Tony Collins's IT Projects Blog

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Kevin Barron, the chairman of the House of Commons' Health Committee, gave a sympathetic hearing last week to Richard Granger, head of the NHS's £12.4bn National Programme for IT [NPfIT].

Barron's fireside friendliness towards Granger was a contrast to a hearing on 26 June 2006 when the House of Commons' Public Accounts Committee investigated the NPfIT.

The NHS Confederation, which represents more than 90% of statutory health service organisations, has expressed concerns to the House of Commons' Health Committee about aspects of the National Programme for IT [NPfIT] in the NHS.

In a paper to the committee, which is investigating aspects of the NPfIT, the NHS Confederation said that organisations continue to be "fully committed to the overall vision" of a Care Records Service" which aims to give 50 million people in England an electronic health record.

But it said that "delays in the delivery of key operational systems which feed the NHS Care Records Service, such as patient administration systems, are "causing real problems and costs within the service".

One highpoint of the first hearing of the Health Committee's inquiry into the National Programme for IT [NPfIT] on 26 April 2007 was an exchange between Martyn Thomas, who has called for an independent review of the scheme, and the committee chairman, Labour MP Kevin Barron.

Thomas made a good case for a review of the NPfIT and Barron appeared to remain sceptical throughout. Barron had not particularly welcomed his committee's deciding to hold an inquiry into the NPfIT.

Richard Granger, head of the NHS's National Programme for IT [NPfIT], when asked whether he supported the call for an independent review of the scheme, had made it clear that his door was open to critics whose comments were based on robust evidence.

But Martyn Thomas, visiting professor of software engineering at Oxford University's computing laboratory, emphasised the need for a review that was independent of the programme team

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing, Independent MP, Dr Richard Taylor, summed up the spoken evidence of the first group of witnesses, Richard Granger, Harry Cayton and Dr Gillian Braunold, as "bland platitudes".

These three witnesses had left the committee room after giving their evidence, without waiting to hear what the second group of witnesses - Martyn Thomas, Dr Paul Cundy and Andrew Hawker - had to say.

Speaking to Thomas, Cundy and Hawker, Dr Taylor, MP, said: "I am echoing David [David Amess, Tory MP on the committee]. It is so good to have you three after the bland platitudes we had from the first lot - absolutely refreshing. We were told user involvement was there from the beginning, and you said obviously it was not..."

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Martyn Thomas said: "One of the things that concerns me about the programme is that there is no definition of what is an acceptable level of security breach.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Dr Paul Cundy was asked by David Amess MP: "Dr Cundy, is it a good thing that general practitioners will be offered a choice of suppliers for their electronic record system and does the decision to offer choice represent a change of direction by Connecting for Health and will it mean a less centralising approach to these issues?

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Dr Paul Cundy said: "I know from my system in my practice is that there are times when I, quite frankly, do not have an immediate clue as to what is going on with a patient, and we have 20 years' worth of patient electronic records.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Richard Granger said: "...I would say with the time overruns that one of the problems with this programme is there was no financial contingency.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Martyn Thomas said: "One of my concerns about the way the programme is going is that it is in danger of locking itself out of the advances that will be made in the availability of healthcare systems around the world.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing Martyn Thomas said:

"It seems to me that there are two issues that are being run together here. The overall objectives of the system seem to be trying to tackle two problems in parallel and those two issues are perhaps in conflict.

"On the one hand, there is the question of putting in good IT to support the clinicians supporting the patients, and I think everybody in the NHS is entirely behind that. Where IT can improve healthcare, it is sensible to deploy it once you are in a position to be able to be able to roll it out without disturbing things too much.

There is also the issue of transforming the way that the Health Service operates and the way that the Health Service is managed and the need for information to be available in order to be able to change the management structures.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the first Health Committee hearing MP Jim Dowd asked Richard Granger: "When you say it [the NPfIT] has got more functionality than originally envisaged, is that because the original estimates were just wrong?"

Richard Granger replied: "I do not know of a large-scale IT enabled transformation programme in a complex organisation that from its starting point to its mid point has a direct correlation.

"I think it would be a fantasy to imagine. I know people write fantasies, but in the real world it would be ridiculous to imagine that halfway through a ten-year programme you would only be doing the same things as you set out five years ago.

This is one of a series on this blog of some of more memorable comments made by witnesses and MPs at an inquiry into the National Programme for IT [NPfIT] by the Health Committee of the House of Commons.

The witnesses at the first hearing on 26 April 2007 were:

- Richard Granger, Director General of IT for the NHS and head of the NPfIT
- Harry Cayton, National Director for Patients and the Public, Department of Health
- Dr Gillian Braunold, a GP and National Clinical Lead for GPs, Connecting for Health.
- Martyn Thomas, visiting Professor of Software Engineering, University of Oxford,
- Dr Paul Cundy, Chair, General Practitioners' Joint IT Committee
- Andrew Hawker, NHS Patient

A list of who is on the committee is at the end of this article.

At the Health Committee hearing the chairman Kevin Barron asked Martyn Thomas why he was calling for an independent review of the NPfIT. Barron's view appeared to be that the facts independent reviewers would discover would already be known to the project team. So why have an independent review? In reply Thomas gave a sound summary of the benefits of an independent review over one commissioned internally.

Barron asked: "Do you think that people who are involved in the National IT Programme at the moment are aware and conscious of those facts, whether reviews have been published or not in terms of that? Do you think they are not capable of knowing that as something in their daily business, as it were? The programme is not without its problems. Are these people who are developing it not capable of being able to do that?"

Thomas replied: "I have reviewed a lot of large technical programmes over the years, and I want to stress, I am not asking to review this one personally, I am not for a second bidding for that job, but my experience of carrying out those reviews is that people get blinded by the fact that they are too close to the project and they get compromised by the fact that they cannot stand back and admit errors.

Below is an article posted today on Computer Weekly's website about an MP's criticism of a "weak" report by the Health Committee on the electronic patient record, which is part of the NHS's National Programme for IT. A blog comment on the committee's report will be posted later.

Comment and summary of highlights of a report on the Electronic Patient Record by the Health Committee of the House of Commons

Comment

As predicted, the Labour-dominated Health Committee of the House of Commons has avoided calling for an independent review of the NHS's National Programme for IT [NPfIT] but its report makes a series of compelling arguments for one.

As there are two new blog entries on the summary care record - part of the NHS's National Programme for IT - I've provided (below) further context by publishing the findings of MPs on the Labour-dominated Health Committee.