Government snubs key recommendations of Public Accounts Committee on NHS National Programme for IT

The government under Gordon Brown has rejected a call by an all-party group of MPs for an independent review of the business case for the NHS’s National Programme for IT [NPfIT], in the light of progress and experience to date.

It has also rejected a call by the Public Accounts Committee for an urgent independent review of the performance of local service providers to the NPfIT, against the obligations of their contracts, which are worth £6.2bn.

The rejections are part of a formal response by the government of a highly critical report on the NPfIT which was published by the committee in March 2007.

Ministers have accepted some parts of the committee’s report – but none of the recommendations that called for independent assessments of aspects of the NPfIT.

The government had been due to publish its response to the committee’s report by 26 May 2007. But it did not do so until 25 July, the day before Parliament broke up for the summer recess.

The committee had called on the government to “commission and publish an independent assessment of the business case for the Programme in the light of progress and experience to date”.

In reply, the Brown government said the Department will publish an annual statement of costs and benefits of the programme later this year. But the statement will be its own compilation – not an independent assessment.

The government’s reply to the committee said: “The Department does not consider there are grounds for an independent review of the business at this stage.”

It added: “The contracts with suppliers have stood the test of time including the flexibility to deal with changes to suppliers; the costs of the Programme remain under control and, although there have been delays to the delivery of some items, much has either been delivered early or remains on target. The annual statements of the costs and benefits of the Programme will themselves provide an increasing evidence base.”

And rejecting the call for an urgent independent review of the performance of the main NPfIT suppliers, the government said: “The Department does not agree the need for an independent review of the performance of Local Service Providers as a whole. It is better to target reviews at individual problems. This has been done in the past, through the engagement of third parties, and will continue to be a feature of supplier management.”

In response to the committee’s most serious charge – that at the present rate of progress it was unlikely significant clinical benefits would delivered by the end of the 10-year contracts worth £6.2bn – the government said: “Significant clinical benefits are being delivered already by the programme”.

It cited PACS digital x-ray systems, which are well-regarded by the NHS although they were not specified as core products in the original plans for the NPfIT.

The government used its response to the committee to list what it saw as the successes of the programme such as 185,000 electronic prescriptions transmitted on a typical day.

But not all of the government’s assertions in its response to the committee were accurate. The response said that an “independent assessment by Ovum analysts confirmed that savings of £4.5billion had been achieved through the use of aggregated requirements rather than individual trusts conducting their own procurement.”

Ovum made no claim that the savings of £4.5n had been achieved, however. It produced what it described as an “estimate” of savings over the entire 10 year life of contracts, to 2013. Its projected savings were based on sets of what it called “scenarios”. It estimated the savings at about £4.7bn less projected central costs of more than £1bn. Ovum then put the savings at about £3.6bn – an estimate based on assumptions.

The NPfIT’s main suppliers, CSC, BT and Fujitsu have experienced delays in the delivery of systems – the NHS Care Records Service – that should allow clinicians, at NHS sites across England, to access useful and reliable medical records.


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Public Accounts Committee report on the NHS National Programme for IT

Ovum report on the estimated savings due to be achieved by the NHS National Programme for IT

NHS trusts ask for costs to cover delays to NPfIT

Confidential briefing to Tony Blair on the NHS’s National Programme for IT