Review of the Papers, Tuesday 19 June

Government

• The increased use of external consultants by government is costing the taxpayer nearly £2bn a year and is failing to ensure value for money, according to the public accounts committee. In a report published today, the PAC estimates that in the past three years, spending on consultants in the public sector has risen by a third from £2.1bn in 2003-04 to £2.8bn in 2005-06, with central government accounting for £1.8bn, largely to increases in the NHS. Central government has made "some progress" in implementing previous recommendations made by the National Audit Office, the report says. These include increased use of framework agreements to cut the costs of buying in consultancy as well as involving qualified procurement staff. However, the report states that "much more can be done" to improve value for money and identifies several areas where departments across government require "significant improvement". http://www.ft.com/cms/s/8f6f42bc-1e01-11dc-89f7-000b5df10621.html
• The NHS could face pressure from its big three suppliers - BT, CSC and Fujitsu - to change the £6bn contracts they have signed, following Richard Granger's departure from the helm of the world's biggest civil IT project. Four years after the original contracts were signed, the £12bn programme, to provide an electronic patient record and much else, is changing - although it is not yet entirely clear how. Strategic health authorities are being given direct responsibility for improving implementation. A tender is being completed to bring on additional software and service suppliers. And while key parts of the infrastructure are now in place, big questions remain about when new patient administration systems will go in to hospitals, along with the associated software needed to provide a shared, electronic patient record. http://www.ft.com/cms/s/5e7e23f8-1e01-11dc-89f7-000b5df10621.html
• Gordon Brown will only give the green light to Crossrail if there is a "substantial contribution" from business and the project's cost can be met within tight public spending limits. Although ministers are hopeful that a deal can be ironed out before October's comprehensive spending review - which will set departmental expenditure for the next three years - it is understood that talks over the scheme's cost and the crucial issue of where the money comes from still have some way to run. The Treasury, according to Whitehall officials, is examining in detail a business case for the trans-London rail link that has been submitted by the Department for Transport as part of its spending review bid. http://www.ft.com/cms/s/f869aac4-1e00-11dc-89f7-000b5df10621.html
• Smokers are to be asked not to smoke in their own homes to protect council staff. Health and safety officers at Liverpool city council have drawn up plans to request residents not to smoke at least half an hour before a visit by staff and to open windows and not light up during a home visit. The plans are to protect employees from exposure to second-hand smoke. The council says the rules are not a "ban" and it will not be able to force householders to comply. But if residents insist on smoking at home during a visit from a council employee the visit will be ended and they will be asked to attend a council office - which comes under the nationwide smoking ban from July 1.The rules will apply to residents in both council houses and private homes being visited by staff, including social workers, enforcement officers and planning officers. http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/06/19/nsmoke119.xml

Conservatives

• A new public health act and efforts to fight obesity will be at the heart of Conservative proposals today for reform of the National Health Service, the Financial Times understands. David Cameron, Tory leader, is expected to highlight the latest findings of his health policy working group, announced today, when he unveils what party insiders are describing as a "white paper" tomorrow. Separate public health budgets, a beefed-up department for the chief medical officer and annual reports to the Treasury on the effectiveness of public spending decisions will be proposed in a 100-page document analysing the problems at the NHS. It will call for less bureaucracy, greater autonomy for health service professionals and more accountable decision-making. It is expected to propose five tests to measure NHS performance, focusing on innovation and productivity as well as quality of care. http://www.ft.com/cms/s/3cd75c8c-1e02-11dc-89f7-000b5df10621.html

EU

• The Government was in chaos over the European constitution last night as a damaging rift opened between Tony Blair and Gordon Brown over whether a referendum may be necessary to approve plans to hand more power to Brussels. Only two days before a crucial summit that will decide whether the EU takes greater control over British policy on justice, policing and foreign affairs, open disagreement over tactics broke out at the very top of government. Last night the Tories said the rights of the British people to be governed by their own Parliament were being put at risk by "confusion" and "bad feeling" caused by the long drawn out handover of power from Mr Blair to Mr Brown. Mr Blair's problems mounted further when President Nicolas Sarkozy of France dashed hopes of a new Anglo-French accord over the constitution and instead joined Spain to demand a massive extension of EU powers. http://www.telegraph.co.uk/news/main.jhtml;jsessionid=VI0BIVCLMGJUDQFIQMFCFF4AVCBQYIV0?xml=/news/2007/06/19/neu119.xml