Secrecy over Microsoft's UK government dealings on NHS IT

It’s unclear why there is so much secrecy over Microsoft’s dealings with the NHS which are, after all, in the interests of taxpayers.

Officials at the Department of Health say that the NHS receives exceptionally low prices for Microsoft licences. But the details are subject to confidentiality clauses.

They have declined to give the House of Commons’ Public Accounts Committee any information on the:

– committed volume of business which the NHS has agreed with Microsoft

– the total cost of the commitment

– the maximum potential financial penalty for non-compliance.

And in October 2007 there will be a unique event at Microsoft’s headquarters at which the supplier’s worldwide CEO Steve Ballmer will have an opportunity to address the chief executives of primary care trusts across England on the £12.4bn National Programme for IT [NPfIT]. The Chief Executive of the NHS David Nicholson will also be present.

Gordon Brown, his ministers, the Department of Health and NHS Connecting for Health, which runs part of the NPfIT, are confident that the programme is already a success.

Officials, then, should have nothing to fear if any trust chief executives at the October event express misgivings about the NPfIT or facets of it. If the NPfIT is a success, officials will be able, with authority, to counter any concerns and criticisms.

So why has the Department of Health NHS Connecting for Health barred the media from attending this unique event?

One begins to wonder whether officials are concerned that they may have no credible responses if chief executives of trusts express concerns about the NPfIT at the October event.

The chief executives may be wholly supportive of the NPfIT, congratulate Nicholson and his officials for what has been achieved and make clear their confidence about the future of the programme.

Or some may ask:

– about future funding for the programme given their other priorities and commitments and, in some cases, deficits

– what happens if the core software for the Care Records Service continues to be delayed

– why they should commit to the NPfIT when some trusts have experienced serious disruption when implementing national systems

– why, when their old systems need replacing urgently, they should commit to interim solutions from NPfIT local service providers whose software may be inferior to non-NPfIT products

– whether the £2.5bn spent on the NPfIT is value for money

One wonders if the government wants to prevent reporting of any such concerns because they could conflict with ministerial messages about the success of the NPfIT.

Microsoft’s spokeswoman would not even confirm that Steve Ballmer would be speaking at the October event. And when I asked NHS Connecting for Health whether I could cover the event, its spokeswoman said:

“Thanks for your interest but this is a closed event so you will not be able to attend.”

The Department of Health says that attendance is “by invitation only”. Even invitations to primary care trusts are extended only to the chief executive, the chair of the trust’s professional executive committee or the chairman of the board. There is only place per trust.

David Nicholson complained in January 2007 that NHS Connecting for Health had a bunker mentality. He wanted more openness. Now it’s looking as if the government as a whole is making defensiveness and secrecy over the NPfIT a matter of policy.

If the NPfIT is the success the government claims, why does it shrink from the scrutiny of the press and an independent review of the programme?


Government asks Trust chiefs to attend private NHS IT event held by Microsoft

Lib-dems call for review over National Programme for IT

Computer Weekly’s evidence to the Commons Health Committee on the need for independent review of the NPfIT

Experts call for independent review of the NPfIT

Report highlights NPfIT’s ‘impressive milestones’

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Of /course/ the National Programme isn't altogether a success. Yet. When a major requirement is fast, realtime connection between a number of very different systems, from different providers, and serving an absolutely vast number of users and services, there are inevitably going to be problems.

However... it is in absolutely everybody's interest that it's done right. And, depending on who you are, your opinion of just what "right" means will vary, sometimes wildly, from that of the next guy.

We want data security. We insist on it. But there are times when clinical expediency will absolutely require lapses in that security. Making decisions about how to implement this stuff where, effectively, both "rights" are wrong, is complicated and involves heated debate. Debates which allow journalists to pick an issue, reduce it to a headline, then stir in a heady mix of "what-ifs"...

We should not be doing this behind closed doors? Perhaps. But if the difference is more delay while the discussions get interrupted by various concerned individuals and organisations insist on adding their two penn'orth to the crapstorm that's already circling the project, then it's dead in the water.

There ARE successes. Some PACS implementations have been excellent. Early adopters of CRS are generally places where even a flawed system is better than what they had before. The national NHS email system is starting to look like a serious contender, and is already successful in places where mail servers weren't already bedded in.

There are a lot of people working on making this stuff work. Some of us have been involved in NHS IT for decades. Journalism of this type is, I'm afraid, simply unhelpful. You haven't even mentioned any of the /real/ problems -- some of which are, I agree, not trivial, but few are unfixable given clear communication, consensus, calm discussion and careful resourcing.

It's all getting better. In fairness, it can't not. There are a number of scabs you can pick at, and it might be helpful for you to do so -- it can help keep people focussed on the correct goals -- but this sort of reporting is too wide of the mark to be either use or ornament.