saving energy in the national health service : published by the uk audit commission

2
fuel imbalances which will generate the real interest. Overall, the study gives the impress- ion of a certain degree of complacen- cy. Much of the reserve data is accepted as realistic with little or no discussion. In fact, the oil numbers are very close to those used in the BP Statistical Review of World Energy which has always simply accepted gov- ernment reserve figures without ques- tion or comment. The huge increases in oil reserves posted in the Gulf in 1987 pass virtually unremarked. In one year, four countries increased their proven reserves from 152 billion barrels to 314 billion barrels - Vene- zuela increased by 225%; Abu Dhabi by 297%; Iran by 190%; and Iraq by 212%. There is little doubt that these increases had more to do with OPEC politics than with rethinking geology. Also many serious issues concerning investment receive limited attention. In particular, more needed to be said about the consequences of institution- al changes in the energy sectors of many countries. The pressures for pri- vatization from economic ideology, the World Bank and the IMF are increasingly making energy companies answerable to the diktat of various stock markets. A key issue will be the extent to which such capital markets operate on the sort of time horizon required by much of the investment needed to create the capacity. Short- termism may well prove a major bar- rier to energy investment. While the report does thoughout refer to the possible impacts of environmentally driven policies, much more could be said about what will certainly be among the key drivers of energy in- vestment decisions. Finally, there are serious down- stream issues for oil which the report completely ignores. It is quite plausi- ble to argue that the real bottleneck of the next 20 years (and oil accounted for 39% of world primary energy us- age in 1990) will he in refining and not in the production of crude oil. There is a view that environmental pressures will mean no new refineries are likely to be constructed in either North America or Western Europe. While capacity creep can provide some re- lief, eventually this constraint could presage major changes in the patterns of global energy supply. There is also the issue of the demand for a lighten- ing barrel meeting a heavier crude barrel in a refinery industry surviving on previous investments and facing uncertain economic prospects. If this publication had followed the pattern (and price) of the other excel- lent working papers produced by the OIES there would be no grounds for complaint. Working papers cannot be expected to provide chapter and verse, but for this price, more might be reasonably expected. Paul Stevens University of Surrey Guildford, Surrey, UK No coherent strategy or purpose SAVING ENERGY IN THE NATIONAL HEALTH SERVICE Published by the UK Audit Commis- sion ‘Value for money’ is the ostensible leitmotif of the entire UK public sec- tor. The Audit Commission is the organization created to ensure the aspirations are achieved in England and Wales. Back in 1985, the Commission cut it teeth on its original victims, the local UTILITIES POLICY April 1992 authorities, with a report on their approaches to energy conservation. It was readable, pithy and pulled no punches. It named names, particularly of those councils with records to be proud of, pour encourager les autres. It provided figures on the total amount that could be saved over the next five years, if the specific policies it recommended were introduced. It set simple yardsticks on manpower and investment ratios for each author- ity to follow. And five years later, the Audit Book reviews Commission returned to the issue, to establish what had been done with their report. They found that whilst some had responded well, many had ignored its recommendations. As a result, District Auditors have been publicly criticizing those councils which are still failing to spend enough on energy efficiency-on the basis that limiting such investment means higher overall fuel bills - and thus poor value for money. Proven record I tell this tale of earlier Audit Com- mission work, simply because it de- monstrates that this organization has a proven record of providing worth- while publications which can and do have (eventually) considerable effect. Sadly, this publication Saving Ener- gy In The National Health Service is unlikely to prove so valuable. It may be because the Audit Commission has only recently taken responsibility for health service expenditure, thus lead- ing to unfamiliarity. It may be because health service energy budgets are less than one-quarter of those of local au- thorities (albeit still some f225 mil- lion). It may simply be that the health service - run by appointed rather than elected people - is more difficult to oversee. Whichever, this 73 paragraph report - glossily well produced as it is, and incorporating many interesting back- ground statistics - is likely to fail to achieve any obvious purpose. That is for one simple reason: it sets no target against which any health authority manager can judge himself. Instead, it falls back on the ‘15% reduction in energy consumption over the next five years’ target set in 1990 for the whole public sector. But that by itself is an utterly meaningless figure. Any fool can re- duce energy consumption: you can simply reduce service levels (or better still, close down whole areas of opera- tion altogether). What is surely re- quired is some more practical means of demonstrating better energy man- agement techniques - perhaps as their local authority counterparts did in 1985, by requiring 10% of the fuel bill be reinvested into energy efficiency 169

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Page 1: Saving energy in the national health service : Published by the UK Audit Commission

fuel imbalances which will generate the real interest.

Overall, the study gives the impress- ion of a certain degree of complacen- cy. Much of the reserve data is accepted as realistic with little or no discussion. In fact, the oil numbers are very close to those used in the BP

Statistical Review of World Energy which has always simply accepted gov- ernment reserve figures without ques- tion or comment. The huge increases in oil reserves posted in the Gulf in 1987 pass virtually unremarked. In one year, four countries increased their proven reserves from 152 billion barrels to 314 billion barrels - Vene- zuela increased by 225%; Abu Dhabi by 297%; Iran by 190%; and Iraq by 212%. There is little doubt that these increases had more to do with OPEC politics than with rethinking geology.

Also many serious issues concerning investment receive limited attention. In particular, more needed to be said about the consequences of institution- al changes in the energy sectors of many countries. The pressures for pri- vatization from economic ideology, the World Bank and the IMF are increasingly making energy companies answerable to the diktat of various stock markets. A key issue will be the extent to which such capital markets operate on the sort of time horizon required by much of the investment needed to create the capacity. Short- termism may well prove a major bar- rier to energy investment. While the

report does thoughout refer to the possible impacts of environmentally driven policies, much more could be said about what will certainly be among the key drivers of energy in- vestment decisions.

Finally, there are serious down-

stream issues for oil which the report completely ignores. It is quite plausi- ble to argue that the real bottleneck of the next 20 years (and oil accounted for 39% of world primary energy us- age in 1990) will he in refining and not in the production of crude oil. There is a view that environmental pressures will mean no new refineries are likely to be constructed in either North America or Western Europe. While capacity creep can provide some re- lief, eventually this constraint could presage major changes in the patterns of global energy supply. There is also the issue of the demand for a lighten- ing barrel meeting a heavier crude barrel in a refinery industry surviving on previous investments and facing uncertain economic prospects.

If this publication had followed the pattern (and price) of the other excel- lent working papers produced by the OIES there would be no grounds for complaint. Working papers cannot be expected to provide chapter and verse, but for this price, more might be reasonably expected.

Paul Stevens University of Surrey

Guildford, Surrey, UK

No coherent strategy or purpose

SAVING ENERGY IN THE NATIONAL HEALTH SERVICE

Published by the UK Audit Commis- sion

‘Value for money’ is the ostensible leitmotif of the entire UK public sec- tor. The Audit Commission is the organization created to ensure the aspirations are achieved in England and Wales.

Back in 1985, the Commission cut it teeth on its original victims, the local

UTILITIES POLICY April 1992

authorities, with a report on their approaches to energy conservation. It was readable, pithy and pulled no punches. It named names, particularly of those councils with records to be proud of, pour encourager les autres. It provided figures on the total amount that could be saved over the next five years, if the specific policies it recommended were introduced. It set simple yardsticks on manpower and investment ratios for each author- ity to follow.

And five years later, the Audit

Book reviews

Commission returned to the issue, to establish what had been done with their report. They found that whilst some had responded well, many had ignored its recommendations. As a result, District Auditors have been publicly criticizing those councils which are still failing to spend enough on energy efficiency-on the basis that limiting such investment means higher overall fuel bills - and thus poor value for money.

Proven record

I tell this tale of earlier Audit Com- mission work, simply because it de- monstrates that this organization has a proven record of providing worth- while publications which can and do have (eventually) considerable effect.

Sadly, this publication Saving Ener- gy In The National Health Service is unlikely to prove so valuable. It may be because the Audit Commission has only recently taken responsibility for health service expenditure, thus lead- ing to unfamiliarity. It may be because health service energy budgets are less than one-quarter of those of local au- thorities (albeit still some f225 mil- lion). It may simply be that the health service - run by appointed rather than elected people - is more difficult to oversee.

Whichever, this 73 paragraph report - glossily well produced as it is, and incorporating many interesting back- ground statistics - is likely to fail to achieve any obvious purpose. That is for one simple reason: it sets no target against which any health authority manager can judge himself. Instead, it falls back on the ‘15% reduction in energy consumption over the next five years’ target set in 1990 for the whole public sector.

But that by itself is an utterly meaningless figure. Any fool can re- duce energy consumption: you can simply reduce service levels (or better still, close down whole areas of opera- tion altogether). What is surely re- quired is some more practical means of demonstrating better energy man- agement techniques - perhaps as their local authority counterparts did in 1985, by requiring 10% of the fuel bill be reinvested into energy efficiency

169

Page 2: Saving energy in the national health service : Published by the UK Audit Commission

Book reviews

measures, and that one trained energy manager be employed for every fl million spent on fuel?

Instead this publication limits itself to endorsing over-enthusiastically a statistical management technique cre- ated under the unlikely acronym of CUSUM, which coincidentally has been developed by the very same in- dependent consultancy which just happened to be advising the Audit Commission on this study.

In places it tries to address detailed technical issues, albeit emphasizing the more glamorous hi-tech projects in preference to more mundane energy technologies. Most of all, the authors do not address any obvious target

audience. The content suggests it is trying to address both general mana- gers and energy technicians, and in doing so, enables its message to fall neatly between the two.

Possibly the most potentially in- teresting aspect of the final report is the decision to look overseas for ex- amples. However, it is a bit much to describe a translation of an earlier French study into 14 hospitals, and a visit to a single acute/psychiatric hos- pital in West Germany, as ‘Interna- tional Experience’; again, a wasted opportunity.

Immediately after its publication, this report met with resounding critic- ism from a wide range of health ser-

vice professionals, both in the relevant technical press and at a series of ex- planatory seminars.

Despite the good intentions behind it, the lack of coherent strategy and purpose has diminished its potential usefulness considerably. There is already a welter of top down pressure on health authorities from ill- conceived documentation from ivory towers. In its current form, this Audit Commission report is likely to be filed on the same distant shelf as these, and all its good intentions lost.

Andrew Warren

Association for the Conservation

of Energy

London, UK

Electricity in the house

ELECTRIFYING AMERICA: Social Meanings Of A New Technology

by David E. Nye

MIT Press, Cambridge, MA, USA, 1990, $26.95

Electricity is so commonplace and has been around for so long that - at least in the industrialized countries - we simply take it for granted. We don’t even think about it. The fact that it is always there when we need it, and everywhere we go, makes it a non- issue. And yet, when the infrequent power outage occurs, we are literally thrown back to the Dark Ages. It makes us realize how dependent we are on this most wonderful energy form.

But, David Nye is not like most of us. He has gone back to Muncie, Indiana, USA, in the late-1880s, and through elaborate research, has recon- structed life in a typical American city before and after the introduction of electric power. In small, measured doses, he describes how life must have been like before electric lights, electric stoves, electric irons, washing machines, radios, and all those other things that use electricity to run. And his account of this life is truly electrify-

170

ing. We are reminded, for example, that gas lamps were hot, dangerous, smelly, and burned all the oxygen in the room. And they were not particu- larly well-suited for night time read- ing. How do we know that? Because Muncie public library loaned out eight times more books per inhabitant after the introduction of electric lighting than before!

Impact on everyday life

Although the book is full of interest- ing Tables and statistics, it’s David Nye’s down-to-earth account of the facts and their impact on everyday life in an average American city that is captivating. By the time one gets through the third chapter, one begins to realize that electricity is more than a convenient form of energy - it is a way of life, it has changed how we work, entertain, and live.

The historical context and setting of the book makes it so much more rel- evant to appreciate the dramatic changes that followed the widespred use of electric power. How factory productivity and layout changed, and how rural electrification improved liv- ing standards on the farm. Mixed in with the serious and semi-serious topics comes some interesting and

bizarre accounts of the early-day magic of electricity. Everything from electrical belts (to restore lost sexual powers) to stunning electrical light shows that drew people from afar, to the introduction of the first electric chair in 1888. Here again these fasci- nating anecdotes are told without too much fanfare, as a matter of fact. Nye’s book has something for every- one. The technical types will enjoy all, the historians will wonder, the anthropologists and sociologists will find new perspectives, the novel read- er will learn a few things and better appreciate what life would be like without electricity.

Electricity next to godliness

There is a notable quote from a Ten- nessee farmer, speaking to his neigh- bours at a Sunday church meeting where he says, ‘Brothers and Sisters, I want to tell you this. The greatest thing on earth is to have the love of God in your heart, and the next greatest thing is to have electricity in your house.’

Fereidoon P. Sioshansi

EPRI

Palo Alto, CA, USA

UTILITIES POLICY April 1992