Was the NHS IT project scrapping a neatly balanced trick?

Now that the dust has settled following the government’s decision to abandon the NHS National Project for IT in its current form, in favour of a less centralised format, we can reflect.

That is exactly what Robert Morgan, director of outsourcing consultancy Burnt-Oak Partners, has done for us with the concise piece of opinion about what went wrong.

This is Robert’s opinion piece.

“The coalition government has performed a neatly balanced trick in cancelling the NHS National Programme for IT. It artfully appeals to:

•    Common sense by abandoning centralisation nationally – always doomed to be hugely political and divisive even if it could have been implemented, which was always in doubt

•     The individual trusts who have now been handled back decision making so long as decisions support the existing national structure

•    Service providers will have to fight each competitive bid at the various Trusts, but will no doubt make larger margins along the way

•    The Whitehall mandarins who feared the advent of vast compensation claims from the service providers for stopping the programme, had this skilful compromise not been crafted so well (all existing obligations will be honoured)

•    The headlines in the media that another £0.7bn of savings has been found with no staffing loses or other awkward issues being highlighted
 
In one sensible move all critics have been silenced.

Huge potential litigation from another area has also been avoided – that of clinical negligence. Behind the scenes most management knew that “going live” would most likely have failed.

Vital data either not being available or being lost coursing failures of critical medical decision making around treatment, history of symptoms and medication, pre-theatre prep, etc. Systems failure here would have risked lives, reputations and resultant claims running into billions.

This project was recognised as the world largest single IT project, worth close to £13bn over its life-time. As you would expect the project suffered from various expected and unexpected problems.

The government for instance negotiated each of the major contracts separately and failed to standardise terms and conditions, ways of handling disputes, definitions of obligations and commercial remedies. This non-standard approached added hugely to the government oversight of progress and amending procedures.

BT suffered £1.2bn in write-offs; Accenture’s inability to make a profit forced their exit and not for the first time in huge governmental projects, severely hurt their prestige; Fujitsu was dismissed by government and there is still an unanswered claim of £0.7bn in this regard. CSC extended its share of revenues when the others fell – but are they making money overall?
 
The government insistence on using a small software house (iSoft) to play a pivotal role at the heart of the system should and did ring alarm bells. What followed next was more akin to an Ealing Studios farce with both system and scalability failures; financial uncertainty and faltering, followed by rescue and close investigation. Still it worked in the end.

With a dependency on IT like nothing before it, perhaps this government will be less ambitious and consequently achieve far more. Let’s hope so.”

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