The worst that can happen now is for ministers to go into denial mode

Five years into the NHS’s National Programme for IT [NPfIT] a report of the House of Commons’ Public Accounts Committee has depicted the scheme as a failure so far.


The all-party committee spent nine months investigating the NPfIT. Its report has been checked for credibility and factual accuracy by the National Audit Office. In fact the National Audit Office wrote the first draft of the report of the Public Accounts Committee.

The PAC report raises “doubts over whether the contracts will deliver what is required”. It finds that at the present rate of progress “it is unlikely that significant clinical benefits will be delivered by the end of the contract period”, which is around 2014.

About £2bn has been spent so far, in part on what the report says is “old technology”.

The findings are uncompromising. And they do not surprise us. Computer Weekly warned in early 2002, when the NPfIT was announced, that it was overly ambitious.

But the Department of Health – and governments – do not listen to those they arrogantly dismiss as nay-sayers and doom-mongers. Once they fix on a good idea they surround themselves with supplier representatives and others who will support it.

To counter this dangerous lack of challenge, Computer Weekly has, over the years, directed bright lights into the programme’s darker corners. And we have been criticised by some for doing so.

Now the report of the Public Accounts Committee has gone well beyond any of the criticism in Computer Weekly.

We do not blame the failure so far on NHS Connecting for Health which runs the scheme. Nor are the problems the fault of so many IT specialists, managers, executives and clinicians who have tried to make a success of local implementations. And there have been some islands of success. What has failed is the process.

The scheme was conceived in secret and money was allocated to it without any specific Parliamentary approval or debate; it was announced before the main potential end-users, clinicians, were canvassed on what they most wanted from a large IT spend; it was launched as an centralised initiative of unprecedented size when it was known then that the main lesson from the Department of Health’s much smaller earlier centralised initiatives was that they don’t work.

In the Department of Health’s junkyard lies the wreckage of projects such as Wessex Regional Health Authority’s Regional Information Systems Plan, the Hospital Information Support Systems and Read Codes version 3.

On all these projects – including the NPfIT – accountability has been, for all practical purposes, non existent.

The worst that can happen now is for the government and the Department of Health to go where they feel most comfortable: into denial mode. The committee’s report is a force for good, a motivation for change. It’s an opportunity to rethink the programme, not simply tinker with it.

For the sake of patients, taxpayers and the NHS the remaining £10bn must be spent with only care and treatment in mind – not wasted on trying to prove that the original scheme was sound after all.

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