This is a fuller version of an article on Computer.Weekly.com’s homepage.
Ministers and officials have decided not to publish this year a draft annual statement to Parliament on the costs and benefits of the NPfIT to the end of March 2008.
The annual benefits statement for the National Programme for IT was in draft form last November, 2008. It has never been published.
The Department of Health’s NHS Connecting for Health says the annual benefits statement will be published, in a different format, in 2010 – which may be after the 2010 general election.
If published now, the statement could renew the political debate over whether the NPfIT is value for money.
But the report’s suspension is likely to disappoint some staff at NHS trusts who have contributed facts and figures to the Department of Health on their organisation’s participation in the programme.
Much work went into withheld report
Trusts have been required to state the costs of their legacy systems, the costs associated with the storage of medical records, the percentage of medical records with a valid NHS number, the percentage of care plans competed, the percentage of appointments where the outcomes were recorded, a percentage of patients who were given a copy of their care plan, and percentage of discharge follow-ups which were recorded within a specified period.
The board of the national programme was aware of the existence of the draft annual benefits statement last year. Those in the know include David Nicholson, the NPfIT overall senior responsible owner and Chief Executive of the NHS.
The summary minutes of a meeting of the NPfIT National Programme Board on 18 November 2008 said: “The board heard that the second NPfIT Annual Benefits Statement for the period to March 2008 was in draft.”
The first annual benefits statement
The first (and only) annual benefits statement for the NPfIT, for the year ended 31 March 2007, was published in March 2008. It said that £2.4bn had been spent on the programme, nearly £1.5bn less than expected.
On the day the report was published the government underlined its importance by holding a press conference at the Department of Health’s headquarters in Whitehall.
The conference was chaired by the then NPfIT minister Ben Bradshaw who asked Richard Jeavons to answer most of the questions from journalists. Jeavons was then a leader of the NPfIT but has since quit.
The first annual statement included “where we are now” statements and claims of estimated savings of £1.14bn. It also set out the actual expenditure on the NPfIT to date, details of advance payments to suppliers, and the “headline ten-year forecast expenditure”.
The DH position on withheld report is absolutely unclear
When I asked the Department of Health’s press office why it hadn’t published the second annual benefits statement, a senior press officer claimed that the DH had made it clear to the Public Accounts Committee earlier this year that, as the DH was improving data collection, the annual benefits statement would not be published until 2010.
In fact the Department had said nothing to the Public Accounts Committee about postponing publication of the statement.
The Department had told the Committee that the DH will
“consider the recommendation to publish an annual report of progress against the timetables and revised forecasts. This may, from 2009-10, take the form of a single document combining the Annual Report and the Annual Benefits Statement”.
I don’t doubt that officials at the DH do what they do in the public interest. That’s chiefly why they’re there. The salaries for middle-ranking and some senior officials are hardly breathtaking.
But the burden of public duty can be lightened by word games.
Once ministers and officials have decided to withhold a report that taxpayers have funded, they sometimes come up with a coded form of words to justify it. To the untrained eye the words say little or nothing. Until their meaning is unlocked by the Department’s intelligibility key.
This is how the game is played. The DH has compiled a draft annual statement on the benefits and costs of the National Programme for IT. Much work has gone into it: trusts across England have been given a series of questions by Whitehall, the answers to which will officials hope, show the NPfIT in a good light.
Before the benefits statement is released, the House of Commons’ Public Accounts Committee publishes a report on the NPfIT which calls on the Department of Health to publish much more information about the programme, and to have it audited by the NAO.
A simple solution would have been for the DH and NHS Connecting for Health to have accepted the committee’s recommendation, say that the new information will be in the 2010 benefits statement, and then go ahead and publish the 2009 NPfIT costs and benefits statement. The information in the statement is in any case historic: it covers the year from 2007/8.
But no. The DH decides not to publish the 2009 statement. [Perhaps some at the DH decided that if it had been published it would have provided facts and statistics on the NPfIT to reignite the political debate, in the months before a General Election, about whether the NPfIT should be scrapped to save money.]
Should anyone ask what has happened to the 2009 statement, DH officers craft some words to justify withholding it.
So when I ask the DH press office why the 2009 benefits statement has not been published a senior press officer says:
“We made clear in January  in our response to the PCA [sic – Public Accounts Committee] that as we are improving data collection, the Annual Benefits Statement would not be published until next year (2010). This can be found at: http://www.official-documents.gov.uk/document/cm75/7568/7568.asp.”
In fact the DH had not made it at all clear to the committee. It told the committee what would be published in 2010. It didn’t say that the 2009 benefits statement would be postponed. This is what the DH told the committee:
“The Department will consider the recommendation to publish an annual report of
progress against the timetables and revised forecasts. This may, from 2009-10, take
the form of a single document combining the Annual Report and the Annual Benefits
So an obscure paragraph in a 10,000-word government report is the DH’s justification for withholding a statement on the benefits and costs of the £12.7bn NPfIT (in the year before a general election).
In the scheme of things the subterfuge is not major. But it’s an example of a way of thinking at the DH that makes a game of accountability.
Why didn’t the Department of Health announce that it was not producing an annual benefits statement on the NPfIT in 2009 and give its reasons?
Perhaps because the DH has an instinctive abhorrence of simplicity; and openness.
MPs want more transparency over IT projects – IT Projects blog
The NHS has a poor history of stopping doing things – Paul Corrigan blog