Why do we write so much about the NHS's National Programme for IT?

“It’s the politicians and the media that are screwing up the system. Sure mistakes have been made – but it’s the biggest non-military IT system implementation yet – so can we please allow the people a bit of leeway when they get things wrong.”

This comment on the website of The Register – Give the Guys a Break – will be welcomed by many supporters of the NHS’s National Programme for IT [NPfIT]. It sums up the view that those running the NPfIT should be left alone to get on with it, without criticism in the press and without concern about data confidentiality being expressed by some MPs and groups such as The Big Opt Out and the Foundation for Information Policy Research.

The comment on The Register said also: “If you watched just the first ten minutes of the Health Select Committee meeting yesterday [26 April 2007], you would realise that whilst there have been major errors in implementation – the system is getting there.

“If it wasn’t for silly politicians arguing about how the e-care records are stored, and they let the people with the expertise get on with it, then I’m sure the system would be implemented faster.”

Much of the first ten minutes of the initial hearing of the Health Committee into the NPfIT was given over to a speech by Richard Granger, head of the NPfIT. Clearly Granger impressed the author of the above comments.

We acknowledge there are some who are working in the NHS who believe that the NPfIT cannot flourish under the oppressive gaze of a closely-scrutinising press, and that MPs should stop making critical statements on a subject they know little about.

The same people may also believe that all Progress has resulted from people who took unpopular positions, and that those who push back the technological boundaries will first be called mad, then dangerous, and finally everyone will agree with them.

We do not agree with this view, however. IT managers in the NHS have concerns about aspects of the NPfIT, as do the NHS Confederation, the Royal College of Surgeons, the British Medical Association, the Royal College of Paediatrics and Child Health, the Royal College of Physicians, the Royal College of Nursing, and the Information Commissioner. All submitted papers to the Health Committee.

A further paper from the Renal Association and the Renal Information Exchange Group says the renal community is among the most IT literate in the NHS. It finds that the National Programme for IT is flawed by consistent over-optimism, and there have been assumptions made that “technical advances will overcome very large system-related challenges”.

Separately Joyce Grenfell (1910-1979) said that “Progress everywhere today does seem to come so very heavily disguised as Chaos”.

We believe that those pushing for progress should go forward in a measured way, while paying the utmost attention to past mistakes. Some parts of the NPfIT have been successful; but there is growing evidence that “progress” in other areas has been accompanied by disruption and even potential threats to the safety of patients, as at Nuffield Orthopaedic Centre.

No regulator seems concerned about the disruption to the care of patients when go-lives go wrong. There is no statutory reporting of major IT-related incidents at hospitals even when they affect the integrity of patient records. There has been no reporting of gateway reviews on the NPfIT. And ministers have refused to commission a published, independent review of the NPfIT.

So the only effective scrutiny of the NPfIT is by the media, by Parliament and by the NHS itself. That is one reason Computer Weekly – and this blog – will continue to look at the NPfIT so closely.