money so that we can use it to secure greater equality, then I must earn their trust that I will use that money well.

“From £700m which I believe is likely to be written off with the botched attempt to introduce a politically uncontroversial benefit change with Universal Credit, to £1.6bn extra cost incurred by the previous Government in signing the contract for the Aircraft Carriers without any money in the Defence budget and then delaying its implementation; from the failure of successive Governments to tackle the many billions lost through fraud and error or IT investment, to the inability of successive Governments to deport foreign nationals who have committed crimes and ended up in our prisons, the failures are too many, they occur too often and they occur with persistent and unbroken regularity.”

Media shuns “good news” stories

“Of course we do things well. I think of recent positive reports on the Troubled Families programme, the Prison buildings programme or the implementation of the Crossrail contract. And trying to get proper recognition of these successes is well-nigh impossible. …

“I remember being rung up by a researcher on the Today programme who wanted me to go on to speak about education for 16-18 year olds. She asked what I would be minded to say and I told her that it was a good report and I would be complimentary. ‘I thought you would be critical’ she responded. No it’s a positive report I replied. Well, she said, I’d better go away and read it, She  rang me half an hour later to tell me they had dropped the item from the programme.

“But despite acknowledging the good things that are done, I remain frustrated and angry at so much wasted expenditure and poor value for money.”

Grandstanding

“… If we do want to ensure public attention is drawn to something, it may involve the occasional bit of grandstanding. I don’t apologise for that, for I have very few tools available which I can use to get purchase and have an impact.

“If a bit of grandstanding is the only way to stop something happening again and again, we will use it – with big corporations, top civil servants and any establishment figure whom we believe has a case to answer…”

PAC versus a civil service freemasonry?

“I received a letter from the departing Cabinet Secretary which was widely circulated around Whitehall and to officials of the House accusing the Committee of treating officials unfairly and reminding me that civil servants are bound by duties of honesty and integrity and therefore should only be asked to give evidence on oath as ‘an extremely unusual step’.

“Then a researcher from the Institute of Government came to see me, armed with a report of interviews she had undertaken with senior civil servants. She was just the messenger, but her message from senior civil servants was blunt. I quote:

‘The NAO/PAC are modeled on the red guards – not a convincing grown up model of Government… the chair is an abysmal failure… the worst chair I have ever seen….. MH is informed by friends in the media… PAC profile is seen to be bashing senior officials and determined to get media soundbites.’ ‘It is under appreciated how important dull committees are.’

And then the final shot…  ‘Should the PAC be broken up?’

“Basically, the explicit threat relayed to me was that if we did not change how we held civil servants to account, we would be closed down. Shut up or we’ll shut you down.

“The story sounds like something from Yes Minister, but more seriously demonstrates a fundamental lack of respect for Parliament that I find deeply worrying.

‘How dare you MPs touch us’ was what they were saying. It felt like we were up against something akin to a freemasonry.

“Now that was January 2012 and things have moved on… but have they?

Civil servants unaccountable?

“The sad truth is that in that struggle between civil servants and politicians, the civil servants are most likely to win, because whereas we are here today and gone tomorrow, they are there for the long term.

“There remains a deep reluctance among too many senior civil servants to be accountable to Parliament and through us, to the public. The senior civil servants hide behind the traditional convention that civil servants are accountable to ministers who in turn are accountable to Parliament.

“That principle worked when it was first invented by Haldane after the First World War and the Home Secretary worked with just 28 civil servants in the Home Office. Today there are over 26,000.

“It worked when the public did not demand transparency. Today they do.

“It worked when public spending was primarily funneled through large departments running large contracts. In today’s world with a plethora of autonomous health trusts and academy schools, in a world where  private providers are providing public services in a range of fragmented contracts, delivering everything from welfare to work, healthcare and now probation services, in today’s world the old accountability framework with the minister being responsible for everything is plainly a nonsense.

“And whilst we, of course, want to maintain an impartial civil service, that is not inconsistent with the need to modernize accountability to Parliament and the public.

“There is a fundamental problem at the heart of the traditional accountability system. How can civil servants be accountable to ministers if the ministers do not have the power to hire and fire them?

“It is the accountability framework that is broke and in need of reform – not the Public Accounts Committee…

Need for reform

“The promise to reform the Civil Service has produced a few welcome changes, like a Major Projects Academy to train people to manage big projects, but the change has been too little, too piecemeal and too marginal, not fundamental.

“We just need to build different skills and do it, not talk about it.

“We may need to pay more so that working in and staying in the public sector becomes a more attractive proposition for more talented people. Trumpeting success in keeping public sector salaries down is not sensible if you end up wasting money or hiring in expensive consultants to clear up the mess or do the work for you.

“We need to transform the way people get promoted. At the moment, you’re a success if you leave your post after two years in the job and move on.

“When I was Children’s Minister, after two years I had a better institutional memory than any of the civil servants with whom I was working.

“And when the PAC reviewed the Fire Control Programme, which aimed at reducing costs by rationalising how 999 calls were dealt with, but ended up costing nearly £1/2 bn when it was written off as a failure; we found that there had been 10 different responsible officers in charge of the project over a five year period.

“I know some projects take longer than the Second World War, but continuity of responsibility is critical to securing better value.

Centre of government “not fit for purpose”

“It is also clear to me that the way the centre of Government works is not fit for purpose. We have three departments Treasury, Cabinet Office and Number 10 all competing for power, rather than working together.

“And all of them seem to be completely unable to use their power to drive better value.  Treasury carves up the money and then does little to ensure it is spent wisely.

“They only worry whether the departments keep within their totals. This is not a proper modern finance function at the heart of Government that you would see in any other complex organisation.

“So, for instance we all know that early action saves money, be it in health, education, welfare spending or the criminal justice system. Treasury knows this too, but they are doing nothing to force a change in the way money is spent.”

Lessons unlearnt

“There is little learning across Government. The mistakes in the early PFI contracts are being repeated in the energy contracts negotiated by DECC [Department of Energy and Climate Change]…

“Nobody at the centre seems to think through the impact of decisions in one area on another. So of course cuts in local authority spending, where nearly 40% of their money goes on community care services, will impact on hospitals and bed blocking.”

“Too much thinking is short-term.  PFI, to which the current Government is as wedded as past governments, is building up a huge bill for future generations; assets worth £30bn today will cost £151bn over time. And using PFI locks us into ways of delivering services which quickly become outdated – like large district hospitals when we now want to care for people outside hospitals in the community.”

Price of fish 

“None of this is rocket science. So why doesn’t change happen? Why is there such resistance? Radically transforming the culture must be at the heart of securing better value.

“If the machinery of Government is so resistant, we need to take that challenge outside party politics. Only by working together across parties and over time will we be able to secure the culture, capability and organisation that we all need to deliver on our different political priorities.

“When I first took this job I read the IPPR study which said that whilst officials dreaded their appearance before the Public Accounts Committee, they were confident that it would never ‘change the price of fish’.

“I am determined to change the price of fish.

That is why we have instituted new ways. We now have regular recall sessions, calling back people to tell us why they haven’t accepted our recommendations, or why they haven’t implemented them. We bring back people after they have moved jobs to hold them to account for what they did in post.

“That caused a minor revolution when we first did it. I wanted Helen Gosch, who had moved from DEFRA to the Home Office to come back and account for the mess she had made administering the rural payments agency, paying farmers late, paying them the wrong amounts and having to send money back to Brussels because of the errors. She refused our invitation and only caved in when I ordered her to appear.”

More protection for whistleblowers please

“We try to use our analysis of past expenditure to improve spending in the future; understanding problems with past rail investment can help improve the delivery of future projects. We take regular evidence on the big change programmes, like Universal Credit or the Probation service.

“And I take seriously the material I get from whistleblowers. My time on the PAC has strengthened my respect for whistleblowers. Without them, we would have been less effective on tax avoidance and on the performance of private companies receiving taxpayer’s money to deliver public services.

“A major regret for me is that I was unable to prevent the treatment meted out to Osita Mba by HMRC. He was the official who sent us the documents on the Goldman Sachs affair. The department used the Regulation of Investigatory Powers Act, designed to get terrorists, to get into not just his emails and phone calls, but into his wife’s phone records. In the end he couldn’t stand it any more and quit HMRC. We clearly need to do more to protect whistleblowers.”

Investigative journalism

“I am also probably one of very few MPs who has a good word to say about journalists. From  eye Eye to the Times and from the Guardian to Reuters, their fantastic investigative work (when they do it properly) has helped us uncover abuse, malpractice and waste in a way we just couldn’t have done without them.

“For despite the excellent work produced by the National Audit Office, they are constitutionally separate from and different to the Parliamentary Committee. So we need our independent sources of help.”

My goal

“Unlike our American counterparts, who have 120 staff working to their committee, 80 working for the majority party and 40 for the minority party, we have a small committee staff who focus purely on process.

“If select committees are to increase their effectiveness they need to be better resourced. It’s partly about people, although I would hate to mirror our American colleagues because their system is very much more partisan.

“But it is also absurd that when we wanted to hold an international conference on tax avoidance we were told we had no money. It is just plain wrong that when we wanted to test whether a parliamentary committee should have access to company tax files to hold HMRC properly to account, we were unable to fund legal advice to support our case that HMRC should be accountable to us.

“Both the NAO and HMRC paid for expensive legal advice to oppose us. We had no money to secure our own advice.

“Select committees should have clear statutory powers to call for all papers and people to help them hold the Executive to account. We still don’t know whether Vodafone should have paid £6bn or £2bn with an interest free staging of the payments when they settled their tax bill with the Revenue. We should know and you should too…

“Reflecting on what I have said may leave you thinking everything is wrong. I know that there are many brilliant public sector workers and many stunning public services.

“Inevitably our work focuses on the problems and the challenges. But I come at it with a determination to seek and secure improvements. Because I care about public service and because I passionately believe in the power of public services to transform people’s life chances and to create greater equality in our society. That is my goal.”

Comment

One of the striking things about the PAC is the way it leaves crude tribal party politics at the door. That’s one of the reasons it’s quietly disliked by some senior officials: they cannot condemn the committee’s partisanship. It produces 60 unanimous reports a year. But do they make any difference?

One irony is that senior officials cite the PAC as a key Parliamentary device holding them to account. They lasso and rope in the PAC for their own purpose.

The work of the PAC in holding the civil service to account is cited by lawyers for the Department for Work and Pensions in repeatedly refusing to release four old Universal Credit documents.

In reality the PAC does not make much difference to the way Whitehall departments are run. But waste would probably be much greater if it didn’t exist.

What’s not in doubt is that Hodge is a great chairman of the PAC. If anyone can change the price of fish she will.

Governup

HMRC seeks smaller IT contracts – a big risk, but worth taking?

By Tony Collins

Public Accounts Committee MPs today criticise HM Revenue and Customs for not preparing well or quickly enough for a planned switch from one main long-term IT contract to a new model of many short-duration contracts with multiple suppliers.

It’s a big and risky change in IT strategy for HMRC that could put the safe collection of the nation’s taxes at risk, say the MPs in a report “Managing and replacing the Aspire contract”.

But the Committee doesn’t much consider the benefits of switching from one large contract to smaller ones, potentially with SMEs.

Is the risk of breaking up the huge “Aspire” contract with Capgemini, and its subcontractors Fujitsu and Accenture, worth taking?

Suppliers “outmanoeuvre” HMRC

The PAC’s report makes some important points. It says that HMRC has been “outmanoeuvred by suppliers at key moments in the Aspire contract, hindering its ability to get long term value for money”.

The costs of the Aspire deal have soared, in part because of extra work. Before it merged with Customs and Excise, Inland Revenue spent about £200m a year on its IT outsourcing contract with EDS, now HP.  Customs and Excise’s contract with Fujitsu cost about £100m a year.

After the Revenue and Customs merged, and a new deal was signed with Capgemini, the money spent on IT services soared to about £800m a year – arguably out of control.

HM Revenue and Customs spent £7.9bn on the Aspire contract from July 2004 to March 2014, giving a combined profit to Capgemini and Fujitsu of £1.2bn, equal to 16% of the contract value paid to these suppliers.

HMRC considers the contract to have been expensive,  and pressure to find cost savings in the short-term led it to trade away important value for money controls, says the PAC report.

“For example, in a series of disastrous concessions, HMRC  conceded its rights to withdraw activities from Aspire, to benchmark the contract prices against the market to determine whether they were reasonable,” says the report.

“It also gave up  its right to share in any excess profits. In 2007, HMRC negotiated a three-year  extension to the Aspire contract just three years after the contract was let, extending the end of the contract from 2014 to 2017.

“The Department has still not renegotiated the terms of the contract in line with a memorandum of agreement it signed in 2012 designed to separate Capgemini’s role in service provision from its role as service integrator and introduce more competition.”

Big or small IT suppliers?

The Aspire contract between HMRC and Capgemini is the government’s largest
technology contract.  It accounts for for 84% of HMRC’s total spend on ICT.

Today’s report says that Aspire has delivered certainty and continuity over the past decade but HMRC now plans a change in IT strategy in line with the Cabinet Office’s plan to break up monopolistic contracts.

In 2010, the Cabinet Office announced that long-term contracts with one main supplier do not deliver optimal levels of innovation, value for money or pace of change.

In 2014, it announced new rules to limit the value, length and structure of ICT contracts. No contract should exceed £100m and no single supplier should provide both services and systems integration to the same area of government. Existing contracts should not be extended without a compelling case.

The Cabinet Office says that smaller contracts should allow many more companies to bid, including SMEs, and provide an increase in competition.

HMRC agrees. So it doesn’t plan to appoint a single main supplier when Aspire expires in 2017.  But PAC members are worried that the switch to smaller contracts could jeopardize the collection of taxes. Says the PAC report:

“HMRC has made little progress in defining its needs and has still not presented a business case to government. Once funding is agreed, it will have only two years to recruit the skills and procure the services it will need.

“Moreover, HMRC’s record in managing the Aspire contract and other IT contractors gives us little confidence that HMRC can successfully achieve this transition or that it can manage the proposed model effectively to maximise value for money.

“HMRC also demonstrates little appreciation of the scale of the challenge it faces or the substantial risks to tax collection if the transition fails. Failure to collect taxes efficiently would create havoc with the public finances.”

The PAC recommends that HMRC “move quickly to develop a coherent business case, setting out the commercial and operational model it intends to put in place to replace the Aspire contract. This should include a robust transition plan and budget”.

Richard Bacon, a long-standing member of the PAC, said HMRC has yet to produce a detailed business case for the change in IT strategy.

“HMRC faces an enormous challenge in moving to a new contracting model by 2017, with many short-duration contracts with multiple suppliers, and appears complacent given the scale of the transformation required.

“Moreover, HMRC’s record in managing IT contractors gives us little confidence that HMRC can successfully achieve this transition or that it can manage the proposed model effectively to maximise value for money.”

Comment

The PAC has a duty to express its concerns. HMRC needs stable and proven systems to do its main job of collecting taxes. A switch from a single, safe contract with a big supplier to multiple, smaller contracts could be destablizing.

But it needn’t be. The Department for Work and Pensions is making huge IT – and organisational – changes in bringing in Universal Credit. That is a high-risk programme. And at one time it was badly managed, according to the National Audit Office. But the gradual introduction of new systems hasn’t hit the stability of payments to existing DWP claimants.

This is, perhaps,  because the DWP is doing 4 things at once: running existing benefit systems, building something entirely new (the so-called digital service), introducing hybrid legacy/new systems to pay some new claimants Universal Credit, and is asking its staff to do some things manually to calculate UC payments. Expensive – but safe.

The DWP’s mostly vulnerable claimants should continue to be paid whatever happens with the new IT. So the risks of major change within the department are financial. The DWP has written off tens of millions of pounds on the UC programme so far, says the NAO. Many more tens of millions may yet be wasted.

But many regard the risks as worth taking to simplify the benefits system. It could work out a lot cheaper in the end.

At HMRC the potential benefits of a major change in IT strategy are enormous too. Billions more than expected has already been spent on having one main supplier tied into the long-term Aspire contract (13 years).  Isn’t it worth spending a few tens of millions extra running parallel processes and systems during the transition from Aspire to smaller multiple contracts?

It could end up costing much less in the end. And running parallel new and existing systems and processes should ensure the safe collection of taxes.

If government departments are not prepared to take risks they’ll never change – and monolithic contracts and out-of-control costs will continue. Is there anything more risky than for HMRC to stay as it is, locked into Aspire, or a similar long-term commitment?

HMRC not ready to replace £10bn Aspire contract, MPs warn – Computerworld

Taxpayers face havoc from HMRC computer changes – Telegraph

CEO and CIO resign after troubled EHR go-live

By Tony Collins

At the foot of the Blue Ridge Mountains, Georgia, in America’s deep south, about 70 miles from Atlanta, is Athens .

It was named at the turn of the 19th century to associate its university with Aristotle and Plato’s academy in Greece. It is home to the Athens Regional Medical Centre, one of the USA’s top hospitals.

There on 4 May 2014 the Centre went live with what it described as the most meaningful and largest scale information technology system in its 95-year history – a Cerner EHR implementation.

Now the Centre’s CEO James Thaw and CIO Gretchen Tegethoff have resigned. The Centre’s implementation of the electronic health record system seems to have been no more or less successful than at UK hospitals.

The main difference is that more than a dozen doctors complained in a letter to Thaw and Tegethoff.  A doctor leaked their letter to the local paper.

“Medication errors”

The letter said the timescales to install the Cerner EHR system were too “aggressive” and there was a “lack of readiness” among the intended users. They called the system cumbersome.

The letter referred to “medication errors … orders being lost or overlooked … (emergency department) and patients leaving after long waits”. An inpatient wasn’t seen by a physician for five days.

“The Cerner implementation has driven some physicians to drop their active staff privileges at ARMC [Athens Regional Medical Centre],” said the letter. “This has placed an additional burden on the hospitalists, who are already overwhelmed. Other physicians are directing their patients to St. Mary’s (an entirely separate local hospital) for outpatient studies, (emergency room) care, admissions and surgical procedures. … Efforts to rebuild the relationships with patients and physicians (needs) to begin immediately.”

The boldness of the letter has won praise in parts of the wider American health IT community.

It was signed by the centre’s most senior medical representatives: Carolann Eisenhart, president of the medical staff; Joseph T. Johnson, vice president of the medical staff; David M. Sailers, surgery department chair; and, Robert D. Sinyard, medicine department chair.

A doctor who provided the letter to the Athens Banner-Herald refused a request to openly discuss the issues with the computer system and asked to remain anonymous at the urging of his colleagues.

Swift action

One report said that at a meeting of medical staff 200 doctors were “solid in their vote of no confidence in the present hospital administration.”

Last week Thaw wrote in an email to staff: “From the moment our physician leadership expressed concern about the Cerner I.T. conversion process on May 15, we took swift action and significant progress has been made toward resolving the issues raised … Providing outstanding patient care is first and foremost in our minds at Athens Regional, and we have dedicated staff throughout the hospital to make sure the system is functioning as smoothly as possible through this transition.”

UK implications?

The problems at the Athens centre raise questions about whether problematic Cerner installations in the NHS should have consequences for CEOs.  Health IT specialists say that, done well, EHR implementations can improve the chances of a successful recovery. Done badly an EHR implementation can harm patients and contribute to death.

The most recent installations of Cerner in the NHS, at Imperial College Healthcare NHS Trust and Croydon Health Services NHS Trust, follow the pattern of other Cerner EHR go-lives in the NHS where there have been hints of problems but the trusts are refusing to publish a picture of how patients are being affected.

What has gone wrong at Athens Regional?

IT staff, replying to the Banner-Herald’s article, have given informed views on what has gone wrong. It appears that the Athens Regional laid off about a third of the IT staff in February 2014, about three months before go-live.

Past project disasters have shown that organisations often need more, not fewer, IT staff, advisers and helpers, at the time of a major go-live.

A further problem is that there appears to have been little understanding or support among doctors for the changes they would need to make in their business practices to accommodate the new system.  Had the organisation done enough to persuade doctors and nurses of the benefits to them of changing their ways of working?

If clinicians do not support the need for change, they may focus unduly on what is wrong with the new system. An organisation that is inherently secretive and resentful of constructive criticism will further alienate doctors and nurses.

Doctors who fully support an EHR implementation may find ways around problems, without complaining.

One comment on the Banner-Herald website says:

“While I have moved on from Athens Regional, I still have many friends and colleagues that are trying to work through this mess. Here is some information that has been reported to me…

“Medications, labs and diagnostic exams are not getting done in a timely manner or even missed all together. Some of this could be training issues and some system.

“Already over worked clinical staff are having to work many extra hours to get all the information in the system. This obviously takes away from patient care.

“Senior leadership tried to implement the system in half the amount of time that is usually required to do such things, with half the staff needed to do it. Why?

“Despite an environment of fear and intimidation the clinical staff involved with the project warned senior administration that the system was not ready to implement and posed a safety risk.

“I have ex-colleagues that know staff and directors that are involved with the project. They have made a valiant effort to make things right. Apparently an 80 to even a 100 hour work week has been the norm of late.

“Some questions that I have: where does the community hospital board stand with all this? Were they asking the questions that need to be asked? Why would the software company agree to do such a tight timeline? Shouldn’t they have to answer some questions as well?”

“Hopefully, this newspaper will continue to investigate what has happened here and not cave to an institution that spends a lot of money on frequent giant full page ads.

“Please remember there are still good people (staff, managers and administrators) that work at ARMC and I am sure they care about the community they serve and will make sure they provide great patient care.”

“The last three weeks have been very challenging for our physicians, nurses, and staff,” said Athens Regional Foundation Vice President Tammy Gilland. “Parts of the system are working well while others are not. The medical staff leadership has been active in relaying their concerns to the administration and the administration has taken these concerns very seriously. Maintaining the highest quality of patient care has always been the guiding principle of Athens Regional Health System.”

Keeping quiet

NHS trusts go quiet about the effect on patients of EHR implementations despite calls by Robert Francis QC and health secretary Jeremy Hunt for openness when things go wrong.

Imperial College Healthcare NHS Trust, which comprises St Mary’s Paddington, Hammersmith Hospital, Charing Cross Hospital, Queen Charlotte’s and Chelsea Hospital, and Western Eye hospital in Marylebone Road, went live with Cerner– but its managers and CEO are refusing to say what effect the system is having on patients.

An FOI request by eHealth Insider elicited the fact that Imperial College Healthcare had 55 different consultants working on the Cerner Millennium project and 45 Trust staff. The internal budget for electronic patient record deployment was £14m.

Croydon Health Services NHS Trust, which comprises Croydon University Hospital (formerly Mayday) and the Purley War Memorial Hospital, went live with Cerner last year, also under BT’s direction.

The trust has been a little more forthcoming than Imperial about the administrative disruption, unforeseen extra  costs and effects on patients, but Croydon’s officials, like Imperial College Healthcare’s spokespeople,  refuse to give any specific answers to Campaign4Change’s questions on the Cerner implementation.

Comment

It was probably unfair of doctors at Athens Regional to judge the Cerner system so soon after go-live but their fierce reaction is a reminder that doctors exist to help patients, not spend time getting to grips with common-good IT systems.

Would an NHS CEO resign after a rebellion by UK doctors over a problematic EHR implementation? It’s highly unlikely – especially if trusts can stop news leaking out of the effects on patients. In the NHS that’s easy to do.

Athens Regional CEO resigns

A tragic outcome for Cerner Millennium implementation?

Athens Regional is addressing computer problems encountered by doctors

Athens Regional is addressing computer problems after patients put at risk

CEO forced out?

 

Is this a reason some council and NHS scandals stay hidden for years?

By Tony Collins

Six years into Southwest One’s joint venture between IBM and three public authorities, the outsourced service is not a big success.  

Somerset County Council, one of the joint venture’s partners, has been in dispute with IBM, the major shareholder in Southwest One. It cost the county council £5.9m to settle, including £800,000 in costs when bringing back staff who had been outsourced.

The joint venture’s SAP-based “transformation” led to complaints of poor quality of service by some of Somerset’s finance users; the venture has consistently made losses and on the matter of savings, Somerset Cabinet member for resources, David Huxtable, said there have been some but added:

“It was a very complex contract and lots of the savings were predicated on an ever-increasing amount of money being put into public services and we know in the last four years that has gone into reverse.”

Now IBM has sold its low-margin customer care outsourcing unit which could affect the future of Southwest One.

Yet a smaller partner in Southwest One, Taunton Deane Borough Council, describes the relationship as a “success”. Reports to Taunton Deane’s councillors on Southwest One are remarkably positive.

Dave Orr an IT specialist who used to be work for Somerset County Council and has kept a close eye on Southwest One since it was formed in 2007 has drawn my attention to Taunton’s latest reports on the joint venture. When read quickly Taunton’s reports are upbeat, almost breathless with praise for the joint venture.

Below are excerpts from two reports that have been written for today’s meeting of Taunton Deane’s Corporate Scrutiny Committee.  The first is a “Procurement Transformation Update”, report to the council by Southwest One’s Chief Procurement Officer.

There are no hints of any difficulties on the contract except a comment that cutting spending will make it harder to achieve procurement savings. From Southwest One’s report to Taunton:

“Executive Summary

“As at 31/07/13, in excess of £1.8m [report’s emphasis] savings have been delivered to the Council through signed-off procurement-related initiatives brought about by Southwest One’s Strategic Procurement Service. This is up from £1.59m when last reported in January 2013.

“A further £1.364m of savings are scheduled to be delivered from these signed-off initiatives during the life of the current Southwest One contract, which expires in 2017.

“Multiple projects continue to be progressed by Southwest One Strategic Procurement Service which are expected to significantly add to the pipeline of savings. These Include initiatives for a new pool & spa at Blackbrook; Waste; Insurance; various small scale initiatives within the DLO/HPS areas .”

A second report for Taunton’s Corporate Scrutiny Committee “SouthwestOne Partnership Update report” is written jointly by a team at Taunton council and the CEO of Southwest One. Again it’s upbeat and summarises Southwest One’s performance over the last six months.

“Service delivery for TDBC, viewed in the round, is broadly on track. The majority of services perform well or extremely well (eg Customer Services). We do have concerns in some areas and we are working closely with the services in question to remedy the issues. “

The report says that the shared service model in conjunction with larger authorities provides Taunton with “much needed resilience” (report’s underlining) in service delivery, although “this has been impacted to a certain extent by changes made recently to the contract by the other partners”.

Additionally, “our secondee staff to SWO benefit from ‘assured employment’, which was offered by IBM”.

A survey of staff in June 2013 “saw marked improvements in staff morale and communication”.

Sickness absence for the financial year to the end of March 2013 was slightly down to about 9 days per full-time employee though up a little more recently.

Appendices – now for the problems

It’s only when councillors come to the report’s appendices that they will see some detail of the problems. But how many councillors will scrutinise a report’s appendices? From the Taunton report’s appendices:

“There are service and capacity issues. The helpdesk move caused significant problems, leading to an increased number of issues being raised with the Client Team from TDBC [Taunton Deane Borough Council] staff. We are closely monitoring the plan SWO [Southwest One] have put in place to fix these issues.

“Project delivery capacity and project scheduling continues to cause concern, with improved governance within TDBC highlighting this problem more acutely. Our issue tracker is currently tracking 11 escalated issues with SWOne, 6 of them with a Red RAG status.

“ SRM (Supplier Relationship Management) performance in SAP continues to be well below the required level despite the amount of focus it is receiving from SWOne. Work on a revised governance process for the SAP system is underway and looks likely to deliver a more controlled SAP Change process.”

The most serious problem – and it is not mentioned until the penultimate page of the report’s appendices – is that savings will be nowhere near the original target of £10m.

“This is red, tracked against the original [savings] £10m target. To date £2.8m has been signed-off and it is not yet clear how the lower target of £5.7m will be achieved as there are fewer savings opportunities and initiatives emanating from SWO…”

From the small print of Taunton Deane’s report it is possible to work out that the cost of the council’s SAP implementation was supposed to have been paid off by savings but hasn’t. Indeed a debt of nearly £1m is still incurring interest.

Comment

Perhaps it’s unfair to pick on Taunton Deane’s reports to councillors. The positive tone is little different to dozens, perhaps hundreds, of NHS, council and central government board reports I have read over two decades.

If you’re a director of a public authority your job is probably made harder if you’re getting self-vindicating internal reports on the organisation’s progress. It would be more helpful if management reports were neutral and objective, framed by unvarnished facts.

When you hire a roofing company and it reports back on the finished job, you want to know about the tiles that leave a gap or are loose, not the ones that fit nicely.

NHS trust reports can often be particularly one-sided, often of the type that say:

“We had 3 fatalities on the main staircase last month because of a ruptured floor lining but the overall accident rate in that part of the building is down over the last 3 years and our falls rate overall is 3% below the average for the NHS as a whole.

“Our contractor confirms that the floor lining is within KPI requirements and a repair will be effected shortly.”

It appears that those who write board reports for public authorities feel an obligation to motivate and inspire, to leave the reader feeling good, to clothe bad news in layers of good news, omit it altogether or put it in the appendix hardly anyone reads.

Is this one reason so many outsourcing and NHS scandals stay hidden for years? 

Whitehall to lose its best troubleshooter

By Tony Collins

David Pitchford, who is arguably the civil service’s most able troubleshooter, is to quit the civil service in September and return to his native Australia for undisclosed family reasons. The FT broke the story yesterday.

Pitchford is Executive Director at the understaffed Major Projects Authority. It aims to work in partnership with permanent secretaries and senior civil servants to improve the success rate of major departmental IT and other large projects. 

In practice some senior civil servants in central departments resent the intrusion of the Cabinet Office. They do not like having to present their big schemes to the Major Projects Authority, particularly as it has David Cameron’s mandate to stop or re-scope failing projects.

Fighting intransigence? 

One unanswered question about Pitchford’s quitting is: has his morale been beaten down by departmental intransigence and even ill-will? Has the system defeated Pitchford and the taxpayer – the same system that confronted other Cabinet Office reformers John Suffolk, Chris Chant and Andy Tait?

It is possible that Pitchford feels his work is done now that the Major Projects Authority has finally, and after some departmental resistance, produced its first annual report.

The report’s key feature is its “traffic light” status on the projects it is keeping an eye on. In a foreword to the report, Pitchford wrote:

“April 2013 marks two years of the Major Projects Authority… For the first time, the country’s biggest and most high-risk projects are scrutinised so problems are exposed before they spiral out of control. Over two-thirds of major projects are predicted to deliver their promises on time and on budget, more than double the historic success rate. However, the MPA has studied carefully what goes on in every department, and we have uncovered some weaknesses which we are continuing to address.

“The MPA was established following a landmark report by the National Audit Office in 2010, which recommended a wholesale shift in the administration of major projects. It works closely with individual departments’ project teams and Permanent Secretaries to monitor and improve the management of major projects…the MPA’s Government Major Projects Portfolio has improved the rate of successful project delivery from under 30% to over 70%.

“Our success has been achieved by focusing intensively on the three core elements of successful project management: improving leadership; improving the operating environment; and looking closely at the past lessons.”

Pitchford is a much-valued executive in part because he can see why projects are failing and is straight-talking. He joined the Cabinet Office in November 2009 and in 2010 told a conference what he had discovered so far about the reasons for the failure of UK government projects:

– Political pressure

– No business case

– No agreed budget

– 80% of projects launched before 1,2 & 3 have been resolved

– Sole solution approach (options not considered)

– Lack of Commercial capability – (contract / administration)

– No plan

– No timescale

– No defined benefits

Since then Pitchford has been a little more guarded now about what he says in public. Campaign4Change said in February 2013 that the longer he stays in the innately secretive civil service the more guarded he seems to become but he is still one the best assets the Cabinet Office has. His main advantage is his independence from government departments.

Francis Maude, Cabinet Office minister, said he would “much miss David’s sharp wit and impressive leadership”.

Is Pitchford’s departure a sign that the non-reformers in Whitehall departments are winning the battle against major change?

 

When Whitehall shuns statutory scrutiny

By Tony Collins

In some ways central departments are deeply accountable.

They provide volumes of statistics and reports to the centre of government (Cabinet Office and Treasury) – as far as their limited management information systems will let them – and senior officers will sometimes answer questions from MPs on Parliamentary committees. Their permanent secretaries will meet colleagues in other departments every week.

At the same time, on things that really matter, some central departments – and councils – can be infinitely unaccountable. 

A report by the National Audit Office – which it says was researched and written unusually quickly, partly in response to parliamentary concern – gives a glimpse of how unaccountable central departments (and councils) can be.

When they don’t want to provide information they simply don’t – and nothing it seems can be done to force disclosure.

Power to ignore

With explicit and written approval from David Cameron the Cabinet Office has the power to mandate change in central departments. But senior officials can, if they wish, when faced with central requests for information, ignore, reject, deliberately misunderstand, confuse or minimise answers, or delay until the request no longer need be answered.

This ability of central departments to evade democratic and even statutory scrutiny surfaces in the NAO report Confidentiality clauses and special severance payments.

The report is into the gagging of public servants when they receive payments for ending their employments early. Rightly, the media’s coverage of the report focuses on the NAO’s concerns over gagging clauses that stop officials becoming whistleblowers. The FT said on Friday (21 June 2013)

“More than a thousand civil servants have signed gagging clauses that could stop them speaking out about problems, a system the [NAO] condemned as “unacceptable”.

What the national media apparently did not notice was that the NAO was unable to obtain all the information it had requested of departments.

“Despite the NAO’s statutory access rights, it received only 60 per cent of the compromise agreements requested from departments,” says the NAO.

The NAO has statutory rights of access to information held by departments. Indeed its Comptroller and Auditor General Amyas Morse certifies the accounts of all government departments and many other public sector bodies. The NAO says he has “statutory authority to examine and report to Parliament on whether departments and the bodies they fund have used their resources efficiently, effectively, and with economy”.

Avoiding NAO scrutiny

But some departments have not complied with the NAO’s requests, and one, the Department of Culture, Media & Sport, formally requested not to be involved in the NAO’s investigation.

Says the NAO report

“Unfortunately, some departments did not respond promptly to our requests, and were delayed by their legal teams’ questioning of our access rights.

The NAO adds

“The Department for Culture, Media & Sport requested not to be involved in this piece of work, a position which could not be resolved until after our fieldwork window had closed.

“We found it challenging to gain a complete picture of the use of confidentiality clauses as, by their nature, they are not openly discussed. Our work was also hampered by incomplete records, and access to data as outlined above.

“It took several attempts to identify the appropriate individuals within departments responsible for compromise agreements and the associated payments. We experienced delays in receiving data, and what departments provided was frequently incomplete or in a format that was difficult to collate and analyse.”

So what can the NAO do now it has been snubbed or, to put it in Whitehall-speak, has encountered departmental non-compliance with statutory access requests?

Little or nothing. The NAO has no power to punish. Through MPs on the Public Accounts Committee it can admonish. That is all.

Says the NAO:

“Given the innovative nature of this work, some initial difficulties were anticipated. We will continue to work with departments, the Treasury and Cabinet Office to explore ways in which we can obtain the evidence on a timelier basis. It is important that departments are able to respond more quickly to these investigations in the future.”

Councils too can evade democratic accountability. The NAO has no access rights to local authorities but councils are, in theory, subject to the Freedom of Information Act. In practice they can all but ignore the FOI legislation if they wish.

In March 2010, the Audit Commission published a report on severance payments to council chief executives. The study found that:

• agreed severance packages for 37 council chief executives totalled £9.5 million, 40 per cent of which were in pension benefits;

• three in every ten outgoing council chief executives received a pay-off;

• the average cost to councils of each severance package was almost double the annual basic salary, but in four cases was more than triple; and

• 79 per cent of mutually-agreed severance payments had a confidentiality clause.

But the NAO found that, in a recent survey of councils by a member of the public under the FoI Act, 52 councils refused to disclose information on their use of compromise agreements.

The good news

The NAO says: “Some organisations have chosen to be transparent about severance packages, such as NHS National Services Scotland, who agreed to the disclosure of a director’s remuneration package, despite a confidentiality agreement being in place, following consultation with legal advisers.”

Comment:

How is Francis Maude to reform central government, particularly IT, if officials in central departments can apparently do what they wish?

The NAO found cases of payments that were higher than contractual entitlement, where there was the apparent reward for failure, and no attempt to seek Treasury’s approval.  Is all this lawful? 

On top of this there are departmental officials who avoided the NAO’s statutory requests for information.

If they can circumvent the law they can probably resist any central demands for change. Resistance seems to be regarded within departments as honourable.

One irony is that bureaucrats in Russia probably have little choice but to respond to central demands – whereas officials in Whitehall departments don’t have to.

Radical reform to change Whitehall’s outdated and costly ways is unlikely to happen while senior officers in departments run the system and have the final say.

NAO report “Confidentiality clauses and special severance payments

Francis Maude boasts of £10bn savings but …

By Tony Collins 

This morning Cabinet Office minister Francis Maude held a press conference with his senior officials to announce that civil servants have radically changed the way they work to save £10bn in 2012/13.

The savings are nearly £2bn higher than originally planned and, according to the Cabinet Office, have been “reviewed and verified” by independent auditors.

With a little journalistic licence Maude says: “…we are on the way to managing our finances like the best-run FTSE100 businesses.”

The breakdown of the £10bn savings:

Procurement   £3.8bn
Centralisation of procurement for common goods and services  £1.0bn
Centrally renegotiating large government contracts  £0.8bn
Limiting expenditure on marketing and advertising, consultants and temporary agency staff   £1.9bn
Transformation savings   £1.1bn
IT spend controls and moving government services and transactions onto digital platforms  £0.5bn
Optimising the government’s property portfolio  £0.6bn
Project savings   £1.7bn
Reviewing performance of major government projects  £1.2bn
Taking waste out of the construction process  £0.4bn
Workforce savings   £3.4bn
Reducing the size of the Civil Service   £2.2bn
Increasing contributions to public sector pensions   £1.1bn

Comment

It’s good news and the figures don’t seem plucked out of thin air which sometimes happens when central government announces savings.

The big question is whether the savings are sustainable. Maude has inspired the Cabinet Office’s Efficiency and Reform Group to be motivated and hard-working. But bringing about long-term change in Whitehall – as opposed to restricting consultancy contracts and cutting annual costs of supplier contracts by reducing what’s delivered – is like peddling uphill. How long can you do it without losing motivation and energy? It’s not just parts of the civil service that are resistant to the savings agenda – it is also some IT suppliers, according to Government Computing.

It’s likely that only profound changes in central government operations and working practices will outlast the next general election. At the moment the civil service is like a rubber band that has been stretched a little. It wants to return to its standard shape, which the next government may allow it to do.

The National Audit Office said in its report in April 2012 on the Efficiency and Reform Group in 2011/12:

“Savings to date have differing degrees of sustainability.”

The NAO also said this:

“It is not fully clear how ERG intends to make the reforms necessary to secure enough savings over the rest of the spending review. ERG has yet to translate its ambition for saving £20 billion by 2014-15 into more detailed plans.

“ERG has made progress in developing strategies across its wide range of responsibilities, and is focusing on core activities likely to produce savings. However, until recently ERG’s focus has mainly been on the savings themselves, with less emphasis on delivery of the longer-term changes and improvement in efficiency necessary to make them sustainable.”

And this:

“Departments have still tended to lack a clear strategic vision of what they are to do, what they are not, and the most cost-effective way of delivering it. Much of departments’ 2014-15 savings are likely to come from further reductions in staff. Sustainability of these savings will depend on developing skills and working in new ways while maintaining staff motivation and engagement.”

But the NAO was generally positive about the ERG’s contribution to savings.

“ERG’s actions to date, particularly its spending controls, have helped departments deliver substantial spending reductions.”

We hope the Cabinet Office’s diligent efforts continue  – sustainably.

Efficiency and Reform 2012/13 savings. Summary report.

Some suppliers still resistant to change? – Government Computing.

Could HMRC have a major IT success on its hands?

By Tony Collins

It’s much too soon to say that Real-Time Information is a success – but it’s not looking  like another central government IT disaster.

A gradual implementation with months of piloting, and HMRC’s listening to comments from payroll professionals, software companies and employers, seems to have made a difference.

The Cabinet Office’s high-priority attempts to avoid IT disasters, through the Major Projects Authority, seems also to have helped, by making HMRC a little more humble, collegiate and community-minded than in past IT roll-outs. HMRC is also acutely sensitive to the ramifications of an RTI roll-out failure on the reputation of Universal Credit which starts officially in October.

On the GOV.UK website HMRC says that since RTI started on 6 April 2013 about 70,000 PAYE [pay-as-you-earn] returns have been filed by employers or their agents including software and payroll companies.

About 70,000 is a small number so far. HMRC says there are about 1.6 million PAYE schemes, every one of which will include PAYE returns for one or more employees. About 30 million people are on PAYE. Nearly all employers are expected to be on RTI by October 2013.

The good news

 Ruth Owen, HMRC’s Director General Personal Tax, says:

“RTI is the biggest change to PAYE in 70 years and it is great news that so many employers have started to report PAYE in real time. But we are under no illusions – we know that it will take time before every employer in the country is using RTI.

“We appreciate that some employers might be daunted by the change but …we are taking a pragmatic approach which includes no in-year late filing penalties for the first year.”

It hasn’t been a big-bang launch. HMRC has been piloting RTI for a year with thousands of employers. Under RTI, employers and their agents give HMRC real-time PAYE information every time the employee is paid, instead of yearly.

When bedded down the system is expected to cut administrative costs for businesses and make tax codes more accurate, though the transitional RTI costs for some businesses, including training, may be high and payroll firms have had extra costs for changes to their software.

RTI means that employers don’t have to complete annual PAYE returns or send in forms when new employees join or leave.

The bad news

The RTI systems were due to cost £108m but HMRC’s Ruth Owen told the Treasury sub-committee that costs have risen by tens of millions:

“… I can see that it [RTI] is going to cost £138m compared with £108m. I believe that is going to go up again in the scale of tens of millions.”

She said that in October 2012.

Success?

The Daily Telegraph suggested on Monday that RTI may be “ready to implode”.

But problems with RTI so far seem to be mainly procedural and rule-based – or are related to long waits getting queries answered via the helpline – rather than any major faults with the RTI systems.

In general members of the Chartered Institute of Payroll Professionals report successes with their RTI submissions, and some comment on response times being good after initial delays at around the launch date.

Payroll software supplier Sage says the filing of submissions has been successful. There was a shaky start, however, with HMRC’s RTI portal being under maintenance over the weekend.

Jonathan Cowan from the Sage Payroll Team said: “There was understandable confusion and frustration over the weekend with businesses unable to file due to HMRC site issues.”

Accountingweb’s readers have had many problems – it said RTI “stumbled into action –  but few of the difficulties are, it seems, serious. “Have I missed something, but RTI despite all the commotion doesn’t seem that bad,” says an accountant in a blog post on the site.

Payrollworld says RTI problems have been minor. “The launch of Real Time Information (RTI) has encountered a number of minor issues, though payroll suppliers broadly report initial filing success.”

Comment

It’s not everyday we report on a big government IT project that shows signs of succeeding. It’s too early to call RTI a success but it’s difficult to see how anything can go seriously wrong now unless HMRC’s helplines give way under heavy demand.

It’s worth remembering that RTI is aimed at PAYE professionals – not the general public as with Universal Credit. Payroll specialists are used to solving complex problems. That said, RTI’s success is critical to the success of Universal Credit. A barrier to that success has, for now, been overcome.

Perhaps HMRC’s RTI success so far shows what a central department can achieve when it listens and acts on concerns instead of having a mere consultation; and it has done what it could to avoid failure. They’re obvious precepts for the private sector – but have not always in the past been characteristics of central government IT schemes such as the NPfIT.

Francis Maude –“unacceptable” civil service practices

By Tony Collins

Francis Maude laments civil service inaction over a cabinet committee mandate for centralising procurement. It “corrodes trust in the system”.

Gus O’Donnell, the former head of the civil service,  confronted Francis Maude, the Cabinet Office minister in charge of civil service reform, on BBC R4’s In Defence of Bureaucracy last week.

The irreconcilable differences between O’Donnell and Maude were obvious and may be a sign of how difficult it will be for the minister to make lasting and deep cuts in IT-based spending, simplify overly complex processes, and reduce duplication.

O’Donnell spoke of the virtues of the civil service that have served the country for more than a century, particularly its impartiality.  But Maude said the “value of impartiality can sometimes turn into indifference”.

O’Donnell said: “We need to be proud and passionate about the public sector ethos…” and confronted Maude for saying things about the civil service “that are not always totally positive”.

Indeed Maude said,

“Most of the civil servants I deal with are terrific, work hard and do really good work.  It is not universal.”

O’Donnell then confronted Maude for saying that ministers in this and previous government have too often found that decisions they have made don’t get implemented. Is that the fault of ministers or civil servants, asked O’Donnell.

“I’d be astonished if it’s ministers,” said Maude who added,

“ I had a meeting the other day around this table …  where a decision was made by a cabinet committee, more than a year ago, on the centralising of procurement. It had happened to a very minimal extent.

“If there is a problem with it, that can be flagged up and tell us. Just to go away and not do it is unacceptable … it is protection of the system. This is the speaking truth unto power thing. What is unacceptable is not to challenge a ministerial position but then not to implement it. That is what corrodes trust in the system.”

About £230bn a year – nearly a third of everything government spends – is on public sector procurement.  In 2010, Nigel Smith, then CEO of the Office of Government Commerce, spoke to the “Smartgov” conference about the need for major reform in the way government buys things.

He spoke of the need for re-useable software, open source if possible, and said that suppliers regularly use fragmentation within government to maximise profits. “This has got to change,” says Smith.

He said there were 44,000 buying organisations in the public sector which buy “roughly the same things, or similar things, in basic commodity categories” such as IT and office supplies.

Massive duplication

He spoke of “massive duplication”, high tendering costs on suppliers, and a loss of value due to a lack of true aggregation. He said suppliers had little forward look of opportunities to tender and offer innovative solutions for required outcomes.

“Contract management with supplier relationship management is inconsistent, with too little attention paid to continuous improvement and benefits capture within contract.

“The opportunity to improve outcomes and efficiency gains should not be constrained by contract terms and innovations should not stop at the point of contract signature.

“If we miss this opportunity [to reform] we need shooting.”

So it is clear procurement [and much else] needs reforming. But in the R4 broadcast last week (which unfortunately is no longer available) O’Donnell portrays a civil service that is almost as good as it gets.

He speaks of its permanence in contrast to transient ministers. His broadcast attacks the US system of government in which public service leaders change every time there is a new government.  The suggestion is that the US system is like a ship that veers crazily from side to side, as one set of idealogues take the captain’s wheel from another. O’Donnell implies that in the UK civil service stability lasts for decades, even centuries.

The virtues he most admires in the UK civil service are what he calls the 4 “Ps” – Pace, Passion, Professionalism and Pride.  His broadcast speaks of the UK civil service as a responsible, effective, continual and reliable form of administration.  

Comment

O’Donnell’s most striking criticism of Maude’s intended reforms of central government goes to the heart of what Maude is trying to do: change what is happening in departments.

When, in the broadcast, Maude suggested that civil servants were not challenging ministerial decisions and were not implementing them either, O’Donnell replied that Maude was “overstating the issue”. But O’Donnell went much further and added a comment that implied Maude should leave departments alone.

O’Donnell said

“These sorts of problems mainly arise when ministers at the centre of government want to impose their will on secretaries of state who want to be left alone to run their departments as they see fit.”

Is O’Donnell giving permanent secretaries and departmental ministers his support if they continue to snub Cabinet Office reforms?

It is hardly surprising Maude is a bundle of frustrations. Central government administration cannot be reformed if departments have the autonomy to refuse to implement decisions of a cabinet committee.

It is ironic that cabinet committee decisions are binding on the entire Cabinet – but not, it seems, on departments.

Perhaps the gap between political and civil service leaders at the centre, and senior civil servants in departments, is as irreconcilable as ever. Today’s UK civil service is more than ever “Yes Minister” without the jokes.  Should this be the dysfunctional basis for coalition reforms of central government?

Perhaps this explains why Maude is trying to implement open standards, make government procurement friendly to SMEs and encourage the use of G-Cloud while the Department for Work and Pensions and the Foreign and Commonwealth Office are  agreeing new mega-contracts,  with the same handful of monolithic suppliers.

Sir Jeremy Heywood, the current Cabinet Secretary,  is perhaps a little more Maude-friendly than O’Donnell when he says in the R4 broadcast,

“There are lots of things we need to do better. Too many projects that we undertake are delayed, are over budget and don’t deliver on all the benefits that were promised. We are not as digital as the most effective private sector organisations are. We have been slow to embrace the digital revolution.”

Fine words. But if a cabinet committee’s decision on centralising procurement has little effect, how is Sir Jeremy going to convert his words into action? Or Francis Maude’s?