NPfIT central contracts will never work - MP tells BBC

Richard Bacon, a member of the Public Accounts Committee, talked to BBC R4 Today presenter John Humphrys this morning about his committee’s report on the National Programme for IT [NPfIT].

Earlier on the Today programme Humphrys spoke to Jane Dreaper, the BBC’s Health correspondent, on the committee’s report. 

Bacon has taken a close interest in the NPfIT for several years and has put many detailed questions to officials about it. Usually he gets replies that are vaguer than he would like.

Bacon’s interview on Today programme:

Humphrys:  It’s no secret that a massive computer system that’s supposed to improve the NHS in England has been running into big problems. Now a committee of MPs has confirmed the worst fears for it. The Conservative Richard Bacon is a member of the Public Accounts Committee. Hugely behind schedule apart from anything else Mr Bacon?

Bacon: I’m afraid it is. Part of the problem is the way they started it. This was a project that was decided on very quickly –

Humphrys: About six years ago?

Bacon: Originally in February 2002, at a meeting in Downing Street, which took about half and hour. That was when the original decision was taken to let all these enormous contracts which were centralized …

Humphrys: They have spent already – we, it is our money – have spent £12bn?

Bacon: They haven’t spent £12bn. Originally it was going to be £2.3bn, then it became £6.2bn, then £12.4bn and now £12.7bn. Not all that is spent. Two years ago it was about £2bn that had been spent, and now it is about £3.5bn to £4bn, although one of the problems is that the estimates of the costs, what’s been spent locally, are still very unreliable. The Department of Health does not really have a handle on that. We think somewhere in the region of £3.6bn is going to be spent locally in total but that’s not a safe figure.

Also the costs at the centre are very high – probably about £1.5bn of central costs – because of these enormous contracts and the administration that goes with them, much of which is unnecessary in terms of delivering the clinical benefit which is mainly – if you can get the clinical benefit – not national at all but local, within one health community. You are joining up – this is the theory anyway – the different parts of the NHS within one area –

Humphrys: That would be a good thing to do?

Bacon: If you could do that, that’s where the benefit comes from. If you could get a system that’s deep – that is to say in the range of different clinical functionality that it has – and also broad, in terms of the different organisations that take part within one area, in other words acute hospitals, GPs, mental health teams and even social services, if you can get that within one area you would get considerable clinical benefits including reducing adverse drug events, reducing mortality and so on, but we are miles away from that.

Humphrys: Should it be dumped – the whole thing – or can it be rescued in your view?

Bacon: I think in its present form, with these large central contracts, it is never going to work and it’s a fantasy to think it will. It needs to be recast giving local hospital chief executives the spending power, making them the customers, and allowing them to choose the systems they want so long as they meet common standards.

Humphrys: Richard Bacon many thanks. 



Public Accounts Committee report published today [27 January 2009] on the NPfIT

Government given six months to get £13bn NHS IT project back on track – Daily Telegraph

Frustration over NPfIT – BBC health correspondent

Warning over fresh NHS IT delays – BBC News

MPs question the future of £12.7bn NHS IT scheme – Computer Weekly today [27 January 2009]

Government IT disasters – a clear case for change – Computer Weekly viewpoint [27 January 2009]

NHS IT warnings the government iognored – Computer Weekly [27 January 2009]

Government should tell NHS hospitals to abandon National Programme for IT if problems persist – Nursing Times