DoH deploys flimflam in battle for hearts and minds

The Department of Health dramatically announced a non-story today, pausing from its negotiations with disfavoured ICT suppliers to publicly condemn – again – the computer systems they supplied under the National Programme for IT.

The department announced the “acceleration of the dismantling” of the National Programme. But could not say how it had been accelerated or what exactly was being dismantled.

“The statement today is a commitment to accelerate the process,” said a Department of Health spokeswoman. “We are not giving today the detail of what that will involve.”

The department announced a year ago that it was scrapping the National Programme for IT and has been in negotiations with suppliers ever since.

It is still in negotiations with suppliers and still announcing that it is scrapping the programme. But it cannot accelerate anything until the negotiations are concluded.

Primary programme suppliers BT and CSC have contracts for the supply of patient systems that extend to April 2015 and hold the NHS to paying a further £2.91bn for the scheme, said the National Audit Office in May.

Also over the summer, the Cabinet Office Major Projects Authority sent DoH its recommendations for the future of NHS IT. The DoH spokeswoman said today the MPA had concurred with its year-ago announcement about the scrapping of the National Programme. The year-ago announcement, made by Health minister Simon Burns, had concurred with Cabinet Office IT policy. The DoH today said it was concurring with the MPA recommendations.

The DoH refused to publish the MPA report. It said it was a Cabinet Office report. The Cabinet Office, which is big on government “transparency”, refused to publish the report. It said it was a report about the NHS and therefore the business of the DoH.

The DoH 2010 announcement had unveiled a “Connect-All” strategy. This would involve introducing common systems standards so that any supplier could supply any system to the NHS, simply plug it in and it would integrate and communicate with any other system. This was similar in principle to Cabinet Office policy for government IT.

Coincidentally, a story fell into your humble correspondent’s lap this week that the System One patient system CSC has supplied to GPs and community Trusts under the programme was not compliant with the NHS Data Model and Dictionary. It was therefore not interoperable, and not in keeping with either the terms of its National Programme contract nor the “Connect-All” policies of the DoH and Cabinet Office.

DoH’s negotiations with CSC are the most excruciating of matters that must be “accelerated” before it can get on with “dismantling” the National Programme. Neither party was able to confirm the rumour about CSC’s interoperability.

Also coincidentally today, trade association Intellect, representative of BT and CSC, produced a report on the interoperability of NHS systems. DoH’s non-announcement had included one new detail, which was that it and Intellect were going to conjure up a market for the supply of health computer systems.

The market had of course been asphyxiated by the DoH’s previous collaboration with Intellect members in the National Programme. Intellect today said it aimed to “create a vibrant marketplace” for small health ICT suppliers by its new venture with the department. It attached the interoperability report to its press release.

The department refused to discuss what was really happening: that was its negotiations with suppliers. BT and CSC also refused to discuss the negotiations.

All it and suppliers would say in addition was how much the National Programme had actually bought with the £6.35bn it had spent to date. That amounted to a national network, email and booking systems, and software to archive medical images.

Commentators thus found it hard to grasp exactly what had happened today. The Daily Mail reported: “£12bn NHS computer system is scrapped… and it’s all YOUR money that Labour poured down the drain”.

A hubbub ensued. The DoH was scheduled to make a major announcement about the programme later today. Word was, it was going to be scrapped.

David Rose, assistant news editor of The Times newspaper, got closer to the truth, or at least expressed a view that has echoed around the corridors of National Programme suppliers today: “Lansley bashes Labour ahead of that party’s conference?,” he tweeted this morning.

Health Secretary Andrew Lansley had coincidentally been doing the rounds with a complaint about the financing deals the last Labour government had used to build hospitals. The deals had many years to run. They were expensive. They didn’t fit with the coalition government’s aim to dismantle the NHS…

Lansley didn’t really say he planned to dismantle the NHS. His department presumably only wanted to dismantle the National Programme, and hospitals, and any residual reason anyone might have to suppress their cynicism in face of such flimflam.


BT said in a statement it was not renegotiating its NHS National Programme contracts with Department of Health. It was nevertheless in talks of one form or another about the future of its relationship with DoH.

That was relayed in media-speak: BT “continues to work with the Department to explore how best to meet the needs of the modern NHS”.

That includes also the contract BT has to supply care records systems to acute trusts in London at a price nearly 50 per cent over prices expected even in the £multi-billion National Programme.

Shortly after the publication of this article, the Cabinet Office published its Major Projects Authority review of the National Programme. It has not published other reviews and has been unable to say whether its policy is now to publish its reviews or not.

The BT London contract had anyway been so poorly managed, said the MPA Review, it had a “crisis” that almost resulted in termination. All has been well, apparently, since about January.

That raises further doubts about the department’s claim to have “accelerated the dismantling” of the Programme.