Was NHS IT plan agreed before Downing St meeting?

Among the Downing Street papers released to Computer Weekly by the Cabinet Office under the Freedom of Information Act is a letter which indicates that the NHS IT programme was agreed largely before a meeting of Tony Blair on 18 February 2002. It seems that Blair’s main influence on the programme was, initially at any rate, to compress the projected timescales.

The letter is from Simon Stevens, then No 10 health adviser. He writes to Tony Blair to brief him before a meeting on NHS IT at Downing Street. The meeting is to be chaired by Blair and attended by representatives of two IT suppliers, Cabinet Ministers, policy advisers, and health experts.

The letter leaves the casual reader in little doubt that a plan for a “step change” in NHS IT has been all but decided and that one of the biggest remaining challenges is speeding up progress.

Letter to the Prime Minister – 14 February 2002

Cc: [edited by me to exclude names of those known to be at the meeting): Jonathan Powell, Jeremy Heywood, Andrew Adonis, Sally Morgan, Peter Hyman, Alistair Campbell


You are chairing an internal seminar on NHS IT on Monday afternoon. The purpose of the event is to provide you with:

– an update on the state of NHS IT

– the vision and strategy for modernising it

– progress towards agreed implementation targets and milestones and

– options for making faster progress

It is therefore relevant both to the SR [Spending Review] discussion, and to our longer term strategy on health. (You will remember that Derek Wanless also highlighted healthcare IT as one of the key areas for greater investment.)

I attach the briefing paper DH [Department of Health] were asked to provide you on the current state of play, and options for a step change in NHS information systems. I also attach optional reading from one of the leading US health journals on the impact of new information systems on healthcare delivery. (There is a lot more I can give you in this vein if you are interested.)

As to format Phil Hunt and Sir John Pattison (the DH lead director) will open with a short presentation, followed by discussion which you will chair for around 45 minutes. After you depart, the seminar will continue for another 45 minutes or so. I have invited Gus, Andrew Smith, Peter Gershon and Andrew Pinder, amongst others. Cisco and Microsoft will also be present, as DH’s private sector partners.

Questions to probe at the seminar include:

– is the vision and strategy the right one?

– is the proposed implementation route actually going to deliver? In particular is the balance right between centralisation and decentralisation? (The private sector often argue that this is one where an even more centralised approach is needed.)

– is what is proposed ambitious enough? What would take it further, faster?

Simon Stevens [Health adviser to Tony Blair]


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Secret Downing Street papers reveal Tony Blair rushed NHS IT – longer article

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