Richard Granger, head of the national programme for IT
in the NHS, has sought to allay fears among health service trust
executives over the local costs of implementing national
systems.
Speaking after Computer Weekly revealed last week that the total
implementation costs for NPfIT systems could be between £18.6bn and
£31bn, Granger said the money would be available to fully fund the
initiative.
He also acknowledged that the health service would spend a total of
£35bn to £40bn on IT over 10 years. The statements were made in an
interview for BBC Radio 4's File on Four investigative series. A
40-minute programme about the NPfIT, on which Computer Weekly has
collaborated, is due to be broadcast tonight (19 October) at
8pm.
Despite Granger's assurances, NHS trusts around the country are
struggling to find the resources needed to implement the
NPfIT.
One trust board, King's Lynn and Wisbech, has warned its Strategic
Health Authority that "local funding to support the NPfIT creates
considerable cost pressure on an already financially stretched
local health system".
Terry Walton, head of IT at Lewisham Hospital in South London,
said he was not entirely reassured. "I have yet to see evidence
that the extra money necessary will appear in trust budgets,
specified for the use of IT."
However, Granger said, "The programme is fully funded. If you look
to the Wanless Report [which laid the ground for the NPfIT], you
will see a target of 3.5% to 4% of total NHS budget to be spent on
making the right information available to run the NHS and serve
patients, and we will sit well within that envelope."
He then acknowledged that the NHS could spend £35bn to £40bn over
10 years on all its IT requirements, both the clinical systems
being delivered by the national programme and other systems.
Asked where all the money was going to come from, he replied, "That
money is already in budgets and fully-fundedÉ [The NHS] has a 10%
year-on-year increase in funding to accommodate activities such as
this and that is all set out in the NHS plan and the Wanless
ReportÉ The money is there, this is fully funded and we are on
budget."
His statements appear to address doubts that arose after health
minister John Hutton said that local costs of implementing the
national programme would be met from the existing NHS IT budget of
£1bn a year.
Subsequent statements by the Department of Health and Nigel Crisp,
chief executive of the NHS, made plain that Whitehall was planning
to spend up to 4% of the total NHS budget on IT. This would more
than double its current general spend on IT.
The department said, "Any suggestion that vast unforeseen
expenditure has been incurred, or that patient services will be
robbed to meet this is nonsense."
Crisp said the current spend of about £1bn a year on IT systems,
together with sums from annual allocations, will be "redirected to
support the new systems".
But though Granger gave a firm assurance the national programme
is fully funded, Crisp and the Department of Heath spoke of large
increases in spending on the NHS and IT in particular but stopped
short of giving a clear assurance to trust boards that there will
be enough money to implement national systems locally. This has
left trust IT executives continuing to question if and when the
anticipated extra money from the Department of Health will
materialise.
Walton said he has been seeking clarity over funding for local
implementations and ongoing support for more than a year. "I do not
think there have been any adequate answers on this," he said. "My
view is that communications over the programme have not been
adequate with people out here." MPs are also seeking answers.
Richard Bacon, a member of the Commons Public Accounts Committee,
has asked health secretary John Reid for clarification of the
NPfIT’s costs. "I would also like to know how much trusts are
expected to contribute to the cost and how they are going to get
the money. Many are deeply overstretched and have endemic financial
crises," he said. Liberal Democrat shadow chancellor Vincent Cable
plans to ask the Department of Health to publish the business case
for the NPfIT.
James Drewer, healthcare programme manager at suppliers’ body
Intellect, said he and his members fully support the national
programme.
"However, we urge the Department of Health to take steps to
clarify the details of the funding arrangements as quickly as
possible," said Drewer. "Without such clarification it will remain
unclear to what extent the NHS trusts will financially contribute
towards the programme and crucially what resources they will have
left after any such commitment to concentrate on IT projects that
fall outside the NPfIT."
NHS finance directors want answers
The NHS Confederation, which represents senior executives of
health service organisations, has expressed concern about the lack
of clarity over the costs of implementing the national programme
for IT in the NHS.
Gary Fereday, policy manager at the Confederation, said, "The
aspiration is that expenditure will be largely covered by savings
made from the scheme and an increase in the IT budget. As yet,
however, there are no clear figures for the costs facing NHS
organisations and finance directors, as the people responsible for
making the budgets balance, are concerned at this
uncertainty.
"This is not the same as saying that costs are escalating, or
that the national programme is not delivering, but simply shows
that finance directors are being rightly cautious about how they
spend public money."
Health minister adds to uncertainty over implementation costs of
the NHS IT plan
John Hutton: "We think it is goin to cost the same"
Trusts highlight local challenge of IT plan