Procedure Committee
Oral evidence: Written Parliamentary Questions: Departmental performance in Session 2024-25,
HC 828
Wednesday 7 May 2025
Ordered by the House of Commons to be published on 7 May 2025.
Members present: Cat Smith (Chair); James Asser; David Baines; Bambos Charalambous; Sir Christopher Chope; Mr Lee Dillon; Tracy Gilbert; Mary Kelly Foy; Mr Tom Morrison; Joy Morrissey; Lee Pitcher; Michael Wheeler.
Questions 1-24
Witnesses
I: Karin Smyth MP, Minister of State with responsibility for secondary care, Department of Health and Social Care; and Tom Riordan, Second Permanent Secretary, Department of Health and Social Care.
Witnesses: Karin Smyth and Tom Riordan.
Chair: Good afternoon, and welcome to this public session of the Procedure Committee. Since 2010 the Committee has held Government Departments to account for their performance in responding to written parliamentary questions—or WPQs for short—which are an important tool for MPs in raising matters of public interest and dealing with much of their constituency work.
Our predecessors regularly asked Ministers to come before them when a Department’s answering performance fell below the expected level of 85% of WPQs being answered on time, so that they could explain what issues they were facing and how they planned to resolve them. That is something we intend to continue in the present Parliament.
To that end, we are joined today by Karin Smyth MP, Minister of State at the Department of Health and Social Care, and Tom Riordan, the Second Permanent Secretary, to discuss the Department’s performance in the first six months of the present Parliament. Good afternoon to you both. Before we begin, could you introduce yourselves formally for the record?
Karin Smyth: I am Karin Smyth. I am Minister of State for Secondary Care at the Department of Health and Social Care.
Tom Riordan: I am Tom Riordan. I am the Second Permanent Secretary at the Department of Health and Social Care.
Q1 Chair: Thank you both for coming today. As is traditional for the Chair, I will start with the first question, which is about the Department’s performance. It managed to improve its performance during the 2023-24 Session, but it has dropped again during the first part of the 2024-25 Session. Can you explain why that has happened?
Karin Smyth: I can, but if it is in order, I would like briefly to make a few comments. I am really pleased to be here this afternoon. You said that WPQs are an important tool for parliamentarians. I absolutely get that, and the Secretary of State absolutely gets that; we understand how important it is for us all as MPs to respond to constituents. It is a really high area of concern, and I am keen to outline some of the problems and solutions. That is why we wanted to make sure we had the Second Permanent Secretary here to go through some of this as well.
I will get Tom to go through what we have put in place as a result of recognising that performance has dipped in this period. Broadly, the sheer volume that has come in post election, with the change of Government, has been huge. The Department—obviously under the previous Government—had that huge rise during covid, and then managed to get that under a bit more control. Obviously, I have seen what Minister Argar reported to the Committee.
Our initial response—on the record of the last Government, but in the early days of your Committee—came from the Secretary of State, and we made sure that we enacted the provisions set out in Secretary of State’s letter. The volume kept rising at that point in time, and has risen considerably. There have been some changes, but I am not making excuses for some of that.
I thought it would be helpful if, at this point, Tom went through some of the things we put in place to manage some of this. Would that be appropriate, or do you want to come back to it?
Q2 Chair: Before we move on to that, Karin, the Department of Health and Social Care has consistently received a high level of WPQs; my understanding is that it has had more WPQs than any other Department for a considerable time. Has something happened recently that has meant that it has been particularly struggling? Is there anything you can identify, as a Minister in the Department, that explains why performance has dipped recently?
Karin Smyth: What we see every time the Department puts out something major—and we are putting out an awful lot of change—is that that understandably results in a spike in what comes in. That is part of what has happened, despite us putting in those measures from July, at the beginning of our term in office. We have seen spikes around particular announcements—for example, the announcement around NHS England caused another huge spike, and we understand that local Members of Parliament want to understand how that will work. We have also had a change of Ministers, which obviously contributed to some of that. But broadly, the volumes, despite some of the things we put in place, have continued at almost pandemic levels.
Q3 Chair: I am happy to hear from Tom about the Department’s mitigation. Now would be a good opportunity to hear that.
Tom Riordan: Thank you, Chair. As the Minister said, the volume continues unabated. I have just checked for last month, and we had 1,179 PQs in April. That is more than double what has happened in each of the last five years, so it definitely feels as if it is here to stay.
We obviously had recovered performance at those higher levels, and it has dipped. Part of that has been to do with the new Government coming in and us trying to get used to working together and making sure that we have the right processes in place. One example is redrafts: because of the tight deadline on named day PQs in particular, if you have a redraft, you can do it in the two days, but it makes it incredibly difficult, especially if you are going back through to arm’s length bodies as well.
We have regrouped around the things that were working. The capacity is there: we have double the staff we had previously in the team that does this. We have an early intervention system, as we have called it, for named day PQs. If we are reaching the deadline by which a policy team needs to have sent a draft through to the private office and the PQ team, and we are in danger of not hitting that, there is an early alert that goes through. We have specific league tables; a bit of competition always concentrates minds in organisations, and that has been quite effective in working out where the pinch points and problems are. That is, as the Minister said, often linked to events: if there has been an announcement about GPs, as there was last week, we tend to get quite a lot of questions in to that team. Sometimes it is to do with that.
We have a programme of learning and development for the Department, and there have been dedicated sessions. We had 700 people dialling in to the most recent one, so people are clearly getting the message that this is important and that we have to deal with it. Refreshed and more accessible internal guidance has been important. I just had a look at it in preparation for coming before the Committee; it is quite clear and there has been a real attempt to get that clarity of process and of “right first time” into the system, which maybe we have not had in times previously. NHS England, which we rely on for probably around a quarter of our PQs, has also introduced a new system to track and monitor named day PQs in particular.
Those are the measures that were set out in the letter, and there are some additional things we have been trying to do, which I could go into if you would like me to at some point.
Chair: We will probably come on to those, and I am conscious that colleagues have questions.
Q4 Mr Dillon: You said you reviewed the guidance in preparation for this meeting. Where does the author of that guidance sit in the organisation? Karin, as the Minister you have responsibility, as Wes outlined in his letter, to drive that forward, and obviously you are second Permanent Secretary, Tom. Why did you not see that document before it was approved and operational? It sounds as though you had just read it now for the first time, even though it has been implemented—I don’t know whether that is fair.
Tom Riordan: The guidance is used by people who are dealing with the PQs and clearing them every day. That is its purpose. It is aimed at the people who are drafting the PQs. That is the audience I need to be concerned about. When I picked up that we were underperforming, it was important that I read that in preparation, but the person who is ultimately responsible is the Permanent Secretary. The person in the organisational structure is the director of strategy, who is responsible for the team who co-ordinate that, and he is over this every day to ensure that we are doing what needs to be done.
Q5 Michael Wheeler: Our predecessor Committee was understandably very sympathetic, during the pandemic, as to the difficulties it posed the Department in terms of responding to WPQs, but why do you think it has taken so long since the pandemic for performance to recover to the strong pre-pandemic levels?
Tom Riordan: Obviously, the Department was right at the heart of what happened during the pandemic. It was the part of Whitehall that was probably most in the eye of the storm, and there was a massive need to make sure that everything possible was being done to deal with the virus and to keep people safe.
Parliamentary accountability remained really important during that period, but inevitably there was an impact because of what happened. That includes the turnover of staff during that turbulent period, when people like me got brought in from the outside to help and others stayed through it. There was a recovery, but it inevitably took a bit of time to get people recruited into the core team, to double the number of people and to review the processes, so that we were getting the response levels that we needed. The key arm’s length body for us was NHS England, which was similarly the one that was right at the frontline trying to deal with things as well. It was just a sheer practical issue around recovery and getting back to normal business. Those are the main things.
Karin Smyth: On the post-election response, the volumes are really significant. Obviously, policy has changed with the new Government. That takes a bit of time. The redraft issue, which we also alluded to, is significant.
I think I speak for all Ministers who respond when I say that it was our feeling that, as a new Administration, we wanted to make sure that the answers that went back to people reflected the new priorities of the newly elected Government. It takes time for policy teams in the Department and NHS England to respond to that. I had a number of redrafts and had discussions with teams to say, “Actually, I don’t think this is good enough to go back to colleagues, and the policy has changed.” That takes a bit of time to roll through. That is part of the volume issue with such a huge new intake in Parliament and a high level of interest in the health service.
As I said in my opening comments, people want to know, quite rightly, what is going on. There has been a huge change with a new Government, and that has been reflected in things like redrafts, because we are trying to make sure we get that right. We are also giving quite fulsome answers. I think there are some issues in there for us. We answer more, but we have not got the same rates of things like proportionate cost. We do answer. We answer quite fulsomely in most cases. We have not been referring to other documents and other links in some cases. All that is taking time, but we have to balance the fulsomeness of answers and that volume against the important targets that Parliament has set us. That is a very live discussion, and I am keen to hear from colleagues about their views on some of that and on the quality of the responses.
Q6 Mary Kelly Foy: My question has probably been answered. I wanted to know what steps you had taken since the election in July to try to improve answers to questions. Is there anything you want to add on that?
Tom Riordan: Just two or three things, if I may. We have looked at certain pinch points—some of the resource, not just in the Department and the officials team but in the way that the political team looks at things. We are one Minister down from the original number of Ministers we had. We have a lot of parliamentary business. We have to make sure that the balance is right in terms of the special advisers looking at some of the answers. That has been improved.
On the redraft rate, we have disseminated more about ministerial preferences in some of the feedback. It is a good thing that our Ministers want to sign off all the PQs, but that means we must have really good back processes, especially if redrafts are happening.
We have also tried to look at how much more information we can make available to MPs so that they do not need to ask the question in the first place. We have improved the information that is available in the House of Commons Library on health conditions, numbers of GP and dental practices, for example. Lots of information from the digital bit of the NHS is now provided on a constituency and local authority basis. We have been trying to do that to deal with the demand issue that is coming through. Those are probably the main things I would mention. We have tried to look more laterally at why people are asking so many questions.
Q7 Mr Dillon: The Secretary of State wrote to us about the team now being fully recruited. Tom, you alluded earlier to doubling the capacity; do you think you have the right resource in place now to be able to get back to that 85% target, given that, as Karin said, it is unlikely that you will see the deluge drop off? Or will you look to recruit more staff?
Tom Riordan: On the staff we have, we are improving our performance. It is on the way back. We do not yet have the fully verified figures for our performance in the last month, but it is likely to be much better than it was previously. That is good news. What we have been doing is making a difference. To your question about whether we will be able to hit the 85%, that is an incredibly stretching target for us. The nearest Department to us gets probably around 60 or so—two thirds fewer PQs than us.
Mr Dillon: MHCLG.
Tom Riordan: Yes. The team said that we answer more PQs on time than any other Department has actual PQs. The volume and work involved in what we are doing is huge. It is a huge logistical exercise. I am confident that we are going to get back nearer to the target. That target, which changed from 80% to 85%, is always going to be, for this Department, incredibly challenging to achieve, but we will do everything that we can to do it. We will keep looking at trying to improve.
We have taken this really seriously, hence our both wanting to be here today. We really appreciate the importance of parliamentary scrutiny. I started off my career drafting PQs when I was in the civil service. I know what it is like, and I know how hard the process is sometimes. So, we will be doing everything that we can. Our performance is definitely improving. Whether we will be able to hit that target or not I could not say categorically at this stage.
Karin Smyth: It is a very strange business turning up to the Department and doing this new work, as some of you will be aware. Certainly, when it was first brought to my attention, I was turning them around and signing them off very quickly. Some of you might know that I am a former NHS manager, so I look at targets. I said, “I’m signing them off really quickly. Why is this a problem?”, as did Minister Kinnock, Minister Gwynne and then Minister Dalton.
I do want to assure colleagues that on a personal basis, not hitting the target for Parliament matters. We did ask that: we drove the teams and all our offices to say, “What’s going on in this process?” I pay tribute both to the team who were working on this in the Department and to our private offices, who are saying, “Okay, we need to get through these. These are really important.” It was about trying to streamline that process even before being called back before the Committee, because we wanted to make sure that we understood what was happening to us. I did not understand why I was falling behind, given the turnaround time that I thought I was hitting. We drove it individually and then looked at it systematically, as Tom has said, but they are pulling out.
You asked a question about whether we would put more resource into this right now, given that, obviously, we are making huge cuts to establishment and financial as a result of what we have to do to fix the NHS. Would we propose to put more staff time into this right now within the Department? That is obviously something we continue to look at, but I don’t think that would be the right solution at this particular point in time. We need to look at other ways to make sure we hit the target and, crucially, make sure that colleagues get the answers they need to serve their constituents. That is the ultimate point of the target and the questions. As Tom alluded to, we are ensuring that information is available in a format that people can access.
We are very keen to hear from the Committee or other Members of Parliament about what would help, what would help their staff and what it is that they are not getting. Obviously we have a lot, as Tom said—a quarter or so go to NHS England. I know that Members of Parliament want information from their local systems, and we want to make sure that they have that. The change with NHS England will take a stage out of the process, because it will become part of the same team. That will take a while to come into play, but it is another part of the process that will improve. We are very keen to explore all ways of thinking about how we get the information to Members of Parliament in the right way.
Tom Riordan: The named day target is the hardest one, by definition, because it is so tight. Often, you are talking about two days. On data, for example, basically the digital part of NHS England that used to be called NHS Digital will get something before 10 in the morning, and to hit our deadline we need to get that back by 5 pm the same day. If there is any new element in there, it is incredibly challenging to do that in those circumstances. We will be doing everything we can to hit that target within the resources that we have available. As I say, performance is definitely going to improve, but that named day target is the most stretching one of all.
Mr Dillon: It is quite interesting, as Members putting these in, to know how much work and effort goes on and what the systems are—for us to be a bit more considerate as well and give you a bit longer to answer, if we do not need it that urgently.
Q8 Michael Wheeler: You mentioned the NHS England changes. In his letter to us last September, the Secretary of State set out that NHS England had introduced a new system—I think you might have mentioned this earlier—to track and monitor named day responses. How will the reabsorption of NHS England by the Department affect work on WPQs? What steps are you taking to minimise any disruption to written answers during that understandably changing process?
Karin Smyth: In one sense, it is very difficult. I think we are all conscious of the difficulty for staff in an uncertain environment. There are the teams in NHS England. In some cases, they need to go to through their parliamentary team into all our local systems to find out information and make sure that you get the right information back. That team is subject to the merger, as all teams are. Inevitably, some changes will be going on that are difficult for the individuals, but there will be less of the process of going out to another organisation and then chasing through that. It will all be in the one team, which streamlines the process for this activity in time.
Tom Riordan: We are thinking that there will be a new organisation as a result of the merger, and thinking about what that organisation will do and be. One of the main things is that we will be a Department of State accountable to Parliament, running the systems that we run at the moment, but as a single entity, as the Minister said, rather than two separate organisations.
Although we are making some quite significant reductions as part of the merger, that role will have to be a fundamental part of what we do. We think that the challenge of making those efficiencies, but performing better than we are now, is probably outweighed by the clarity we will get from single teams—single policy teams and delivery teams—being together, with more singular messaging going out to the systems about what we need and what we want, together with that attempt to put more information through the House of Commons Library, with the ONS, out to the general public and to you as parliamentarians.
Q9 James Asser: I suspect that a lot of this has been covered, but I will ask it none the less. The Secretary of State’s most recent letter indicates that you have assumed responsibility for driving the work forward in this area, so well volunteered—we appreciate that. What action are you planning to take to drive it forward? You have covered a lot of that, but is there anything else you have not covered about the kind of work you want to take on?
Karin Smyth: As I alluded to earlier, having been on the other side as a manager, I like to look at the process behind things and look at the target to see what has happened. I do think that is important. My interest was heightened by looking at this and meeting the team, which I did quite early on, to have them talk to me about that—as did Minister Kinnock and Minister Gwynne at the time, and subsequently Minister Dalton. I think I then stood up and then got volunteered, but I was very happy to do so and to drive a hard task on the team. But I also want to be frank about what the issues are, hence my frankness about the resource and how we manage the demand.
I pay tribute again to the team, because they want to do better; that is very clear, and I am very impressed with the team we have. It is partly about formalising that a bit more, on behalf of the whole Department now, and to be the lead Minister for that, coming here today, taking things back and having regular meetings and sessions with them.
I am sure you all find this in your own constituency teams; I certainly always have. Whether I agree with it or not, I have valued the correspondence I get in my office. The questions that you get tell you what you don’t know, what is important to you, who you are talking to and what you are talking to them about. It is a real indicator of what is happening in the wider system, so I am very happy to do that; I think it provides intelligence on where we need to be better.
There will be a regular session to keep on top of that and to see what the issues are and where they are coming up. We will make sure that we work with the Permanent Secretary and the directors to make sure that the focus is still on that. Your issue is not correspondence, but obviously that is also an important part of the Department’s parliamentary focus.
Q10 Lee Pitcher: Karin and Tom, I would like to ask about governance. When you come together as a departmental management board, is WPQ performance a standard agenda item that you discuss?
Tom Riordan: Yes, it is. It is discussed as part of our parliamentary business, if you like, and accountability responsibilities. It is fair to say that it has increased in visibility since the dip in performance, and the league tables have been important in drawing out that sense of visibility about performance and accountability across the board. Although those ExCo meetings, as they are called, are important, equally important is the fact that an email has just been circulated this week in which the team has set out how we are doing, particularly on named PQs, and there is an attachment that breaks down into the different teams and shows their relative performance. There is a call-out of the really good stories. We have a lot of people at 100%, which is great. You can also drill into where it is obvious that there has been a bit of a spike in interest after announcements.
Having worked in a system like that when I was coming through as a middle manager, I know that when you get an email like that and you see that you are bottom of the league, you really want to do something about it. It is about the combination of what the Minister set out, in terms of that top-of-the-office “This is really important” message, and the follow-through with the discussions in the senior team meeting about how this needs to remain a priority, with the real work then being done outside those meetings to make sure that we are on it. After today—well, there is nothing like a parliamentary Select Committee to concentrate minds to make sure that we get better.
Q11 Lee Pitcher: Now you have the visibility, and you are having those discussions on a more regular basis at management board. In terms of actions to take away, have you set yourself some internal targets around getting back to 85%? You described to Lee Dillon the difficulty of achieving 85% on named days questions, but is there a plan that says, “To get to 85%, we need to be at 84.3% by this date, and this is how we are going to do it”? Does that plan exist?
Tom Riordan: We have not set individual milestone targets on the way to it. There were a couple of things that happened with the dip in performance. A change of Minister will always lead to a bit of a hiatus and a regrouping of how we organise ourselves. In individual teams that are quite busy, if you get issues like sickness absence, it has an effect. We are on the road to recovery now. Whether we need to move in that direction in future is something that we may want to consider, but the main thing is that you can be confident that we are on our way back. I think if we got close to it, we might want to think about that sort of thing, but basically we do not have interim milestone targets.
Karin Smyth: It is not a linear thing or a constant thing. Although you can see the volumes, we are a Department—this was put to me the other day on another subject—that is making a lot of announcements. We are wanting to keep abreast. We recognise how important health is to the population and to all our constituents, and that does elicit spikes. If through the power of Government we can link up the announcements to the response that we are expecting, that would be clever, so we might try to do that, but it is not a linear thing; there are spikes, and we need to be able to respond to them. It is partly about how you get information back out. What is it? Is that standard information? Is it about directing people? We have had a lot on NHS England, for example. We are directing people to Jim Mackey’s letter and correspondence to assure people.
We can perhaps be a bit smarter about the linkage to the answers, and we will certainly take that into the team so that people get a better response more quickly. We may also do things in Parliament again. We are open to suggestions and ideas. We are trying to do surgeries, drop-ins, things with the Library and newsletters that provide people with the information they need as much as possible. I am hoping to do something on medicine shortages and supplies, for example; the team are very keen to do an event in Parliament. Those sorts of things will help with the demand and the genuine questions that people have.
Lee Pitcher: I do not want to miss the opportunity to say how good it is that we are praising those people who are achieving outcomes and getting 100%. The positives are massively important, to show other people that role-model leadership, so that praise is fantastic to hear.
Karin Smyth: It is quite competitive in the ministerial team.
Lee Pitcher: I can imagine.
Chair: Who knew that a group of politicians could be competitive?
Q12 David Baines: We accept the fact that you are inundated with PQs. I do not know what stages they go through when being dealt with, but where exactly in the system are they occurring? Is it in policy teams, or is there some sort of central processing? Could you walk us through the process of where a PQ goes when it is submitted? Have you identified where the things that are slowing it down exist?
Karin Smyth: Tom, do you want to go through the process?
Tom Riordan: Yes. When a PQ is tabled, it comes to the central team—the core team that deals with and co-ordinates all the PQs. It is immediately allocated to a policy team and sent straight out for a response. A deadline is set, depending on whether it is a named day PQ, an ordinary written or a Lords written—they have different deadlines, as you know. There can be a pinch point there: if it is not clear which policy team it should go to, there is a potential challenge whereby it goes somewhere and then a team sends it back saying, “This isn’t us; it’s someone else.”
Sometimes questions are asked that can hit more than one team. To illustrate that, a question came in today about the steps that were taken to ensure that NHS systems used by GPs and pharmacies are protected against IT outages. That is a classic one: is it for the GP and pharmacy team, or is it for the IT team? The team describes them as orphan PQs. That is a challenge.
The PQ then goes out to the policy team—if the policy team needs to send it to an arm’s length body like NHS England, it needs looping in—and back. Once the draft has been done, it goes back to the PQ team and then goes for clearance through ministerial offices, Ministers and spads if necessary. It then gets submitted back through the PQ team to Parliament and the process here. If there is a redraft, at the next stage it goes right the way back through the system. If it has to go back through an arm’s length body as well, that is what tends to add to delays. It is almost impossible, if that happens, to hit a two-day deadline for a named day PQ if you are talking about the sort of data issue that I mentioned, or a new piece of work.
Sometimes the nature of the content is relevant as well. If the data or policy exists, then it is a straightforward reply, where we just need to put that down on paper or put the background note together. That is much easier than if there is a new line that needs to be developed and agreed.
Karin Smyth: May I add to that? I know that your purview is the Commons, but my colleague Baroness Merron has sight of what comes down from the Lords. Where a Commons question is asked on an area that she leads on—for example, on life sciences, women’s health or mental health—then it needs to be her and me, because she is the policy lead in the Department. That is why you get a joint response on certain areas, because of the way responsibilities are divided up. That is another important safeguard and another pinch point to make sure that we are both happy with the response.
On the redraft, it took me a while to recognise that it works that way even if it is literally just a sentence that is not right or that we are not content with. You might feel “This doesn’t really need to go all the way back, does it?”—you almost want to type it out yourself—but obviously that is not the way Departments or civil servants work. Those are the sorts of things we need to iron out.
As I alluded to earlier, getting a Department used to a new Government takes a bit of time. That was part of a pinch point, but I think we have settled that now. There are also what Tom alluded to as ministerial preferences. We all have words and phrases that we perhaps do not use, that we do not feel are in our voice and that we do not sign off, and teams have got used to that a bit more now.
Q13 David Baines: On this issue of redrafts, you were saying, Tom, that if something lands on the Minister’s desk and they are not happy with the way it is worded, or with the contents or the style of it, and it needs a redraft, it has to go right back through the process, which strikes me as quite onerous, to be polite. When you say it goes right back through the system, do you mean it literally goes right back to the very first point, and is then divvied up to a policy team again?
Tom Riordan: No, it will go back to the same policy team, with the need for it to be changed and a steer about how it should be changed or whether it can be. If there is an arm’s length body element to it, it does not go back through the system; it just gets allocated straight back to the team, or the person, who sent it, to redraft it in a way that then gets signed off.
The other thing I would say is that, because the timescales are so tight to hit the deadline, something may get to Ministers’ offices with a five or six-hour window. The point about parliamentary business is also really important: we are probably the Department with the most parliamentary business in terms of oral PQs and Bills going through Parliament.
Karin Smyth: And Westminster Hall.
Tom Riordan: Yes, and Westminster Hall. So it often comes down to the sheer logistics of people being able to look at things and take the time needed to sign them off.
Q14 Mr Morrison: We are talking quite a bit about named day questions. They perform poorly, compared to ordinary questions, and that is a trend across Government. I have two questions. First, I would be interested in how you think we can improve that. Could a change be made in the system from the parliamentary side? Secondly, is best practice shared across Departments? DEFRA might be doing something different that you can nick, or vice versa. Does that happen between Departments?
Tom Riordan: The difference between an ordinary and a named is two days or five days, but Members do not necessarily need to choose the two days—it could be three of four. So there is that element, and the question whether it really needs to be that urgent.
Is there also something in the system whereby Members are frustrated at not getting a reply by the deadline of five days, so they go for the two days? There is maybe something about what is happening that we could dig into in the conversations we have with Clerks and that may be worth reflecting on. Having looked at this really closely, just the sheer logistics of the two days is really hard. There could be a different target, but is it acceptable to have a different target for things that are urgent?
On the other point, yes, there are regular meetings between the different Departments. The area we have picked up through those discussions is that the level of redraft is higher for us. That might be to do with the sheer amount of policy we are dealing with and the changes that are happening—we are in the middle of the 10-year plan process, for example—but it might also be to do with the more logistical issues that we have mentioned. But, yes, we do have regular meetings, and we are always keen to pinch good ideas.
Q15 Joy Morrissey: What challenges do you face in providing timely, accurate and helpful answers to questions for arm’s length bodies? In particular, I am thinking of air ambulance. I know that there have been some cross-party issues with MPs asking about air ambulance for several months—since November, I think. They still not have had a response. That is one example, but there are several others involving arm’s length bodies in particular. Will you clarify that, please?
Karin Smyth: I know I have answered some questions on that particular issue, but as Tom alluded to, it is about going to someone else in the time, and making sure that we get the answer back correctly. Obviously, we have a lot of arm’s length bodies, NHS England being the largest. The questions go out to local systems, if it is a particularly local one, which is what most Members of Parliament want to know about, so that is a two-stage process. Other questions can be quite technical, such as those on things from the MHRA—the Medicines and Healthcare products Regulatory Agency—for example, which is one of my areas, or a lot of the prevention public health ones that Minister Dalton will be answering, as some of those might require links with other bodies on the ground. It is about the time and the number of steps in the process—in part, that adds to Tom’s point about the named day.
When I became an MP, it took me a number of years. I did not know for years—to display my own ignorance—that there were not different criteria for named day and ordinary questions, that there is no difference. It is purely Members deciding on the timing, rather than it requiring any kind of urgency or criteria. I did not know that for years. That two days is genuinely very tight. Going out to another body, particularly on something that is quite technical, then getting it back and make sure the Minister is happy with it is a big challenge. Tom, do you want to add to that?
Tom Riordan: I think it is all about the nature of the arm’s length body and of the question. If something is a regular answer that we usually need to get from our NHS England colleagues, then we have an SLA—service level agreement—already set up and we have ways of working between the different teams. That is more straightforward than when, say, we need to ask every one of the 42 ICBs—integrated care boards—whether they have done a certain thing, and we have to get that information back in a short period. Sometimes, we need to talk to non-departmental bodies, other organisations, in some cases local authorities, air ambulance or charities. There might be some challenges in getting responses from organisations that are not as geared up, usually, for us to have a relationship where we can get the information quickly.
Q16 Joy Morrissey: It might be useful—I would be sympathetic—to correspond with MPs, even if just to say, “I am trying. I am in the process,” because this air ambulance thing has been going on since November and involves a bunch of MPs. Perhaps the letter got lost or there is just a wait, but I think it would be great to have something. I know it is hard, because you do not want to say, “I do not know the answer yet,” but that sort of void of information is quite challenging for MPs. I understand, though.
Karin Smyth: I am very happy to take that. I have answered questions and/or correspondence, but absolutely take that if people are not feeling that there is something. We know that your purview is not correspondence, but there are some backlogs and things that have not come out properly. We are conscious of that as MPs, because obviously we talk to colleagues, and we are here. If there are specifics that you want to make sure that I am aware of, I will make sure that we pick them up.
Q17 Bambos Charalambous: The Secretary of State told us that a significant proportion of WPQs produce answers where the information is already in the public domain. I wondered what percentage of the written answers are in the public domain. Does that indicate a problem with the accessibility of information published by the Department?
Karin Smyth: I stand to be corrected, but I don’t think we know the answer to your first point, because I am not sure we have done that, so let me come back to you on that, if that is okay.
On your second point, that is a good challenge. This is all public, so everyone can see what questions have been asked. As I said earlier, it does indicate what people don’t know. You accept that sometimes it is about directing—this is in this place, so nobody can know everything. Your point about whether it is opaque is a fair challenge—do people understand or know what is happening in their local systems, and are they asking questions that I believe, in many cases, they should be able to ask of their local systems?
I hope that one of the things that we can do better, perhaps as a result of coming together as one team—this is what the Secretary of State has tried to make sure happens with NHS England and the Department since we came into office, and now that is more formal—is to recognise that that democratic oversight also happens locally. I know that is variable. That relates to both information that goes out locally and, absolutely, information from the Department.
If there are ways in which the Department can produce information or have it here in the House of Commons Library, or on websites, we are very open to hearing those ideas and suggestions. The NHS England website—I know this partly because I came from the system—has a lot of information. There is an awful lot of information produced by and available from NHS England. Sometimes that might not be in a form that Members of Parliament or the public can access; so again, I am open to how we make that happen. It is a huge part of our country’s expenditure and taxpayers’ money, and we want to make sure that people know what is going on.
Q18 Bambos Charalambous: Is that more about improving communications with Members, particularly if the data is about their constituency? I wonder whether you can be more proactive about communicating that with Members and, as you mentioned, signposting where they can find that information. It would be incredibly helpful if you could take that back.
Tom Riordan: One of the additional things that we have done is send out regular bulletins to MPs, highlighting the data sources that we have made sure are available and that can be broken down by constituency and by, I think, upper-tier local authority areas, but probably lower-tier ones as well.
I know you will not be able to read every single email that comes in straightaway, but having dealt with MPs’ offices a lot in my career, I wonder whether there is a way we can highlight this to the people in your offices who are doing the casework and research. Sometimes corporate bulletins come round and will not necessarily be read, whereas if we personalise it a bit more, that might flag it in a more effective way. That is definitely an area that we are keen to do more on, to make sure that everybody is aware of what information is available and the fact that it is constituency-based, which I know is the most useful thing.
Karin Smyth: The Secretary of State, in his April letter, alluded to being very keen on that and to working with the Committee and Parliament on how best to do that. We are very open to suggestions from the Committee afterwards, or to discussing that.
Q19 Sir Christopher Chope: As the Minister knows, I ask quite a lot of questions about the vaccine damage payment scheme. A lot of those questions ask for information that could be supplied, say, on a monthly basis, because we are talking about statistics, including how many claims have been made, how many have been dealt with, how many have been appealed and so on. To use that scheme as an example in this discussion, would it not be possible for you to provide a regular monthly update on the vaccine damage payment scheme? That would certainly reduce the number of FOI requests that come from some of the claimant groups, and the number of PQs that I put in on that.
That is one question; I have another question about something I don’t really understand. I was a Minister a very long time ago, but I had to deal with all the questions that came in on what was then known as the community charge—although other people described it as the poll tax. You can probably imagine that there was a very large number of such questions. What used to happen is that, by the time the question reached my desk, there would be a background brief to it, and a draft, and if I wanted to change the draft, my private secretary and I would work together to change it, and that would be that. It would not have to go back on an iterative basis. I wonder how often you, as a Minister, will make a change to the draft yourself and ensure that that draft is what stands. If you have been given the right briefing, I do not understand why, when the Minister has changed the draft—it may well be an issue of style or wanting to be more open—it has to go back down the line. If it has to, why can it not just be on the basis of a phone call?
Karin Smyth: Shall I take that last bit first? You are absolutely right to point out your experience. I think it is happening less, as hopefully after nine months in the job one gets a bit better, and people get more used to my own style, and the issues, the change of policy, and so on. As I have said a number of times, we are changing a lot of policy. We are announcing change all the time, so it has not levelled out yet, and I do not expect it to level out anytime soon. As well as continuing with the changes to NHS England in the Department, we have the 10-year plan, the long-term workforce plan and a lot of issues around the new hospital programme. I do not expect the level of interest or the level of change to slow down anytime soon. We are not dealing in a static period, and I welcome the challenge. As new issues come up, we have to get them into the system.
On your point about standardising processes and getting more information out, so that we do not elicit these requests, I think there are challenges to me about having stronger political oversight in the Department and about being very clear about what can be standardised and what we can put out more frequently, so that we do not have repeat questions. I certainly go back to the team and say, “I’ve answered this question. It’s published information. Why is this coming back in different ways?” I don’t have the pleasure of oversight on your questions, Sir Christopher, because this goes to another colleague, so I cannot answer specifically.
Tom Riordan: We can take that away.
Chair: We could get something in writing, if that would be good for accuracy.
Tom Riordan: I don’t know the detail of the scheme to know whether it is possible to do that, but we can certainly take that away. There are occasions where the Minister will just change something, and it does not need to go back through the line, but sometimes the steer is that it needs to be changed in a more fundamental way. I think it does happen the way you describe it; it just does not happen all the time. I think I might have been one of the ones sending you the PQs at that time.
Chair: Revenge always comes in the end, doesn’t it?
Q20 Tracy Gilbert: Thank you both for your contributions. I heard what you said about having a new staff team who are getting to know your style, and that all takes time to develop. That has been helpful, and things are improving—you can see that. You also spoke about better communications to new MPs so that we are better equipped to deal with some of the questions.
I also heard the points you made about budgets, and whether having more staff would fix that problem, and whether that would be something you looked at. I am quite clear about your response to that. Taking that all in context, to continue the improvements, and for sustainability, would there be things that were budget-neutral that you think would help with that sustainability and improvement piece?
Tom Riordan: The merger will help. The fewer links in the chain you can have, the better—the more efficient it is and the quicker you can be in turning things round. Without a doubt, that will reduce the number of problems that we might come across. I definitely think that will make a difference. The extra monitoring that we are putting in place now, with the more transparent league table approach within the organisation, is allowing us to see where it is just a spike and where there is consistent underperformance and how we can deal with those issues. It can be about resources and sickness absence, but it might be about something different. That is something we are doing to try to improve things, and I think it is making a difference.
Technology potentially could be used. I have been asked before whether this is an area where AI could make a difference. I am not sure whether you as parliamentarians would want AI answering all your questions, but in some of the background data gathering we do, that is a possibility further down the line. There are pieces of work going on across Government looking at how we can utilise and corral data better and more quickly in less human-intensive ways.
Q21 Joy Morrissey: How will you ensure that efforts to improve the timeliness of responses do not lead to lower quality answers? I am thinking especially of public health questions, where I have seen genuine inquiries about demographic details on tuberculosis vaccines among children or measles outbreaks and there have been very rudimentary responses. I can understand that, because data is recorded differently through all the NHS trusts—I understand what a nightmare that can be—but sometimes questions are about public health outbreaks and why they are happening, and more information rather than less is more reassuring for MPs. I know that is hard and I do not know how we circumvent that, but it is becoming more and more of a concern. Some of the questions that MPs are asking are about genuine concerns, such as why there is a spike on a public health issue in their patch, but they are getting short, rudimentary, blanket responses that do not answer anything. I am just flagging that, and would love to hear your thoughts.
Tom Riordan: This takes me right back to the pandemic—
Joy Morrissey: It feels similar.
Tom Riordan: The relationship we built during that period with a lot of parliamentarians and directly with the directors of public health was really effective in a lot of parts of the country. When we ran into problems, it was often to do with the lack of connection. The Minister mentioned before that where we can build good local relationships between yourselves and your local trusts, but also with the directors of public health who sit in the local authorities, that is the best thing we can do, because then you do not need to come back around this route to get the information. That relationship has maybe abated a little and we could maybe think about how we could do more on it. I am sure that the Association of Directors of Public Health would be keen to think about how we can improve that and ensure that where there are concerns, we can deal with them without you feeling the need to go through Parliament to do that.
Karin Smyth: It is a good example, and I would certainly be conscious of that when we are looking at oversight. I don’t see those directly because it is not my area, but as Tom says, it is about where the gap is. People absolutely need to have that information that is not available somewhere else, so that we don’t lose that in the huge mass of other questions that we have, and we are only just getting through them, if you like.
Tom talked earlier about the logistics and we literally sign them off. I might look at my box at 7 o’clock on a Monday evening and there will be hardly anything in there, but when I go back and look at it at 9 o’clock it will have 20 that have come through from the team in that intervening period that are shut off by the end of the session. If you don’t happen to look at your box at 9 o’clock or if you are sitting taking a debate or whatever, you don’t get to it. That is what we mean by the logistics.
We want to make sure that we catch those. That’s what it’s for, isn’t it? It’s for providing information that is probably not in the public domain, that is of interest to us all as Members of Parliament to do our job—not just things that are available—and separating out those two things, so we get quality of answers back to you as quickly as possible; I think that is the goal we would all seek to attain.
Q22 Joy Morrissey: Children and public health particularly, because I think that wasn’t a focus during covid, but that is where a lot of the diseases start that can be very quickly spread—just to have a heads up on that one.
Karin Smyth: I think that is right. I think there will be others, though, that come out. We all have our pets, don’t we? That is one of the joys of Parliament. So there will be others that come out that are new, where information perhaps isn’t in the public domain, isn’t as clear, and it is right that Members of Parliament have access to that; whereas perhaps you can find other information somewhere else, which means we will get through the whole thing much more quickly. I think that is what we are aiming to try and do. We’ve got the target—we absolutely recognise that; but the goal of that target is to help you all do your job better on behalf of your constituents. That’s what we want—and we get access to information that perhaps should be in the public domain, and that we want to be, that helps you do your job. We shouldn’t lose sight of the objective here as well as the target.
Q23 Chair: Thank you so much for thoroughly covering off so much information. We are reassured to hear, as a Committee, that apparently we are on the road to recovery, which is always reassuring to hear from any health professional. When is it that you expect the written parliamentary questions to be hitting the 85% target again in terms of timescale?
Tom Riordan: Is this the ordinary PQs or—
Chair: Because of what you have explained today, it probably is useful to separate them out. In terms of ordinary questions, when would you hope to be hitting 85% by?
Tom Riordan: I hesitate to give a date, which sounds like I am obfuscating, but I’m genuinely not. I would be really hopeful that we are back on a trajectory by the summer, so that we can be confident that we are on the right path, and we are in a space where you can be happy, as a Committee, that you don’t need to be calling us to see you, and that you might even be commending us again, as you were before, that we had managed to improve performance. I do think that that target is incredibly hard for this Department to hit, given the volumes that we have.
Karin Smyth: We were looking at each other then. We are absolutely aiming for that target; we are writ large against that, and I will be looking at all those areas, and the areas that I don’t know, to absolutely get through the process. If the volume remains the same—and within some of the things we are putting in place that remains a real challenge, so, Chair, I don’t want to commit and then come back and for you to say, “Why didn’t you achieve it?” I want to be realistic about this.
Earlier, you asked what were the milestones towards that, and I think that is a good challenge—that we are perhaps clearer with you about, in managerial-speak, the match of the volume to the resource that is there for it, to make sure that is as sufficient as possible. I have said that there will be spikes; there are more announcements. In response to Mr Charalambous’s point, the challenge on us is, is the information out there so that Members of Parliament know, and can get information from other sources? Your suggestions on that, your help with that, will be really welcome, so that we get to—Ms Morrissey’s point—the real issues that Members of Parliament cannot access in any other forum. That will help us with the volume question. Until we have got a better sight of that, this volume, and as Members of Parliament, in a new Parliament also—it is very new for everyone, isn’t it? We want to keep aiming for a better position by the end of the summer; perhaps we should write to you about that. Does that help, as a milestone?
Q24 Chair: Actually, Minister, if we could have something from the Department perhaps ahead of the summer recess to outline hopefully what progress is being made and how improvements are bedding in, that would be very helpful. Could we get that commitment?
Karin Smyth: Yes. We will get to you by recess, with, as a result of today, any other suggestions that you wish to make—if there are any other observations, we would be very happy to receive those—and any other questions that we haven’t answered, and make sure that we match that volume to supply issue and take on board some of those other suggestions, absolutely.
Chair: The Committee will be continuing to look at written parliamentary questions as an ongoing project, so hopefully we will be sending you a letter, praising you for the progress made. But if there are any issues that have not been covered off, we are always happy to hear from the Department in writing throughout the year.
I thank both our witnesses for their time today; they have been very generous. That concludes today’s evidence session.