Warnings that the NHS's National Programme for IT [NPfIT] was
too centralised and may founder were issued by Computer Weekly and
some its readers when the scheme was launched in 2002.
Staff at the magazine also warned a minister before the
programme was launched that devolved NHS boards, which make their
own decisions on IT purchases, may reject Whitehall's controlling
hand.
But the government went ahead and launched the NPfIT as the most
centralised govermment IT scheme in the history of public sector
technology-based programmes.
Our concerns about the NPfIT were based mainly on the failure of
a plan in the early 1990s to link hospitals in the Wessex health
region. The "RISP" plan failed largely because it was overly
ambitious and because trust boards disliked having IT imposed on
them by regional officials.
These were some of the articles published in Computer Weekly in
2002, when the NPfIT was launched, and in early 2003, before
central IT contracts were awarded.
Early warnings over the NPfIT - articles in Computer Weekly
April 2002
Don't let suppliers and civil servants grab NHS windfall
"When it comes to IT project management, it is a truth
universally acknowledged that big is bad, and small is beautiful.
With more than one million employees, the NHS is certainly big
meaning the prognosis for any centralised overarching IT project is
likely to be bad.
"The NHS should already know this from past experience. In the
early 1980s Wessex Regional Health Authority had a vision for an
integrated information system covering the entire Wessex Health
Authority region. The ensuing IT disaster proved how difficult it
is to impose integrated IT systems across a region, let alone
nationwide."
April 2002
Money for NHS project could grow tenfold
"To implement change and gain the benefits achievable, it will
be necessary to engage people with the correct skills and give them
a clear vision. Choosing the wrong route may increase the costs,
deliver no apparent benefits and create higher ongoing costs,
ensuring the additional funds for a change programme will never
again be seen as affordable "
April 2002
Central controllers could squander NHS windfall
"The £1bn of extra funding for NHS IT outlined in last week's
budget and the Wanless Report, which could become one of the
largest IT investment programmes ever seen in the public sector,
could be wasted if the Department of Health controls spending
centrally, according to NHS IT experts.
June 2002
NHS plans biggest IT project
"The Government has a poor record on meeting NHS IT targets. In
1998 it promised to connect all computerised GP surgeries to the
NHS Network by 2000 - a deadline that was later abandoned."
July 2002
Opinion - Cash transfusion is not right remedy for NHS IT
"The Government has chosen a course that is likely to make it
worse: sweeping and massively expensive changes to NHS computer
systems. We are told it is "the IT challenge of the decade" and "a
Herculean task".
"Why don't people learn? Why are big IT projects seen as a badge
of virility or a sign that we really mean business? They nearly
always cause trouble: the bigger the change, the bigger the
trouble.
July 2002
NHS managers want change but see risk in centralising IT
"The main problem that the Government faces is how to implement
a strategy so dependent on central control across an organisation
as complex and devolved as the NHS."
August 2002
Where is the business plan for NHS windfall August 2002?
"Some of the big suppliers are concerned about the coherence of
the national strategy and whether it can be delivered within the
timescales set. And the smaller, specialist health suppliers are
suffering as NHS procurement activity has died at the local level
in anticipation of the national programme."
November 2002
Key NHS IT project falls short of Gateway goals
"A health service IT project that was highlighted by the prime
minister at last week's E-summit has run into trouble with the
Government's own Gateway review process, which is designed to
eliminate procurement and project failures."
February 2003
NHS courts £5bn IT disaster by following the Libra route
"The National Health Service is about to embark on its
largest-ever IT investment. About £5bn will be spent over five
years. Senior NHS officials are confident of success, but then so
were civil servants when they planned the Libra project for
magistrates courts, which cost nearly three times more than
expected and has never delivered its core software. Tony Collins
examines whether the NHS is learning from history"
March 2003
NHS IT chief threatens to exclude whistleblowers
"IT suppliers critical of the £2.3bn national IT programme have
been told not to talk to the media
"The head of IT in the NHS has told suppliers they could be
removed from shortlists for contracts and excluded from doing
business with the NHS for 10 years, if they publicly question the
national IT programme.
March 2003
Climate of fear in the NHS
"Suppliers have joined users in speaking confidentially about
the climate of fear in the NHS which stops them openly criticising
the way officials plan to implement a £2.3bn national IT
programme."