Derek Wanless, a founding father of the world's largest
civil IT-based programme,the NHS Programme for IT, has
questioned whether it should continue without an audit of finances,
benefits. and technical aspects of the programme.
In a report published yesterday, Wanless called for NHS
Connecting for Health to be "subject to detailed external scrutiny
- and reporting".
"There is a need for an audit of the technical aspects of the
Connecting for Health programme and the financial costs and
benefits before deciding whether or not to continue with the
implementation of current plans.
"Unless there is greater clarity about the costs and benefits of
the programme, it will be difficult to make assessments of the
long-term costs and investment needs of the NHS.
"It is recommended that Connecting for Health is subject to
detailed external scrutiny and reporting so that forecasting of
long-term costs and benefits can be made with more confidence,"
said Wanless.
But the findings of the latest Wanless report conflict directly
with the government's repeated announcements that it has no
intention of commissioning an external published review of the
NPfIT.
And the government rejected a recommendation of the all-party
Public Accounts Committee in April 2007 that there should be an
independent review of the business case for the NPfIT in the light
of progress and experience to date.
Wanless criticised the government's "apparent reluctance to
audit and evaluate the programme".
He said that NHS Connecting for Health "has so far made
negligible investments of less than £500,000 in evaluation, a
fraction of the projected £12.4bn costs".
Wanless also covered the point made in Computer Weekly's
campaign that those running the programme cannot be credited with a
success or held to account for a failure because the programme has
no end date and so does not reach a point at which its outcome can
be judged.
"There seems a real risk that the costs and benefits of NPfIT
will never be accurately assessed," Wanless said.
The report found that the NHS is now in better shape than in
2002 to deliver improved quality and increased productivity, but
"huge challenges" remain.
"It is difficult to understand why Connecting for Health is
being allowed to pursue a high-cost, high-risk strategy that cannot
be supported by a business case," Wanless said.
He also said that the
national programme may create monopolies of suppliers.
"Connecting for Health chose to award a small number of large
contracts to consortia charged with designing and implementing the
technologies. But they could instead have set out to create a
competitive market for IT goods and services. Is it possible that a
robust business case could be created, even now, with a focus on
strategies for encouraging a healthy market?"
The Wanless report will give add much extra credibillity to the
campaign for an independent review. Its contents will be drawn to
the attention of MPs when Parliament returns this Autumn.
Backstory
Representatives of Derek Wanless, former Group Chief Executive
of Natwest bank, had attended a seminar at 10 Downing Street in
February 2002, chaired by Tony Blair, which led to the NHS's
National Programme for IT [NPfIT], the UK's largest technology
investment.
A report by Wanless in 2002 has been cited by NHS Connecting
for Health, which runs large parts of the NPfIT, as a document that
lay behind the drawing up of 21st Century IT - the strategy paper
which launched the national programme. The Wanless report had
called for a large increase in spending on IT to support
improvements in productivity, self-help for patients and NHS
treatment.
Now Wanless, five years on, has published a report on how the
NHS has spent extra billions of pounds allotted to IT and other
parts of the health service. Embarking on the report's research he
had said, "We want to get the facts on the table."
He had also said he wanted his report to take political points
scoring out of the NHS.
The new report makes points that mirror those made by 23 leading
academics and by Computer Weekly in its campaign for an independent
review of the NPfIT.