For three years the Cabinet Office put up legal arguments against our request under the Freedom of Information Act to publish the Downing Street papers on the NHS’s National Programme for IT [NPfIT] – so why has it suddenly confirmed it is to release them?
When we asked the Cabinet Office it said only:
“Having re-examined the balance of public interest the Cabinet Office has decided to withdraw from its appeal to the Information Tribunal.”
If this is true, and it could be, what has prompted a change of heart? What has changed since early December 2007 when the Information Tribunal sent us a copy of the Cabinet Office’s latest legal arguments for not releasing the Downing Street papers?
One thing has happened: we submitted a detailed paper to the Information Tribunal on why it was important to the future conduct of IT projects in central government that the Downing Street papers are released.
It seems that our paper may have been a factor in the Cabinet Office’s decision to release the documents shortly before a hearing of the Information Tribunal on 11 February 2008.
Our paper was not a side issue to the hearing of the tribunal. On receiving it the chairman of the Tribunal took a decision to formally “join” Computer Weekly in the proceedings. The fact that we’d asked for the Downing Street papers in January 2005, when the Freedom of Information Act came into force, did not give us an automatic right to be part of the appeal.
This is what our paper to the Information Tribunal said:
“Public interest grounds for opposing the Cabinet Office’s appeal.
“The National Programme for IT in the NHS is categorised by the government as a “mission-critical” programme. It will involve more than 500,000 NHS employees who may have access to NPfIT systems. It is the largest IT-related investment by any UK government. In my view there are exceptionally strong public interest reasons for the disclosure of information about the seminar at Downing Street which led to the announcement of the NHS’s National Programme for IT [NPfIT].
“If the NPfIT succeeds, it could improve the care and treatment patients by making reliable medical electronic records available when and where they are needed. If it fails it could be one of the world’s largest failures of an IT-related programme. Implementations of new national systems may also disrupt the care and treatment of patients, a criticism made already at some “early adopter” NHS trusts.
“The government has a poor record on delivering successful large IT-based projects and programmes. The National Audit Office said: “The history of failure of major IT-enabled projects has been characterized by overspend, delays, poor performance and abandonment of projects at major cost.”
(Source: The impact of the Office of Government Commerce’s initiatives on departments and suppliers in the delivery of major IT-enabled projects Improving IT procurement, NAO, HC 877 Session 2003-2004: 5 November 2004)
In June 2004 Edward Leigh, the chairman of the all-party Public Accounts Committee, made a speech which captured the essence of the problem:
‘Clearly, IT is one of the most difficult areas for the Government. To be fair to them, the systems that they have to deal with are far more complex and much larger than those in the private sector. We have to accept that. However, lessons are sometimes not learned, and the Government often try to bite off more than they can chew. Often, new Ministers arrive on the scene and load new policies and new burdens on to IT systems that simply cannot cope with them. Frankly, those lessons have to be learned and the Government have to be more conservative and more cautious in dealing with IT in the future.’ (Hansard 29 Jun 2004: Column 213)
“Indeed lessons are not learned. Mistakes by previous administrations are repeated by new ministers and officials who are unaware of the specific causes of previous failures, or of the flawed basis on which some programmes are approved.
“In the NHS there has been criticism of the NPfIT, in part because of a lack of consultation with the medical professions. Whether the programme succeeds or fails will depend to some extent on the support of doctors and nurses. Surveys by companies such as Medix indicate that support for the NPfIT among doctors is waning [Medix survey published November 2007].
“The information on the Downing Street seminar on the NHS in February 2002 has not been disclosed, so it is not known whether the government embarked on this large project without properly considering the risks and the possible disruption to patient care and treatment at NHS trusts. Two major suppliers have withdrawn from the scheme. There are questions about whether the specifications were clear and feasible.
“One reason for the history of failures of large and risky IT projects and programmes in the public sector is, I believe, excessive secrecy. Before initiating risky IT-based programmes, boards of directors in the private sector must be mindful of the reactions of shareholders and customers to any large-scale failure. There are not exactly the same pressures on decision-makers in government. This we must accept. But the inherent lack of pressure to get it right is compounded by secrecy.
“There is little or no opportunity for Parliament, the public or the media to challenge decisions because we don’t know how they were taken or on what basis.
“It is important that governments make decisions that will withstand independent scrutiny at a later date. Those who make important decisions are likely to make them on a more robust basis if they know that the arguments factored into those decisions are going to be made public.
“Even today, five years after the Department of Health embarked on the NPfIT, the Cabinet Office is arguing in effect that Parliament, the public and the media have no right to know the basis on which the decision was made to go ahead with the programme.
“Indeed the Cabinet Office is arguing for continuing secrecy on a programme that has become politicalized.
“The British Computer Society has expressed strong support for the objectives of the programme but noted in a paper on the NPfIT that “political pressure also constrains NPfIT to deny problems and to defend the indefensible”.
(Source: The Way Forward for NHS Health Informatics – Where should NHS Connecting for Health (NHS CFH) go from here? A report on behalf of the British Computer Society (BCS) by the BCS Health Informatics Forum Strategic Panel 15th December 2006)
I believe that the Cabinet Office’s appeal, if allowed, would perpetuate secrecy over how decisions over the NPfIT were made to the detriment of the public interest now and when further large and risky IT-based programmes are approved.”
A little over a month since the Information Tribunal accepted this paper as part of the appeal proceedings the Cabinet Office withdrew from the hearing and said it would release the papers.
We welcome the decision of the Cabinet Office. We hope it marks a cultural shift in favour of more openness about how IT projects are progressing or not, and how decisions are taken to embark on costly and risky IT-based ventures.
We have to add that much expense on lawyers could have been saved if the decision to release the papers had been taken three years earlier.
Forthcoming release of Downing Street papers on the NPfIT
NHS CfH response to Medix survey of November 2007