Select Committee on Public Accounts Minutes of Evidence

Examination of Witnesses (Questions 100 - 119)



  100. Are your targets getting tougher year on year?
  (Mr Gorham) Yes. I shall be discussing the target for that—

  101. What is your target for this year?
  (Mr Gorham) The target for this year, I think we held it at the level it had been. We will be setting a higher target for next year and I will be discussing that target with the relevant director before we finalise our business plan at the end of March. I have to say, when I first joined the Service I did not think our performance on complaints was very satisfactory. We have made a lot of changes behind this, both in terms of the time but also the quality of response. I shall be expecting a better response than that next year.

  102. My final question is a general one, and before you answer it please bear in mind that every Chief Executive of every Agency would like to have more resources. It is a general point. We mentioned earlier the importance of safety, and public confidence in the Service and the procedures which are in place to safeguard against—as far as we can—things like CJD and HIV and Hepatitis C cost money. I think the figure in the Report is £60 million a year.
  (Mr Gorham) Yes.

  103. You, like many Agencies, have been given savings to make. Is there any contradiction in there? Is there any reason why we should be perhaps giving greater priority to safety rather than to savings?
  (Mr Gorham) I think one benefit of paying attention to costs is that it does actually provide the discipline of thinking very carefully about what you are doing. I think that is equally important to safety. If we were getting savings targets which were frankly making it impossible to do our job or were so distracting it took our eye off the ball then I would be expressing my concerns to the appropriate people. I think all of us in the Service—and I think this is reflected in the Report—think there are opportunities to improve the efficiency of the Service. The Department of Health has funded the additional safety initiatives which have been taken in recent years and therefore, at the moment, I think it is perfectly reasonable for the Department of Health and the rest of the NHS to expect us to make our own contribution to being efficient.

Mr Leigh

  104. Giving blood was, I suppose, characterised very much by the voluntary spirit and it has been immortalised by Tony Hancock, of course. I just wonder whether we are falling in between two stools now? I was not very impressed with the answers given to the questions about appointments and long waiting times, and I am referring here to paragraph 3.8. I can understand that in the old days it was very much a local thing, people liked to drop in, you met characters there, such as Tony Hancock, you got your sweet cup of tea at the end of it and all the rest of it. The world is changing now and I think the answers you have given about appointments—It can only surely be in a British public service that you do not have a computer that can cope with people changing their appointment times. To me I find this extraordinary in the modern world where more and more people are working and are under tremendous work pressures, men and women of all ages. Surely you can devise a system by which people can drop in if they want to in the old way or they can get a proper appointment which is kept to and they can change it if they have to? Is that too much to ask for if they are going in giving their own blood for nothing to perform a public service?
  (Mr Gorham) That is certainly our objective. I think we have to be realistic about where we are starting from. The reality is that, I think probably rightly, the priority was given to making sure the IT systems that supported the basic safety of the Service were put right first, and that was a very major task. I was not part of that, it was finishing about the time I arrived. That was a very, very major task indeed. I think it is easy to sit here with hindsight and say clearly there was a need to start on the donor modernisation programmes earlier than it happened. I think the risk that those of us who are now dealing with that face is trying to do it too quickly, without having thought it through. We are actually talking about a very large and complicated Service. On any day there are between 90 and 100 teams operating. If we make changes, we have to make sure that those changes as well as improving the service to the donors, do not compromise safety, and remember safety starts from the point where the donor actually arrives at the session. I can understand your frustration and I think in part I share your frustration.

  105. We are all frustrated. You can identify the problem and you are trying to solve it, are you?
  (Mr Gorham) We are trying to solve it and, rest assured, we will solve it as quickly as we reasonably can.

  106. How long are we going to have to wait for a modern appointment system which you get in any other business anywhere you go? Nowadays people are no longer in the business—whether they are visiting their MP or anybody else—of just queuing up. That is the modern way. Are we looking at five years, ten years, when are we going to be up to scratch on this?
  (Mr Gorham) We would hope to be offering a significantly better service across the whole of the country in three years.

  107. What does that mean "a significantly better service"?
  (Mr Gorham) Certainly to have eliminated the very unacceptable waiting times we are seeing at the moment.

  108. What are the average waiting times at the moment?
  (Mr Gorham) We do not measure the average waiting times, what we measure is the percentage of people who wait longer than the targets we set ourselves.

  109. Just remind me what that is?
  (Mr Gorham) There is a target which is donors waiting longer than 30 minutes before registration and there is a target of donors taking longer than 40 minutes to reach the bed to start their donation. The 30 minutes is part of that 40 minutes, let me make that clear.

  110. I am a member of the public, I am not interested in all that. What I want to know is if I want to go and give blood, on average how long is it going to take me from walking in the front door to walking out of the front door?
  (Mr Gorham) In very many sessions you will be in and out in less than an hour.

  111. What do you mean "in many sessions"? In most sessions, or what?
  (Mr Gorham) It varies at different times of the session and that is the problem. At the moment we have not got our staffing and our session opening times matching what the public now want to do. We will have part of the session running very well and you will get a very good service—

  112. In the middle of the morning, for instance?
  (Mr Gorham) We do not run many sessions in the morning except what we call industrial sessions where we go to firms. What you tend to find is in the early evening it gets very crowded and that is the issue we are trying to address. I think that is where we have to make some early improvements ahead of some of the—

  113. So in three years' time I am going to be able to pick up the phone, make an appointment, change it if necessary, and I am going to be able to say "I want to come in at 6.30 to give blood" and you are going to be able to see me and I am going to be in and out in half an hour or three-quarters of an hour, am I?
  (Mr Gorham) That is certainly the objective.

  114. That is the objective in three years' time. Okay. In paragraph 3.5, a number of existing donors, currently 200,000 a year, have stopped giving blood. I have got a confession to make. It was a long time before I started giving blood and one day I was walking past Westminster Cathedral Hall and I saw a big sign saying "Give Blood" and my conscience was pricked, so I went in and I gave blood and I rather enjoyed it. I felt, for once in my life, I was doing something useful.
  (Mr Gorham) We are very grateful.

  Mr Leigh: That is all right. Everybody was very kind, I must admit. I did not get a cup of tea at the end, which was a bit disappointing, but we will leave that on one side, I got an orange juice. I probably got a letter six months later or something but I am feeling a bit guilty because I rather lapsed. Nobody has rung me up, nobody has said "Oh, Mr Leigh, you gave blood on such and such a date, we really need you now. We are coming back to Westminster Cathedral Hall in a week's time, surely you can come in?"

  Chairman: On a Friday.

Mr Leigh

  115. Everybody who has given blood wants to do it again but people are indolent, selfish, all those other qualities I am personally well known for. If you are a business you would chase them up more, would you not?
  (Mr Gorham) Could I just ask you when it was you made your donation?

  116. A couple of years ago, I suppose, 18 months ago.

  (Mr Gorham) We certainly are doing a lot more because, as you say, it is important that we do. One thing we are now doing, we have just started, is to mail our Donor magazine to all our active donors and we have never done that before. We will be doing that three times a year and that certainly joins people to the club, if you like. We are doing a joint venture with the Post Office at the moment to try to clean up wrong addresses in our database, and that has been a big problem with losing people because they move and do not tell us. You will be aware we are doing a lot of tv and radio advertising, which is very much about keeping the public awareness of the nation going. We do a lot of telephone reminding now. It may be that you have slipped off our active base and that is why you are not hearing from us. As I said earlier, we are sending all newly enroled donors a video to encourage them to convert to a donor. We have also looked at our invitation letters and we are trying to make them a lot better. One thing we are trying to do is to make it sound like it is coming from a recipient rather than from us because we think what donors identify with is the blood donation and the benefit to the recipient, not some mysterious body called the NBS.

  117. All right. This 40 per cent of those enroled as donors who fail to give blood, I am just amazed by this. Is there no way that you can do better than that? Why is it so high?
  (Mr Gorham) I think we need to—

  118. Are they frightened at the thought of a needle or what?
  (Mr Gorham) I would be surprised if the ones who enrol are frightened at the thought of a needle. I think people do enrol on the spur of the moment, as it were, because of a particular stimulus. The important thing for us to do is then follow up with another stimulus that actually turns that enrolment into an actual donation.

  119. You cannot tell me anything more about how you can have more success in this field? Again, telephone calls, all the other things.
  (Mr Gorham) I think all of the initiatives that we are taking are designed both to improve the amount of people who enrol and donate and then to keep them donating. There is always going to be some difference between the enrolments and the actual conversions.

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