DH "truth" over NPfIT costs

Smarthealthcare reports that an “argument has broken out over the TaxPayers’ Alliance claim that the NHS National Programme for IT has greatly exceeded its budget”.

The Alliance said that the NPfIT’s original cost was £2.3bn and that the latest estimate is £12.7bn.

The Department of Health responded by saying that the figures were not comparable. “The original estimated cost quoted by the TaxPayers’ Alliance was the amount for the first three years. It was the original allocation in the Comprehensive Spending Review of 2002,” said a DH spokesperson.

The DH added that the higher cost, quoted by the National Audit Office in 2007, is for the whole project through to 2014-15. “So it’s comparing apples with pears,” said the spokesperson.

The DH is being disingenuous however.

The NPfIT, as discussed at Downing Street in February 2002, at a seminar chaired by the then PM Tony Blair, was for a three year project.

Three years in total.

This was made clear in a speech by Sir John Pattison, the NPfIT’s first senior responsible owner who gave a very short presentation on the programme atthe Downing Street seminar. About a month later, at HealthcareComputing 2002, Pattison spoke about what had happened at the DowningStreet seminar:

“The core commitments from now willbe around those four key elements [e-health record, national broadband,e-prescriptions and appoint booking system].

“We have givenour colleagues on the other side of Whitehall [Downing Street] thevision and our proposals have been well received.

“There wasonly one question which I thought was rather tricky and that was ‘howlong will this take?’ I swallowed hard because I knew I had to get theanswer right for the purposes of the audience in which I was standing,and I said three years. The answer was that is too long; how about twoyears? But in the end we got two years and nine months, starting fromApril 2003.”

So the DH’s argument that the £2.3bn allocated to the NPfIT was for an initial three years is misleading. 

Even if one accepts the Department ofHealth’s argument that £2.3bn was only ever the initial cost of theNPfIT, how does the Department reconcile its confidential estimate in2002 of the whole-life project costs of the NPfIT at £5bn with today’s£12.7bn estimate?

This was the confidential Project Profile Model estimate in 2002:

Project-Profile-Model-page-1 smaller.jpg

It says: “Total [whole life] Project Costs:  £5bn.”

Sometime after the Downing Street meeting – we don’t know when or how – thethree-year NPfIT became a 10-year programme; and at some point £2.3bnturned into £6.2bn. Much later the NAO put the total cost at £12.7bnwhich includes an estimate for local costs.
DH misinformation has dogged the NPfIT and made people more cynical about government and politics.  More’s the pity.


ZDNet has a good account of the differences between the Department of Health and the Taxpayers’ Alliance over the NPfIT costs.


Inits response to the Taxpayers’ Alliance, NHS Connecting for Health saysthat it has underspent against schedule, because suppliers are paidonly when they deliver.

This is a fair point (althoughsuppliers do receive advance payments).  What CfH has never made clearis that the total spend on the NPfIT is likely by the middle of next yearto be about £5bn – the total original whole-life costs of theprogramme, as estimated in the Project Profile Model (above). Yet theprogramme, by the end of next year, will be at least five years awayfrom completion.  


Response of NHS Connecting for Health to Taxpayers’ Alliance – NHS CfH website

Proof that £13bn NPfIT was supposed to cost £5bn – IT Projects blog

NPfIT neither triumph nor disaster – Smarthealthcare gets answers to questions it put to the BCS Health Informatics Forum head Matthew Swindells

Taxpayers’ Alliance criticises £10bn NPfIT overspend – Taxpayers’ Alliance

Interview with Gary Cohen of iSoft about Lorenzo