IT expenditure can be broadly split into four types: salaries, depreciation, maintenance and projects. In many organisations most of the first three of these are required to maintain the status quo.
Doubling expenditure on IT in the NHS could mean further investment in infrastructure and people, with no particular re-engineering of the systems and processes. Such expenditure may stay at higher levels in the future with no apparent improvements in service to NHS patients.
Unfortunately, it may be tempting to invest further in an existing infrastructure rather than to embark on a programme of change.
Alternatively, doubling expenditure could mean a change programme for improving service delivery. Project expenditure in many organisations is between 10% and 15% of the overall IT cost. Therefore, an increase in expenditure could translate into a sevenfold to tenfold increase in the funds available for change projects, which creates an opportunity to re-engineer how the NHS uses IT.
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.
We should expect a more efficient NHS and not an increasingly costly one. My advice to the Government is get it right or don't do it - you won't get a second chance.
Owen Williams is head of IT at Knight Frank
This was first published in April 2002