The chief executive of the NHS, David Nicholson, says he is
exploring ways of giving NHS organisations more power and choice
over their IT decisions, while keeping the potential benefits of
the
National Programme for IT (NPfIT).
Nicholson, the overall senior responsible for the £12.7bn NPfIT,
was answering questions from MPs yesterday over articles in The
Times on government IT and the NPfIT in particular. The articles
were the result of a joint investigation by The Times and Computer
Weekly.
At a hearing of the Public Accounts Committee, Conservative MP
Richard Bacon asked Nicholson if he would be happy for hospital
trusts to have more choice and autonomy in their buying decisions,
though if that happened the main IT suppliers, BT and CSC, could
walk away from the National Programme.
Nicholson's reply made it clear he wanted to give more choice to
hospitals but keep the contracts with NPfIT local service providers
and other suppliers because there would be benefits of £4.5bn to
the taxpayer - though only if the contracts "all work".
He said: "I have made no secret of the fact that the National
Programme for IT, in the way it was set up originally, did not take
into account the development of the NHS as a whole [such as] the
reform programme, the decentralisation, the setting up of
foundation trusts, all of that sort of thing.
"The idea that you could by attrition drive a national programme
into an NHS that was unwilling to accept it simply is not
deliverable. So we have been looking at ways in which we can
decentralize and give more power to the NHS, so we get much more of
a pull to the system, rather than just push
"That is why we set up NLOP [NPfIT local ownership programme],
which shifts more responsibility for the first instance to
strategic health authorities, and I want to explore ways in which
we can give individual organisations more power and choice - but
the issue is for us is that we know that, because of the
contractual arrangements we have agreed, across the country as a
whole, there are benefits if they all work of about £4.5bn to the
taxpayer."
Bacon questioned the assumptions on which the £4.5bn estimate of
potential savings was based - a point Nicholson did not answer.
He said that if hospitals urgently need a replacement system
while they wait for the
NPfIT Lorenzo product, and they decide to buy interim
technology for two to three years, and then install Lorenzo when it
becomes available, there should be no additional cost to the NHS.
But if trusts buy their own choice of system and reject Lorenzo the
system's supplier CSC may be compensated - what Nicholson called a
"cost to the NHS".
The compensation would be because the Department of Health has
given Lorenzo's supplier CSC a contractual commitment that trusts
will install the system.
Nicholson conceded that "some organisations have got computer
systems which really do need replacing - desperately need replacing
- and in some circumstances hospitals are making a judgement about
taking an interim solution".
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