FT article on the NHS IT scheme - what has gone wrong

From a good overview article on the NPfIT in today’s Financial Times:

“So what went wrong? Too much ambition, too much speed, too much centralisation, too little local ownership and not enough choice have been just some of the problems.”

Some other parts of the article:

“… the Conservatives’ decision to scrap the central database is a symbolic moment for a £12bn programme that has struggled to deliver from day one. It is currently running at least four years late – and there looks to be no chance in the foreseeable future of its delivering quite what was promised.

“In hindsight, it is easy to see why the programme was set up the way it was – with big central contracts and a one-size-fits-all central offering … Looking back, it was the wrong thing to do…

“It was right to centralise standards for communication and for what should be in the record. It was right to use centralised purchasing power. But the next step, that the whole programme had to be centralised, did not have to flow from that. It proved to be a mistake.”

“… So where does the programme go now? BT and CSC, the two remaining systems installers, have been given deadlines of November 2009 and March 2010 respectively to achieve a smooth implementation in a big acute hospital. Failing that, the department of health says it will “look at alternative approaches”.

“Quite what plan B is, however, remains a mystery. Any decision to cancel the contracts is likely to result in mighty litigation…

“It has been a sorry tale to date. However, Glyn Hayes, former chairman of the British Computer Society’s health section, says that, even if the NHS had gone down a less prescriptive route,a comprehensive health record would still be some way off. ‘It is much more difficult than people think. It takes a very long time. But I do think that by now, seven years on, we would have been further forward,’ says Dr Hayes.

“Suppliers say they’ll get there in the end…”

My comment:

The approach of the Department of Health and Downing Street in 2002 was: “We’ll tell the NHS what to do”. That approach for the NPfIT was always wrong.

But those who said it was wrong in 2002 were labelled doom-mongers. Indeed it was politically incorrect in the early years of the National Programme for IT to criticise any aspect of it.

This is from an in-depth FT article on the NPfIT on 2 December 2003:

Headline: “A dose of technology – how the NHS hopes to transform healthcare with its high-risk £4bn investment …

Text: “Peter Gershon, head of the Office for Government Commerce says … if the programme does fail it should at least be for novel reasons, not ‘the boring, old, familiar ones’.”

Yet the failures of the NPfIT are because of problems which were predicted in 2002. As the FT article says: “Too much ambition, too much speed, too muchcentralisation, too little local ownership and not enough choice …” 

With respect to Mr [now Sir Peter] Gershon these are boring, old, familiar reasons for IT failures in government.

Nobody wants to launch a large new IT-based project or programme in the belief that boring old mistakes will be repeated.

But is it OK to launch a multi-billion pound scheme (costing the taxpayer only £4bn in 2003 according to the FT] if you take comfort in believing that if it fails it’ll be for novel reasons?


NHS computerisation: lessons from what the bosses never learned – good NPfIT piece by Michael Cross in The Guardian on 12 August 2009

NPfIT problems exaggerated says iSoft CEO – IT Projects blog

NHS Connecting for Health hires Director of Human Resources

NPfIT or not? – The Auricle

NHS Confederation raises doubts over Tory NHS IT plans – Health Service Journal