How the Health Committee took decision to hold NHS NPfIT inquiry

We reveal today (Tuesday 28 November 2006) that the Health Committee has decided to hold an inquiry into key facets of the National Programme for IT [NPfIT].

Two MPs on the committee fought particularly hard to persuade their colleagues to hold an inquiry, and continued their campaign despite an initial defeat in October 2006

The two MPs are Sandra Gidley, Liberal Democrat Health spokesperson, and Mike Penning, a tenacious Conservative who were joined in their campaign by their committee colleague Dr Richard Taylor, the only independent MP in the House of Commons.

Twenty-three leading academics had written to the committee calling for it to launch an inquiry.

They said in an open letter to the health committee: “We believe that there is a compelling case for your committee to conduct an immediate Inquiry: to establish the scale of the risks facing NPfIT, initiate the technical review and to identify appropriate shorter-term measures to protect the programme’s objectives.”

But the committee’s Labour chairman Kevin Barron – who in opposition showed a good knowledge of health service IT – and other Labour members, who made up the majority, were unenthusiastic. They thought that MPs, not being experts, would not be able to understand the programme’s complexities well enough to question closely officials and ministers.

So at a private meeting of the committee in October members decided against holding an inquiry.

Being unwell, Mike Penning had been unable to attend that meeting. He believed that such an important decision should be taken when he was there. At a subsequent private session of the committee there was apparently a slightly heated exchange between Penning and the chairman. Penning convinced the chairman and the rest of the committee’s MPs that they should revisit the decision not to hold an inquiry. So the subject went back on the agenda for a private session last week.

In advance of this meeting Computer Weekly gave some MPs on the committee a copy of a confidential NHS paper, released to us under the Freedom of Information Act, which praised aspects of the NPfIT but found deep flaws in other parts of the programme.

On the day of the private session on Tuesday last week (21 November 2006) Computer Weekly, The Guardian, E-Health Insider were among the media organisations that published the results of a survey by online market researcher Medix on the NPfIT. The Guardian’s headline was “GPs revolt over Patient Files Privacy”. The survey brought some good news to those running the NPfIT, and a great deal of bad news. All but a few of the 301 written comments from doctors, which were published as part of the survey, were negative.

In the end the committee did not need to vote on whether to hold an inquiry. The general mood was that it should take place. All credit to Gidley, Penning and Taylor, and of course the academics.

IT and other executives in quite a number of NHS trusts are concerned about various aspects of the programme, particularly the uncertainties and risks of further delays in the delivery of core software. The inquiry means that MPs will be able to question officials on some of these issues, and also on the confidentiality of any health records that are held centrally.

In some ways, MPs on the health committee have more flexibility than members of the Public Accounts Committee which had a one-off hearing on the NPfIT in June 2006.

MPs on the Public Accounts Committee are subject to an informal “10 plus five” rule, which allows questioning for an initial 10 minutes with a later follow up of five minutes – including the answers. If officials give long responses, as they prone to do, they can use up most of the time allocation for an MP’s questions.

The health committee’s MPs can, however, hold several hearings if they wish, and can question officials and ministers at length if necessary. Given that ministers including Caroline Flint bravely present the programme as a success already, it will be interesting to see whether they will hold the line during cross examination by health committee MPs.