Opinion

NHS needs transparency

The Department of Health’s rewriting of the past threatens future NHS IT investment.

Two weeks ago, Computer Weekly reported problems with Snomed, an NHS project intended to introduce a standardised medical coding system. The Department of Health chose to defend itself by attacking the factual detail of our story, even though this was drawn from a recent report from the NHS Information Authority.

If the department’s response was disappointing, it was not unexpected. It has always been quick to resort to denial. Typing the keywords “NHS” and “cover-up” into the Reuters online news archive search yields more than 600 articles from the past 10 years: a telling, if unscientific, illustration of the culture of secrecy and non-accountability that prevails at the Department of Health.
It is time for this culture to be banished.

The NHS is embarking on the biggest IT investment programme – £2.3bn of extra money over the next three years – ever seen in the UK. Clearly, the success of this programme will depend on the involvement of doctors and the efforts of the suppliers that will work with the health service. But the NHS has a credibility gap to bridge before it can expect their full support.

How can the supplier community be expected to trust health department mandarins? Over the past decade, the department has repeatedly dented its own credibility by insisting that projects such as Read Codes 3 and the Hospital Information Support Systems were success stories, when they patently were not. Now it is denigrating existing IT systems and starting a fresh national programme of reform. This is an implicit admission that it has been less than transparent in the past. The department’s Orwellian rewriting of history calls to mind Winston Smith’s best efforts at the Ministry of Plenty.

Suppliers tendering for health service business must take part in a costly bidding process, and factor in the subsequent outlay of incorporating Snomed into its systems. But where is the incentive to action this spend, when there is no guarantee that the NHS will not decide to drop Snomed at some point in the future, as it did with Read Codes 3? Any supplier eyeing the NHS’ £2.3bn windfall must worry that by pitching for business it could end up associating itself with a costly and high-profile failure.

The answer is simple. The Department of Health must be open and honest. It needs to take criticism and failure on the chin. And it needs to start listening to the suppliers; to its end-users in hospitals, clinics and surgeries across the UK; and to Computer Weekly, which will continue to expose the bad practice in NHS IT, and champion the good. Only through transparency and dialogue, will the NHS achieve true progress.

We launched our NHS IT Watch campaign not because we relish the rich pickings the NHS affords for sensational scoops, but because we sincerely want to see – and hasten – profound reform in our health service. In other words, we are in the business not of blame but of accountability. The NHS would do well to follow our lead.

 

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This was first published in February 2003

 

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