The Whole of Government Accounts for 2011-12 presents the combined financial activities of some 3,000 organisations. It provides vital data on which Government needs to act. Key issues have been identified, such as the £19.4 billion liability for clinical negligence claims. But it is frustrating to see other issues seemingly ignored in long-term policy making and spending decisions. In one year, the public sector was defrauded of over £20 billion and the tax gap rose to £35 billion. The financial liabilities for dealing with nuclear waste also keep growing. There is room for improvement in the document itself and how it is used. Users find it hard to understand, for example, why the Government debt and deficit highlighted in the WGA differ from those reported in the ONS's National Accounts. Also, by changing definitions in its commentary published alongside the WGA, the Treasury makes it difficult to track changes over time. The Treasury's introduction in the commentary of a new concept of so-called 'direct' expenditure leaves out key costs such as the interest paid on the National Debt. The publicly owned and controlled bodies - such as Network Rail and the taxpayer owned banks - are still being excluded, in defiance of normal accounting rules. The usefulness of the WGA is also being limited by the length of time it takes to produce the document and by poor quality data from some of the bodies. The accounts have again been qualified over the completeness, timeliness and accuracy of the information supplied for schools and academies

The report Access To Clinical Trial Information And The Stockpiling Of Tamiflu (HC 295) examines two separate but connected issues; the routine withholding of clinical trial information from doctors and researchers, and the effectiveness of stockpiling of Tamiflu during an influenza pandemic. The full results of clinical trials are being routinely and legally withheld from doctors and researchers by the manufacturers of medicines. The ability of doctors, researchers and patients to make informed decisions about treatments is being undermined. Regulators and the industry have recently made proposals to open up access, but these do not cover the issue of access to the results of trials in the past which bear on the efficacy and safety of medicines in use today. Research suggests that the probability of completed trials being published is roughly 50%. Trials which give a favorable verdict are about twice as likely to be published as trials giving unfavorable

Nearly one fifth of consultant posts in emergency departments were either vacant or filled by locums in 2012. Neither the Department nor NHS England have a clear strategy to tackle the shortage of A&E consultants and there is too much reliance on temporary staff to fill gaps. The Committee raised the possibility of paying consultants more to work at struggling hospitals. Greater use in A&E of consultants from other departments could also be made, or mandate that all trainee consultants spend time in A&E, or make A&E positions more attractive through improved terms and conditions. The slow introduction of round-the-clock consultant cover in hospitals - which will not be in place before the end of 2016-17 - is also having a negative impact. More people die as a result of being admitted at the weekend when fewer consultants are in A&E. Changing this relies on the British Medical Association and NHS Employers negotiating a more flexible consultants' contract, and neither the Department nor NHS England has direct control over the timescale or details of these negotiations. Hospitals, GPs and community health services all have a role to play in reducing emergency admissions - but financial incentives to make this happen are not in place. While hospitals get no money if patients are readmitted within 30 days, there are no financial incentives for community and social care services to reduce emergency admissions. Both the Department of Health and NHS England struggled to explain to us who is ultimately accountable for the efficient delivery of local A&E services

This is the fourth WGA to be published and it remains the most comprehensive picture of the government's income, expenditures, assets and liabilities that is available. Parliament lacks real visibility over the government's delivery of its deficit reduction measures under the current Spending Review. The government has currently delivered only half of its planned measures to balance public sector income and expenditure (fiscal consolidation measures). The experience in the delivery of consolidation measures to date, where for example the planned increases in tax revenues have not been realised, also show that the government will face a significant challenge in delivering the next phase of the consolidation. In assessing the government's performance in its management of public finances, the WGA is now an essential tool in supporting Parliamentary accountability. The Treasury has been slow in ensuring that all parts of the public sector comply with the government's expectations on pay restraint, particularly in setting the pay of senior staff. The Committee welcomes the steps the Treasury has taken to ensure that 'off payroll' arrangements within central government are made more transparent and that the Treasury is sanctioning government bodies when they fail to comply with the guidance.

There is at present around £46 billion of outstanding student loans on the Government's books, and this figure is set to rise dramatically to £200 billion by 2042 (in 2013 prices). By 2042 there will be an estimated 6.5 million borrowers of student loans. At the same time estimates for the amount of loans that will not be repaid are also rising and the Government assumes that 35-40% of outstanding loans will never be repaid. That is some £16 billion to £18 billion on the current debt of £46 billion and £70 billion to £80 billion on the estimated value of student loans by 2042. The Department for Business, Innovation & Skills (the Department) is not doing enough to secure value for money from its collection arrangements. The Department is unable to accurately forecast student loan repayments, and does not have a sufficient understanding of the likely future cost of non-repayment to the taxpayer. The Student Loans Company is not doing enough to ensure that it identifies and collects all the repayments due, given the substantial size of the financial assets involved, and will need to demonstrate value for money from the proposed sale of the student loans book.

In pursuing unpaid tax, HMRC has not clearly demonstrated that it is on the side of the majority of taxpayers who pay their taxes in full. Last year the Department collected less tax in real terms than it managed to collect in 2011-12. This was despite the stated ambition to crack down on tax avoidance. The tax gap as defined by HMRC did not shrink, but in 2011-12 grew to £35 billion. Furthermore, this figure does not include all the tax revenue lost. HMRC pursues tax owed by the smaller businesses but seems to lose its nerve when it comes to mounting prosecutions against multinational corporations. It predicted that it would collect £3.12 billion unpaid tax from UK holders of Swiss bank accounts and this figure was built into budget estimates, but in 2013-14 it has so far secured just £440 million. HMRC aims to make the UK more attractive to business but the incentives to international corporations may also enable them to avoid tax. HMRC needs to strike the right balance between support and enforcement. The implementation of the Real Time Information system has been encouraging overall though some small businesses are continuing to struggle. It is of concern that HMRC is planning from April 2014 to fine companies even though some face continuing challenges. The successful implementation of Universal Credit depends on RTI continuing to work properly but the system does not have full disaster recovery arrangements. System failures could have serious consequences for payments to individuals

This report summarises the key areas of the Committee's work over the past five years. It draws out the areas where progress has been made and where their successors might wish to press in future. The Committee has assiduously followed the taxpayer's pound wherever it was spent. Since 2010 they held 276 evidence sessions and published 244 unanimous reports to hold government to account for its performance. 88% of their recommendations were accepted by departments. In many cases they successfully secured substantial changes, for example with the once secret tax avoidance industry. They secured consensus from government and from industry that private providers of public services do have a duty of care to the taxpayer, and in pushing the protection of whistleblowers further up the agenda of all government departments. By drawing attention to mistakes in the Department for Transport's procurement of the West Coast Mainline, more recent procurements for Crossrail, Thameslink and Intercity Express have all benefited from more expert advice and a more appropriate level of challenge from senior staff. After discovery in 2012-13 that 63% of calls to government call centres were to higher rate telephone numbers, the Government accepted our recommendation that telephone lines serving vulnerable and low income groups never be charged above the geographic rate and that 03 numbers should be available for all government telephone lines. They also secured a commitment to close large mental health hospitals.