The loss of leaders on the world's biggest civil IT
programme is beginning to make a mockery of the phrase "public
sector accountability".
Lord Hunt, a pioneer of £2.3bn national programme for IT in the
NHS, was the first to go. Then another of its pioneers John
Pattison, announced he was retiring.
Pattison was the programme's senior responsible owner - a role
created, in the main, to ensure that the same person sees a complex
plan through from conception to the delivery of benefits.
Now one of his successors as senior responsible owner is to go.
Aidan Halligan shares the title with Richard Granger, director
general of IT in the NHS.
Halligan's job has been one of the most challenging in the national
programme: to gain the buy-in of clinicians. So where does his
untimely departure leave the whole strategy?
Medical staff and technologists support the aims of the programme
now as ever. They want standardisation. They want antiquated
technology to be replaced. They want centralised electronic health
records. They give their full support to the charismatic
Granger.
But the programme has reached a low point. Trusts are beset by
uncertainty. Wirral, on which we report this week, is not the only
health community which is forging ahead with a successful local
health strategy.
GPs have voted not to engage with the programme until their
concerns are addressed; and trust IT directors wonder where they
will find the money to implement national systems, fund training
and manage changes. The British Computer Society has warned that
costs may be escalating.
Meanwhile, health officials continue to talk about the programme as
if it has not a hair out of place.
Good leaders need opponents. Unquestioning supporters may push a
project into disaster. Opponents show where the dangers are. If the
national programme is to be saved, and hearts and minds won over,
its leaders must be more open.
The programme is huge. Much will go wrong - inevitably. Officials
should talk openly about these difficulties. They should not simply
announce that the national programme has gone live. They should say
where, what the issues are, how they are being overcome, and what
lessons can be disseminated.
US president Theodore Roosevelt once described the difference
between a leader and a boss. "The leader works in the open, and the
boss in covert." If the national programme is to come through its
credibility crisis, it needs now, more than ever, leaders to live
up to Roosevelt's ideal.