Is the NHS's National Programme for IT costing too much?

The Guardian has published an article today on whether the NHS is paying much more for technology under the £12.4bn National Programme for IT [NPfIT] than would be the case if the initiative did not exist.

Phil Sissons, a former executive at the software group Torex – now part of iSoft – and an ex-consultant to the NPfIT, is quoted as saying: “Publicity from the national programme was that they got some good deals because of the buying power of the NHS. But I don’t believe they reduced the cost at all. There are multiple margins being added to the process each time there is an extra layer of management or another company involved.”

Connecting for Health, which runs the IT component of the NPfIT – but does not manage the larger programme of changes in working practices that need to accompany the introduction of new systems – can argue with some force that it is installing a complex national IT infrastructure as well as local systems. So it’s unfair to compare the cost of a standalone local system and that of a local system running on a new national IT infrastructure.

But how useful is that new infrastructure, and will it ever work to the satisfaction of GPs, hospital doctors and nurses? If it is neither useful nor used, the cost of systems bought through the NPfIT will seem extraordinarily expensive.

That infrastructure today is useful for providing links between local GP and hospital systems and the “Choose and Book” service which should enable doctors and patients to book outpatient appointments online. But even this limited service is beset with concern among clinicians about its unfriendliness and slow performance; and most bookings of hospital appointments are arranged over the telephone.

So will the NPfIT ever prove to be worth the money? This is a question the National Audit Office should have sought to answer in its report last year. It didn’t try.

Meanwhile officials have produced some impressive figures of savings of billions of pounds achieved on the NPfIT so far. Looked at in detail, however, the figures appear to be estimates based on extrapolations: the savings may or may not be achieved. But the spending, on the other hand, is happening now, and it is the subject of the Guardian article.

Computer Weekly has argued time and again for an independent, published review of the programme. The government doesn’t want one, or certainly doesn’t want one that’s published.

This desire within government to leave difficult questions unanswered is not inconsistent with a front page article in the Sunday Telegraph about how detectives in the cash-for-honours inquiry were having to hack into Downing Street systems in the search of evidence, because they believed information was being withheld.

If police in a formal inquiry, which has statutory authority, cannot readily obtain information that is potentially embarrassing to the government, how credible is it that officials and politicians will voluntarily provide information to the public and MPs about weaknesses in a £12.4bn NHS IT programme?

That said, we will still ask questions and campaign for the NPfIT to be reviewed independently.

A Polish journalist in the 1930s Ryszard Kapuscinski said: When is a crisis reached? When questions arise that can’t be answered.