Q91 Mr Bacon: Sir John, is it fair to say that the National Audit Office, from the rather tentative nature of that sentence in paragraph 2.32, is a little more doubtful whether it can yet be demonstrated that it is value for money? It is plainly shiny, it is plainly a high quality environment, but on the principle of bangs for one's buck can we yet say that this is value for money?
Sir John Bourn: No, we cannot say that, as paragraph 2.32 and also recommendation 9 say when we call for a proper system for evaluating it. All you can talk about is where you have got to now; you cannot talk about how it will develop for the future, that is right.
Q92 Mr Bacon: Do you share Mr Trickett's concern and indeed Dr Kohli's that this could be extremely expensive and that there might be better value for money ways of doing the same thing or something similar?
Sir John Bourn: I certainly do, from what I have said before, because you can see that implicit in this way of doing things are extra costs. Of course the argument is that from the extra costs you will get different and better services. In that sense you are not sure how you are comparing like with like. Certainly, as we would look at this as the programme developed, we would be able to say and give a clearer view, particularly if the witnesses accept the recommendations, as they said they do, that they need to have a machinery and methodology for evaluating it.
Q93 Mr Bacon: On page 38, where there is the reference to the capital value of each project, for example in the case of East London and City £5.5 million and it refers to a population of 666,000 people, am I right in thinking that 666,000 people is all the people within that PCT, not all the people who are covered by this project? That is right, is it not?
Ms Leahy: That is right. The population in Newham PCT is about half the 666,000 population there and these schemes cover a small part of the population.
Q94 Mr Bacon: Surely the interesting number is not 666,000 but the list size covered by the project in the way that Dr Kohli has done on his extremely helpful chart,5 one of the most helpful charts I have seen on this whole project, where he comes up in a fairly simple but difficult to dispute way with a calculation of the cost per patient. He says that in the Manor Park LIFT site there are 14,400. That is your list size at your facility.
Dr Kohli: In three practices who are in the site.
Q95 Mr Bacon: Within your site?
Dr Kohli: Yes.
Q96 Mr Bacon: Surely it is the 14,430 patients compared with the £5.5 million which is relevant not the 666,000 compared with the £5.5 million, is it not?
Ms Leahy: Perhaps we should add in more information.
Q97 Mr Bacon: Is it possible that we could get for each of these the number of patients in the lists covered by those LIFT projects? So for the £10.3 million for Barnsley, the patients covered under that LIFT project, ditto for the other six and perhaps you could go a stage further and do something similar to what Dr Kohli has done there so we can compare the cost per patient at each of the sites and also the number of patients who are not covered, in Dr Kohli's case 270,000 or so.
Ms Leahy: We certainly will get that information and put it to you.6 The cost analysis that is there is very much an apples and pears comparison in that the cost of the LIFT schemes include quite a lot more than the costs just in the rent which was quoted. A pure replication of that analysis probably would not be helpful to the Committee, but I am very happy to see whether I can work out how to close the gap to try to get comparable information.
Chairman: I am grateful to the Committee and to you gentlemen for appearing before us. We are a value for money committee and I am very grateful to Mr Trickett and to Sir John for promising a supplementary report. It is clear that we are producing marvellous facilities as far as the general public is concerned and Dr Kohli has made that clear, but we also have to investigate much more fully whether we are getting value for money. Thank you very much.
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