The outgoing National Audit Office chief says every wasted £1bn could pay for millions of visits to A&E and ambulance callouts

I still get angry – and that is the word for it, angry – 10 years into the role, when I see badly-thought-through programmes and wasted public money,” says outgoing watchdog chief Sir Amyas Morse. “And the reason I’m angry is because the citizen ends up picking up the tab. They are the ones who end up suffering.”

For almost a decade, as comptroller and auditor general – the head of the National Audit Office – it’s been Morse’s statutory duty to keep an eagle eye on the spending of central government departments, holding ministers and civil servants to account for cost overruns, project mismanagement and profligacy with taxpayers’ money.

We don’t need people jumping out of an aeroplane in the dark with a parachute of taxpayers’ money

He doesn’t have far to look. As he prepares to leave his post in May, Morse’s final public speech at the Institute for Government last week included a damning list of failures: Crossrail costing £2.8bn more than forecast; changes to probation costing £467m to put right; the smart meters fiasco that will cost at least £500m more than originally estimated; and the Ministry of Defence’s latest unaffordable and unsustainable 10-year equipment plan going over budget by at least £7bn. And that’s just a selection from the past few months.

Morse looks back in anger at the billions that could have been spent on vital services, wasted instead through what he calls “inappropriate bravado” on the part of government ministers, lording it over cowed civil servants, behind an increasing amount of secrecy and spin. “We don’t need people jumping out of an aeroplane in the dark with a parachute of taxpayers’ money,” he says.

A proud Scot – his only meeting with Theresa May was a “brief conversation” at a No 10 Burns Night last year – Morse cares passionately about public services. While his upbringing has contributed to his concern for fairness, it’s his decade at the watchdog, to which he came from a senior position in consultancy PricewaterhouseCoopers via the MoD, that has fuelled his rage over the wasteful ways of too many government ministers. “I really realised that society belongs to us. We’re all paying for it.”

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Public money is finite, he points out. There is no magic money tree. When money is lost in one place, it’s taken away from another programme, usually one that’s easier to cut. Every wasted £1bn, he says, is enough to run NHS England for three days, fund 6.25m A&E attendances, 1.35m day cases in hospital, or 4m ambulance attendances.

Morse has warned the government that it needs to invest more in the NHS and social care, to meet the needs of an ageing population. In 2016-17, the UK spent just over £170bn on health and social care – more than 10% of GDP, but less than the 11.2% of GDP Germany spent in 2015 on health alone.

Despite highlighting last year that the size of the task in preparing for Brexit means “points of failure” will be inevitable, Morse says the civil service has done well since article 50 was triggered. “It was an impossible ask, and they’ve tried very hard to meet it.”

Since 2010, ministers have steadily increased their powers within government departments, intent on driving through their own ideas, not always wisely, according to Morse. He sees it as vital to call this out. “Being Mr Tactful won’t change things,” he says. Last year, he famously had a public run-in with the then work and pensions secretary Esther McVey, after she wrongly claimed that the NAO had called for the rollout of universal credit to be accelerated. Morse wrote an open letter to McVey to “clarify the facts” – the first time the watchdog had released personal correspondence with a minister. “Some ministers see themselves more or less as chief executives, but without the qualifications to go with that,” says Morse. The result is a litany of projects that have been overoptimistic (“When I see the words ‘world-beating’, my heart sinks”), with unrealistic timescales. These include universal credit, the Hinkley Point nuclear power station saga, and, of course, Brexit.

Facebook Twitter Pinterest Hinkley Point nuclear power station is one of a litany of projects that Morse says has been unrealistic, with overoptimistic timescales. Photograph: Matt Cardy/Getty Images

Every year, the NAO audits the accounts of around 370 central government departments, agencies and other public bodies. It has 796 staff, only slightly fewer than the 854 it had in 2007, who also publish more than 60 value-for-money inquiries a year, most followed up with investigations by the Commons public accounts committee (PAC). Between them, the two bodies have now published hundreds of damning and scathing reports. But has it made any difference? “I always liken myself to a squawking crow, squawking away, irritating people. If you squawk for long enough, it’s surprisingly effective in changing people’s behaviour,” says Morse. He points to the NHS, finally collaborating more closely with local social services, after a lot of NAO work on how local primary care systems interact.

It’s not just about publishing reports. Morse has also talked to Whitehall departments and MPs. “He has to deal with the Whitehall geopolitics and fight his corner and he’s very good at it,” says Meg Hillier, chair of the PAC. “He’s good on wider issues, which he’s embraced enthusiastically.”

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Hillier and Morse have had a close, smooth working relationship from the start, says Morse, unlike his initial relationship with the previous PAC chair, Margaret Hodge. “We’re now good friends, but initially we fought like cats and dogs,” he says.

Hodge agrees she was “really cross” with Morse at the start of his tenure over a couple of issues where she’d suggested changes to existing audit arrangements – something Morse felt was a threat to his authority and that of the NAO. “We’re both strong-willed and like our own way,” says Hodge. “But we realised we would get much more done if we worked together.” She commends Morse’s bravery in speaking out. Morse says he likes working with strong women: “They’re more fun than strong men. More insightful and more interested in what you’re thinking.”

While the NAO and Morse are seen as successful, some would like to see an expanded remit. “Within the current system, the NAO has consistently been the voice to expose the failings of the current framework and has been doing this over a long cycle now,” says social entrepreneur Hilary Cottam. “The question is how they can use the data and critique to begin to advocate for something new.”

For now, Morse leaves with good advice for all those spending public money: ask people about where they want their money spent and, above all, understand that hard choices have to be made. When big projects go wrong, they suck up money from other services. “By looking over the walls, I can see that.”

Curriculum vitae

Age: 69.

Lives: Suffolk and London.

Family: Married, three children.

Education: Fettes College, Edinburgh; Jesus College, Oxford University, BA English literature; qualified as a Scottish chartered accountant.

Career: 2009-19: comptroller and auditor general and chief executive officer, National Audit Office; 2006-09: defence commercial director, Minstry of Defence; 1998-2006: global managing partner, operations, PricewaterhouseCoopers; global leader of assurance practice, PwC; 1990-98: managing partner, London office, Coopers Deloitte (negotiated the merger of Coopers Deloitte with Price Waterhouse); partner, Deloitte Haskins and Sells (negotiated a local merger with Coopers and Lybrand).

Public life: Chair of board of audit, United Nations; lay trustee and chair of finance and investment committee, Royal College of Surgeons, knighted in 2014.

Interests: Music (opera, chamber music and PJ Harvey); compulsive reader; golf and working out.

This article was updated on 20 March to correct the number of A&E attendances and day care cases that can be funded by £1bn.