Tony Collins's IT Projects Blog

In response to the article on this blog about "eight generalisations" - some common factors in IT-related failures in the public sector - an evidently well-informed reader writes:

"All valid points. But having helped structure, close and finance a number of Private Finance Initiative//Public Private Partnership backed IT deals I think the key failing is in fact that old favourite: scope creep.

"Consider Inland Revenue sorry HM Revenue & Customs, forced to outsource core IT support under a 10 year fixed price pay for output contract. Of course the Chancellor can't be clear on scope as (s)he reserves the right to change the fundamental tax law every year (eg working tax credit introduction) and requires this be implemented with x months notice.

"Would BP say or GSK ever try a fundamental global restructuring of their business every year for a decade and not expect that (a) staff would become "change survivors" rather than enablers or (b) infrastructure costs might rise?

Bill Thompson who chaired a New Statesman debate on IT and modernisation, said at the end:

"I would like to thank all of you. When Freud was talking about the purpose of analysis, one of the things he said was, "It is to turn life-threatening depression into mere unhappiness". I would like to think that we have done a bit of that in our discussion today."

NHS Connecting for Health, which is an agency of the Department of Health, has asked for an external report on the NHS's £12.4bn National Programme for IT [NPfIT] not to be published. The report includes far-reaching criticisms of the programme.

New Zealand electronic health records developer I-Health is suing iSoft - the main software supplier to the NHS's £12.4bn National Programme for IT [NPfIT].

Comment:

Some NHS trust board executives have a policy of openness when it comes to the commercial, technical, financial and managerial aspects of the National Programme for IT [NPfIT].

And Homerton Foundation Trust in Hackney used to be open about its work on the Cerner Millennium patient record system.

But it has become more secretive after Whitehall officials took a decision to install NPfIT systems throughout Southern England, based on Homerton's system.

A spokeswoman for Homerton said that references to Cerner in its board minutes are now part of "reserved business". This means that the board now publishes nothing about its dealings with Cerner.

A senior executive at a large IT company has given an insight into the things suppliers say to ministers when selling big technology-based schemes to the public sector. Their highly effective arguments have changed little over the decades: the public sector must be adventurous to be world-beating; and that it should be as easy to transact with a government department as it is to buy an airline ticket.

Two things are lost in these arguments: why it is necessary for the UK's public sector to try to be world-beating, whatever "world-beating" means, and there are big differences in public and private IT-based projects.

Private companies have control over their budgets, their workforces and over complexity: they have the power to simplify business processes before or during IT-based modernisation. And they understand that a shortage of the right managerial skills should stop at conception an overly ambitious scheme.

Also private companies do not have to contend with ever changing legislation and ministerial targets that keep specifications fluid. Most importantly they have a very limited capacity for pouring good money after bad.

David, a reader, makes this strong point on the blog entry: why governments are persuaded to invest in big high-risk projects - one theory.

"There is one other major difference between private projects and government projects. When a company screws up, it risks losing business. When a government screws up, citizens don't have a choice to go elsewhere (or at least, most don't). It's not like farmers can say to the rural payments agency "We're taking our business elsewhere".

"Voting is the closest thing to customer feedback, but effective management of IT projects is not on the average voter's agenda. Perhaps that's because they believe that government IT projects inevitably fail, or because they don't see how vital IT is to positive and effective change within the public sector."

A reader Stuart Roebuck makes the following important point on the blog entry: why governments are persuaded to invest in big high-risk projects - one theory

"One problem with the way government tends to do IT projects is the approach of trying to fix everything in one go, rather than a little at a time. It's the old waterfall development mentality that says that changes later in a project become prohibitively expensive, so everything has to be designed up front and at the very end you hand it over to the customer.

"The volatility of public sector policy demands that any realistic approach has to be one that acknowledges the need to change, and the need to be able to change at any time and at minimum cost. It's the whole 'lean manufacturing' issue for software... agile development and all that. Involve the customer throughout: deploy early and deploy often.

"One problem with long term agile development of course, is how you fit that into the current public sector procurement models."

This latest announcement from the Department of Health starts in the way statements from the department too often begin: with politically partsian hyperbole. But those with the perseverance to read on may be surprised to see that officials are announcing a potentially useful service.

The announcement is headlined: Launch of a new flagship super website NHS Choices

This is a letter signed by 79 doctors, nurses and secretaries at Milton Keynes General Hospital regarding the implementation of a Care Records Service under the NHS's National Programme for IT [NPfIT].

Comment:

There's something extraordinary about the IT-related difficulties at Milton Keynes General Hospital.

NHS Connecting for Health, which runs the £12.4bn National Programme for IT [NPfIT], is at times putting on its website replies to our questions before we have published articles related to the questions.

The replies contain some useful facts but they have no context, because Connecting for Health publishes its answers without publishing our questions.

Rather than pull the plug on a failing IT project the US National Security Agency tried for six years to save its "Trailblazer" scheme.

It transferred management responsibility to different teams whose members tweaked the design and made it more complicated. It was passed around among agency and contract personnel until, $1.2 billion later, it still didn't work.

An article on The Register's website highlights some of the dangers of government secrecy. It is here.

It says that government secrecy over deals with the private sector can be "self-defeating, and creates a culture of laxity where officials can make mistakes or abuse their power with impunity".

After a nine-month investigation the Public Accounts Committee is expected to publish a hard-hitting report on the NHS's National Programme for IT [NPfIT] tomorrow [17 April].

Parliamentary convention is that the government gives a written response to reports of the committee within two months. But the government may regard the programme as too politically sensitive to let a report of the Public Accounts Committee stand without an immediate comment.

So we would expect a response from the government that firmly establishes it in denial mode.

Behind the scenes experts at the National Audit Office have played a key role in helping to produce the report of the Public Accounts Committee on the National Programme for IT [NPfIT]

Five years into the NHS's National Programme for IT [NPfIT] a report of the House of Commons' Public Accounts Committee has depicted the scheme as a failure so far.

It's not generally realised that the National Audit Office quietly drafts press releases issued by the chairman of the Public Accounts Committee.

So it's worth looking carefully at the wording of the press release issued by Edward Leigh, chairman of the Public Accounts Committee, over the publication of the committee's report today [17 April 2007] on the NHS's National Programme for IT [NPfIT].

A nine-month investigation of the NHS's IT programme by an all-party committee of MPs has found that the £12.4bn scheme, the UK's largest IT investment, may fail to deliver what is required by the health service.

The Public Accounts Committee says in a report published today [17 April 2007] that the programme has lost three key suppliers, is running late and is having difficulties meeting its objectives - which it says "raises doubts over whether the contracts will deliver what is required".

Richard Bacon MP said today (Tuesday 17 April 2007) that the health service would be better off without Connecting for Health, the Department of Health agency responsible running the national programme for IT in the NHS.

Health Minister Lord Hunt said: ``This Public Accounts Committee Report is based on a NAO (National Audit Office) report that is now a year out of date.

Below is our comment on a statement issued by Health Minister Lord Hunt in response to a report of the Public Accounts Committee on the NHS's £12.4bn National Programme for IT [NPfIT].

Report of the Public Accounts Committee on the NHS's National Programme for IT is here

During an interview with Penny Smith on GMTV's News Hour, the Computer Weekly reporter pointed out that the health minister, Lord Hunt, had made a misleading statement when he criticised a report of the Public Accounts Committee on the NHS's National Programme for IT [NPfIT].

There is widespread coverage in national newspapers of the report of the Public Accounts Committee on the NHS's National Programme for IT [NPfIT].

On the front page of The Daily Telegraph the headline is "Patients 'will not benefit from £12bn IT project". A longer piece inside the paper by Richard Bacon MP, a member of the Public Accounts Committee, is written using a light touch. Bacon says:

"If Connecting for Health [which runs the NPfIT] had been created by one of this country's enemies with the specific task of wasting as much money as possible while causing maximum anger and resentment among doctors, nurses and hospital managers, it could hardly have done a better job. Having been given responsibility for the largest sum of money ever allocated to a health IT programme anywhere in the world, at least £12.4 billion, which incidentally dwarfs the entire NHS deficit, it has failed to deliver."

This is one of the comments in the Daily Telegraph sparked by Bacon's article:

Jean Roberts, head of the Policy Group, Health Informatics Forum of the British Computer Society, says:

"It is interesting to read the Public Accounts Committee report - Department of Health: The National Programme for IT in the NHS - and hear some of the "Radical Steps" and "Way Forward" recommendations being re-confirmed. We look forward to being involved in progressing the high impact and useful parts of the National Programme for IT in a climate of transparency, appropriate resourcing and locally valued business change."

My comment: the phrases "climate of transparency", "appropriate resourcing" and "locally valued business change" sound at first like bland business terms but for the Department of Health they each represent a demanding task.

It could be said that a climate of transparency is something everyone in Whitehall talks about and nobody really wants; and appropriate resourcing is something the Treasury supposes it gives and everyone in the public sector is still waiting for.

Terry Walton, retired head of IT at an acute hospital trust, writes to us about the NHS's National Programme for IT [NPfIT].

"Back in November, we were told that the National Programme would reach 120 installations of patient administration systems by the end of March 2007 [more delays likely in PAS rollout]

"Has anyone bothered to check this out? Did they mean Acute Trusts? How many Acute Trusts now have a working National Programme for IT Patient Administration System, excluding Queen Mary's Sidcup who have to take theirs out and replace it with Cerner, which Milton Keynes don't appear to like very much.

"How much money has been given to the Local Service Providers in total to date? How much of this money is actually paying for working systems and what has the rest been for? How much has the NPfIT organisation itself consumed in salaries for the oh so clever people who have managed to deliver what they have over the last four years, and on legal fees for solicitors creating contracts and new negotations on aspects of the same to reschedule the deliverables?

"Does anyone care any more?"

Below are the results of an investigation by the National Audit Office into the troubled go-live of a Care Records Service at Nuffield Orthopaedic Centre. The Care Records Service is the main part of the NHS National Programme for IT [NPfIT]. The Nuffield Orthopaedic Centre in Oxford was, in Decemb