Strapped for cash? Poppycock! As the NHS wails that it's broke, the woman who fought to account for every penny of public spending says it's 注ぐing millions 負かす／撃墜する the drain?

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As I know all too 井戸／弁護士席, there’s a 普及した obsession with waste in public services. People hate it ― but they don’t know the half of it. During my five years as chairman of the Public Accounts 委員会, we 設立する waste and shocking profligacy everywhere.

It was there in the NHS, in the Home Office, in the Departments for Energy, for Defence, for Work and 年金s, for 商売／仕事 ― and many more. We even 設立する appalling misuse of public money at the BBC.

Let me be （疑いを）晴らす, this 失敗 to 達成する better value for money is not a party-political 問題／発行する. Both 労働 and the 保守的なs have an 平等に dismal 記録，記録的な／記録する on waste. Nor does the public 部門 behave any better than the 私的な 部門. Both waste far too much of our hard-earned money.

During her time as?chairman of Public Accounts 委員会, 労働 politi cian Margaret Hodge 暴露するd?大規模な waste in NHS and 省 of Defence spending

All too often, the same mistakes were repeated. This is partly because politics tends to concentrate on ideas for the 未来 rather than how they’re 存在 器具／実施するd in the 現在の.

Every 大臣 in every 政府 手配中の，お尋ね者 to leave his or her 示す by introducing a new 率先. Once, I counted 18 new 率先s to 取り組む 都市の regeneration taken in as many years by 連続する 大臣s. But no 率先 was 許すd time in which to work.

平等に, few 政府 大臣s seemed to care about the cost to 未来 世代s of 核の waste (£77.5 billion last year alone) or student 貸付金s (an 概算の £600 billion in money 借りがあるd by 2035) or 医療の 怠慢，過失 (a ４半期/4分の1 of the entire NHS 予算 last year, and rising 急速な／放蕩な). After all, they’d no longer be there. The 手足を不自由にする／（物事を）損なうing 法案s would be someone else’s problem.

And the civil service? Shockingly, we 設立する that many 上級の 公式の／役人s were 感染させるd with a 類似の short-termist approach. They felt no sense of personal 責任／義務 for public 事業／計画（する）s because it wasn’t their own money.

いつかs they couldn’t even distinguish between their public 責任／義務 and their own 私的な and personal 利益／興味. Or they 簡単に 転換d the 非難する to another person or 会・原則.

TACKLING THE NHS

圧力（をかける）d for 基金s, the NHS has never had to be so careful about how it spends its money. Or so you’d think.

In 2011, the Public Accounts 委員会 decided to take a の近くに look at the 購入（する） of 医療の 供給（する）s by 61 different NHS 信用s, at a cost of £4.6 billion. To our amazement, we soon discovered a number of absurdities.

Between them, the 信用s had bought 652 different types of surgical gloves and 1,751 types of cannula, at 広範囲にわたって 変化させるing prices. One hospital alone had bought 177 different types of gloves, while another managed with just 13.

Margaret Hodge （人命などを）奪う，主張するs that 達成するing ありふれた sense practice when 取引，協定ing with the NHS's spending is probably more difficult than climbing 開始する エベレスト (とじ込み／提出する photo)

Even when it （機の）カム to A4 paper, the 信用s had managed to buy 21 varieties ― again at 異なるing prices.

When we questioned David Nicholson, then 大統領 of the NHS, about the gloves, he tried to argue that choosing a particular type or make was very important for 外科医s. ‘When you stick a knife in somebody and you are in that intimate 関係 with an individual on a （米）棚上げする／（英）提議する, or whatever, you want everything to be 権利 for yourself,’ he told us.

Somehow, I don’t think many people would empathise with that approach. After all, buying low-cost and efficient surgical gloves should be no more difficult than buying low-cost and efficient rubber gloves for the washing-up.

Why wasn’t someone telling the 信用s to get their 行為／法令／行動する together? 井戸／弁護士席, NHS 信用s are 独立した・無所属 団体／死体s, so the 政府 is 気が進まない to 介入する, even when it’s plainly ありふれた sense to take advantage of the 政府’s 本体，大部分／ばら積みの-buying 力／強力にするs.

Just imagine how much cheaper it would be if, say, there was just the one type of 基準 white shirt worn by anyone who worked in the 救急車 service, 同様に as in the police, 刑務所，拘置所 and 解雇する／砲火／射撃 services. Yet 達成するing this ありふれた sense practice is probably more difficult than climbing エベレスト.

When David Nicholson, ex NHS 長，指導者, was questioned about a hospital buying 177 types of gloves, he argueed that choosing a particular type was very important for 外科医s

The NHS at least recognised that it should try to get better at 本体，大部分／ばら積みの-buying, so it 設立するd a plethora of organisations ― all of which cost money ― to encourage 信用s to collabor ate. There were 地域の collaborative 調達 中心s; 信用s with informal collaborative 手はず／準備; a 国家の 調達 会議 for the NHS; and a ‘国家の 供給（する） organisation’ that was outsourced to DHL.

Did that solve the problems? Not really. One 調査する of more than 4,000 individual 製品s bought through the ‘国家の 供給（する） organisation’ 設立する that more than half the items were more expensive when 購入（する）d 国家的に.

The upshot was that many 信用s went 支援する to making their own 決定／判定勝ち（する）s about what to buy, with some continuing to spend vastly more than others. Indeed, if we did another 一致する in 18 months’ time, I 疑問 much would have changed.

VANISHING GPs

Here’s how a 政府 契約 can go 不正に wrong. In the 事例／患者 of the 私的な 請負業者 Serco, it may even have put lives at 危険 ― and it certainly 原因（となる）d much 苦しめる. It happened in Cornwall, where a 地元の GP co-operative had been running the out-of-hours GP service for £7.5 million a year. Then, in 2011, they lost out when Serco 企て，努力，提案 just over £6 million to take over.

Serco 証明するd good at winning the 契約s but not so good at running the services.

It didn’t take long for its staff to question the company’s 人物／姿／数字s: on how quickly the phone was answered, how 急速な／放蕩な they got a doctor out to see a sick 患者 and how often they called out the 救急車 service.

私的な 会社／堅い Serco won a 契約 to run an out-of-hours GP service in Cornwall - but such was its poor service that 14 per cent of 患者s abandoned calls after unsuccessfully trying to a reach a doctor (とじ込み／提出する photo)

However, no one paid much attention to the whistleblowers at first. Their （民事の）告訴s to both the company and to the health 当局 went unheard. Stories in the 地元の paper were 小衝突d aside.

Serco had a convenient answer, anyway: it 非難するd two 無所属の政治家 従業員s, 解雇（する）d them, and made them 調印する confidentiality 協定s to stop them telling their 味方する of the story.

We finally gave the 問題／発行する a public 審理，公聴会 in April 2013 ― two years after Serco had taken over. And it was soon plain that with いっそう少なく money in the 契約, Serco had 雇うd より小数の people ― so there weren’t enough GPs and most 転換s weren’t fully staffed. 類似して, there weren’t enough staff to 扱う phone calls.

In the summer of 2012, when many holidaymakers were visiting Cornwall, Serco’s 業績／成果 was 特に poor. Calls should have been answered within 90 seconds, but one in four took longer ― and a その上の 14 per cent of those who tried to reach a doctor abandoned their calls. 欠如（する） of staffing also led to more 患者s 存在 referred to the 救急車 service.

欠如（する） of staffing at the Serco 外科 also led to more 患者s 存在 referred to the 救急車 service (とじ込み／提出する photo)

As before, Serco 非難するd all the cheating on individuals. We 設立する that hard to understand, 特に because one of the most shocking 面s of this story was their 試みる／企てる to clamp 負かす／撃墜する on whistle-blowers. Not only was Serco trawling through its 従業員s’ emails to try to identify the whistle-blowers, but it was ライフル銃／探して盗むing through their personal lockers.

Looking more closely at Serco’s 契約, we 設立する that the NHS ‘業績／成果 対策’ 現実に en couraged poor behaviour ― whether it was falsifying data or manipulating computer programmes. Indeed, the 契約 was so 貧しく written that, にもかかわらず all the 証拠 of what was going wrong, Serco could still （人命などを）奪う，主張する 特別手当 支払い（額）s. It couldn’t go on.

逆の publicity started 損失ing their 評判 and they were 軍隊d to 新採用する more staff ― and therefore lost money on the Cornish 契約. They 保釈（金）d out of it in 2013 ― leaving the NHS 信用s to take over their work.

COMPUTER FIASCO

During the course of our work, we （機の）カム across plenty of examples of 政府 IT 災害s. In fact, if any 公式の／役人 について言及するd a new IT 事業／計画（する） to the 委員会, we’d laugh at the very idea that it might be introduced on time, within 予算 and save money.

One of the worst fiascos was the 国家の programme to computerise the NHS, 開始する，打ち上げるd by Tony Blair in 2002. Blair had been 納得させるd during a 会合 with [the Microsoft 大君] 法案 Gates that this 広大な／多数の／重要な 改革（する） would bring about a 国家の system for 調書をとる／予約するing 任命s, a 国家の prescription service and a 国家の health 記録，記録的な／記録するs service.

One of the worst fiascos was the 国家の programme to computerise the NHS, 開始する，打ち上げるd by Tony Blair in 2002

In 2011, we 診察するd just part of the programme: the health 記録，記録的な／記録するs system. The 目的（とする） was to have everybody’s 医療の 記録，記録的な／記録するs held electronically on one big system, so that all NHS doctors and nurses had instant 接近 to them.

The sums 伴う／関わるd in developing this 国家の IT system were mind-boggling. Costs had already risen from an 初期の £2.3 billion in 2002 to an 概算の £11.4 billion in 2011. The 記録，記録的な／記録するs system alone was 概算の to cost £7 billion.

At the time of our 審理，公聴会, the Department of Health and the NHS had already spent some £6.4 billion on the 事業／計画（する） as a whole.

Just think what that money could buy ーに関して／ーの点でs of 前線-line doctors, nurses and much-needed 麻薬s.

But Tony Blair was mad keen on the 事業／計画（する） ― so much so that he 押し進めるd 公式の／役人s to have it 配達するd in time for the 2005 General 選挙.

This meant that political imperatives, macho-style 概念s and 選挙（人）の cycles overrode sensible planning, 主要な to untold waste on a 事業／計画（する） that 公式の／役人s 認める was beyond their capacity to 配達する.

There were other major problems. The 政府 failed to 協議する NHS professionals about how the system should work, and ignored conce rns about 患者 confidentiality. For instance, would an HIV/援助（する）s 患者 really want their 記録，記録的な／記録するs to be so readily 利用できる?

So the Department of Health was trying to do something 完全に new and untested, doing it あわてて, and without any say-so from the 使用者s. It was, of course, a recipe for 災害.

In the end, the Department of Health decided to abandon the 事業／計画（する） ― but 設立する it couldn’t extricate itself from all its 契約s. By the time we started our 調査 in 2011, two out of the 初めの four 請負業者s, BT and CSC, were still hanging on.

The sums 伴う／関わるd in developing the NHS's 国家の IT system were mind-boggling, with a 記録，記録的な／記録するs system alone?概算の to cost £7 billion

Their 契約s were so 貧しく written that 公式の／役人s told us it would cost more to 終結させる them than to continue spending what was of course taxpayers’ money. Both companies had massivel y driven up the price, and 延期するd putting in the 国家の system because of problems in its design. 主として, they spent their time 供給するing 暫定的な IT 解答s for health services that could no longer afford to wait.

In the 事例／患者 of BT, it started selling IT systems to community and mental health 信用s in the South at an 普通の／平均（する） of £9 million each. Yet, bizarrely, Bradford 地区 Care 信用 had bought the same system and the same services from another 供給者, CSE Healthcare Systems, for £1.3 million. As soon as we learned this, we called for the programme to be 停止（させる）d.

The 政府 gleefully 強いるd ― 宣言するing that it was axing 労働’s profligate and wasteful 計画／陰謀. In reality, however, they are still locked into the 貧しく-drawn 契約s with BT and CSC. Then, すぐに after this 告示, the new 国務長官 for Health, Jeremy 追跡（する）, 約束d that the NHS would be paperless by 2018 ― and the 財務省 gave the NHS yet another £1 billion for new 科学（工学）技術 to support and produce 統合するd care 記録，記録的な／記録するs.

So the 政府 has 始める，決める off on the same 疲れた／うんざりした 旅行 yet again ― and costs will no 疑問 keep 開始するing.

• EXTRACTED from Called To Account: How 法人組織の／企業の Bad Behaviour and 政府 Waste 連合させる To Cost Us Millions by Margaret Hodge, published by Little Brown on September 15 at £18.99. ? Margaret Hodge 2016. To order a copy for £15.19 (p&p 解放する／自由な, 申し込む／申し出 valid to September 23) visit mailbookshop.co.uk or call 0844 571 0640. Margaret Hodge will be speaking at the Henley Literary Festival on October 1, henleyliteraryfesival.co.uk

?£6billion fiasco of the 軍艦s we STILL can't use

Want to know how we could save billions of 続けざまに猛撃するs? Simple. The 政府 just needs to stop the unbelievably awful level of waste at the 省 of Defence.

Every year, the Public Accounts 委員会 looked in 詳細（に述べる） at orders for new 計画（する）s, ships and 潜水艦s, 同様に as for new 器具／備品 for the 武装した 軍隊s. Every year, we were shocked.

I 解任する one memorable 審理，公聴会 when we 暴露するd some £8 billion of wasted 支出 in the space of just two hours. And this 注目する，もくろむ-watering sum had been spent on 器具／備品 and support that 供給するd 絶対 no 利益 for the 武装した services.

One story of unconscionable waste 関心d the 契約 to build two 航空機 運送／保菌者s to 取って代わる three 存在するing Invincible 運送／保菌者s (pictured) - at an 概算の cost of £2.8billion

事業／計画（する）s had been abandoned; 審議する／熟考する 延期するs had 追加するd unnecessary costs, and changing specifications halfway through a 契約 had piled on その上の millions.

It was as if the MoD had torn up £8 billion-価値（がある） of bank- 公式文書，認めるs and 投げ上げる／ボディチェックするd them into the 空気／公表する like confetti.

Indeed, our 正規の／正選手 reviews 明らかにする／漏らすd a 深い-seated spend-thrift culture going 支援する for 世代s, that all too often resulted in money 存在 squandered.

In the past, I’d never taken any 利益／興味 in defence 器具／備品: I thought of it as ‘toys for the boys’. But once I became aware of the 広大な sums 伴う／関わるd, I realised that in the 利益／興味s of taxpayers I needed to get my 長，率いる 一連の会議、交渉／完成する these コンビナート／複合体, technical 事業／計画（する）s. And I learned a lot.

One story of unconscionable waste 関心d the 契約 to build two 航空機 運送／保菌者s to 取って代わる three 存在するing Invincible 運送／保菌者s. The 決定／判定勝ち（する） to do this was taken in 1998, and the cost was 概算の at around £2.8 billion.

By July 2007, however, no 契約 had yet been 調印するd and the defence 予算 was wildly overspent. But Gordon Brown was nonetheless keen to go ahead.

Why? Because he was 決定するd not to lose 職業s in the Rosyth shipyards [on the East coast of Scotland]. In other words, the justification for building the two new 運送／保菌者s was dictated more by the 政府’s 産業の 政策 than by its defence 優先s.

Gordon Brown was keen to go ahead with the 事業／計画（する） so 職業s were not lost in the Rosyth shipyards, in Scotland

No one seemed to worry about where all the cash would come from. At the time, there was a 黒人／ボイコット 穴を開ける of at least £6 billion in the MoD 予算 ― but they thought they could save a bit by 減ずるing or 延期するing the 準備／条項 of armoured 乗り物s for 前線-line 軍隊／機動隊s.

明確に this wasn’t going to get them very far, but they hoped that the 財務省 would later come to the 救助（する）.

Some 述べるd this approach as a ‘culture of 楽観主義’. To me, ‘a culture of recklessness and irresponsibility’ would be a more apt description.

By the time the 契約 was?finally 調印するd in 2008, the price of the 運送／保菌者s had gone up by 30 per cent to £3.65 billion. They were 推定する／予想するd to enter service in 2014 and 2016. They even had 指名するs: HMS Queen Elizabeth and HMS Prince of むちの跡s.

Predictably, the MoD ran out of money afte r just seven months. At this point, they 簡単に 停止（させる）d all work on the 運送／保菌者s for two years ― though they still had to 支払う／賃金 for expensive specialist 総計費s and keep many people who’d been working on the 運送／保菌者s in place. Price: £900 million.

But costs have a habit of rising ― and by the end of the two years they 設立する themselves 直面するing an extra 法案 of nearly £1.6 billion.

明白に Gordon Brown and his 政府 were to 非難する ― but no one was ever held to account for this incredible waste of taxpayers’ money.

Things didn’t 改善する under the 連合. すぐに after the 2010 General 選挙, the 政府 considered cancelling the 契約 for the second 航空機 運送／保菌者. But the main 請負業者, BAE Systems, told them that it would cost more to 取り消す than to go ahead.

Now, I know from my own 取引 with BAE, when I was a 貿易（する） 大臣, that this company can be very 積極的な. Whether its （人命などを）奪う，主張するs were challenged or not ― and I 嫌疑者，容疑者／疑う not ― it 説得するd the 政府 to continue building both 航空機 運送／保菌者s. Because of spiralling costs, one of them would then be ‘mothballed’ ― or left sitting 未使用の in 乾燥した，日照りの ドッキングする／減らす／ドックに入れる.

Then the 政府 got to thinking: wouldn’t it be a good idea to have different 計画（する）s for the 運送／保菌者 in service than the ones already 想像するd?

Thus it was decided to fit the Queen Elizabeth with ‘cats and 罠（にかける）s’ ― a catapult 開始する，打ち上げる and 回復 system ―? which would enable the new 計画（する）s to be used on deck.

Price: another £500-£800 million.

Gordon Brown and his 政府 were to 非難する for the spiralling costs of the 航空機 運送／保菌者 交替／補充 事業／計画（する） ― but no one was ever held to account for this incredible waste of taxpayers’ money

いっそう少なく than 16 months later, in May 2012, 大臣s （機の）カム 支援する to the House of ありふれたs to say that they’d changed their minds. Again. They 手配中の，お尋ね者 to go 支援する to the old specifications, after all.

It turned out that civil servants had under-概算の the cost of the changes, partly because they’d forgotten to 追加する 付加価値税 or take インフレーション into account.

Cost of this change of heart: around £74 million.

In 2014, the 総理大臣 発表するd that the 政府 手配中の，お尋ね者 to bring both 運送／保菌者s into service after all ― which 追加するd many more million s to the costs.

And now? Still no 調印する of the 完全にするd 運送／保菌者s. And によれば the 最新の 見積（る）s, the final 法案 for building them will 越える £6.2 billion.

This disgraceful saga, it hardly needs 説, has been at taxpayers’ expense. But what is 特に disconcerting is that civil servants let this happen.

Both Brown’s 決意 to 保護する 職業s in Rosyth and David Cameron’s whim in choosing a different 計画（する） should have been challenged. Their bad 決定／判定勝ち（する）s could, and should, have been stopped.

After all, the 最高の，を越す civil servant at the MoD, the 永久の 長官, is 本人自身で accountable to 議会 for the use of public money.

If he believes that 大臣s are taking 決定／判定勝ち（する）s that don’t 論証する value for money, he is 要求するd to 捜し出す a written 大臣の 指示／教授／教育, known as a ‘letter of direction’. The 問題／発行する then becomes formal and public ― so the 大臣’s justification has to be 強健な.

But letters of direction are rarely 問題／発行するd. And in the 事例／患者 of the 運送／保菌者s, nobody 行為／法令／行動するd. No one 受託するd 責任／義務 for the waste ― and all the 政治家，政治屋s 伴う／関わるd have moved on.

NOT VERY BRIGHT: HI-VIZ JACKETS AT £100 A TIME

Margaret Hodge 設立する the prices different police 軍隊s paid for high-visibility jackets could cost as little as £20 or as much as £100

Let’s imagine you 手配中の，お尋ね者 to order some 基準 boots for policemen in your 地元の 軍隊. Doesn’t sound all that difficult, does it?

Someone would have worked out in 前進する where you could get the cheapest 本体，大部分／ばら積みの order of the 訂正する decent-質 boots. Then a quick phone call or internet order . . . and everyone would be happy.

The trouble with this シナリオ is that it’s probably pie-in-the-sky.

As I discovered during 審理，公聴会s of the Public Accounts 委員会, some 軍隊s were getting their boots for £25 a pair. Others were spending up to £114.

It was a 類似の story for other 基準 items. The prices different 軍隊s paid for 手錠s 変化させるd between £14 an d £43. And their high-visibility jackets could cost as little as £20 or as much as £100.

To make 事柄s worse, police 軍隊s all over the country were 直面するing 穴を開けるs in their 予算s and having to make 削減（する）s in neighbourhood policing.

Nonsensical? Indefensible? Yes ― but that’s not the way that the police 当局 see it.

They all jealously 保護する their 権利 to decide how many pockets their 軍隊’s uniform should have, for instance, and where those pockets should be.

And God forbid that you make them wear the ‘wrong’ boots!

宣伝

Even today, the MoD continues to を煩う the same underlying problems. There’s still strong 圧力 to commit to spending more than they have. They 絶えず change their minds, thus 追加するing unnecessary costs. And they under-price 事業／計画（する）s, which 結局最後にはーなる costing much more. Because so many of these 伴う／関わる the most expensive, up-to-date and 複雑にするd 器具／備品, problems 必然的に arise.

But it’s no good looking around for the civil servant responsible: usually they’ve taken another 職業 within a couple of years.

In particular, too many people who are trained in managing major defence 事業／計画（する）s then leave for better-paid 職業s in the 私的な defence 部門.

一方／合間, the MoD continues to sit on one of the best real 広い地所 大臣の地位s in Britain. Did you know that it owns an astounding 1.5 per cent of all the land in the UK, 価値（がある） around £20 billion? Or that it 所有するs an incredible 57 separate 場所／位置s within the M25 and still has 15 ゴルフ courses?

Yet there’s no point in asking the MoD about all this. It has little idea whether it needs all its land; it has scant （警察などへの）密告，告訴（状） on the 親族 value of 場所／位置s; it doesn’t know which ones are 適切に used or how much they cost to run.

Whether it truly needs all this land or not, the fact remains that many millions of 続けざまに猛撃するs have been 定期的に wasted in the 指名する of defence. And, at the same time, the 正規の／正選手 Army has been 徹底的に 減ずるd by 20,000 兵士s.

The 推論する／理由? Because the MoD needs to save money...

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