NHS IT project is force for good and worth the pain so hush the critics

The media is unduly critical of Granger and the programme

The media has been full of comment on the "problems" at the NHS IT project as Accenture ducked out. Yet again, the comment portrayed the project as a "disaster" - indeed as "yet another public sector IT disaster".

At the centre of that criticism was, yet again, Richard Granger, chief executive of Connecting for Health, which runs the National Programme for IT in the NHS, and the way in which he both procured and managed the project.

I have had an association with practically all of the parties involved in this project right from the start. I have known Granger from day one. My company Ovum has a continuing contract with the NHS IT project team. I have a close board-level relationship with some of the major players, and Ovum counts each of the major suppliers to the project as its long-term customer.

In many people's view that would make me biased and/or highly conflicted the main reason why I have not made public statements or written pieces on the project for quite some years. But maybe there comes a time when you should stand up and make your views heard.

I have yet to meet anybody who opposes the overall objective of the NHS IT project. When it is fully implemented it will be a major force for good. It will save lives. I have little doubt that it will be looked upon throughout the world as a model to be followed.

Achieving that objective will cause pain. Anybody who has ever been involved in any project - big or small - knows that. Why we have so many media observers who are so naïve as to suggest otherwise, baffles me.

I have written many articles over many years against the concept of what I dubbed "one-sourcing" - ie. putting all your eggs in one supplier's basket. Indeed I would stake a claim on being one of the first to advocate "multi-sourcing". NHS IT is the most advanced example of just that. Accenture failing and CSC picking up the pieces is an example of the benefits of the approach, not of its failure.

How many times have you read of public sector contracts failing and us, the taxpayers, picking up the costs of that failure? How many times have "one-source" suppliers been able to extract huge extra sums from the government to correct their own failures?

Granger went out of his way to avoid, or at best minimise, this possible eventuality on the NHS IT project. Why doesn't that major advantage (or indeed any of the other advantages) ever get highlighted by the media?

Granger has undoubtedly been very hard on terms and conditions from suppliers. He has saved millions with the deals he struck with suppliers like Microsoft. If only that approach really had been adopted throughout the public sector, again the savings would have been huge. Current take-up of shared services and collective buying across all government departments is still lamentably slow.

So was Granger too hard on these poor, weak suppliers? First, we are not talking about naïve start-up companies here. Accenture has had more experience of, and money from, large government IT contracts than most. I refuse to have any sympathy with complaints about the contracts it willingly entered into.

Second, if all the main suppliers were now bleating (or bleeding), I would pay more attention. But they are not. CSC was rather pleased and happy to take over from Accenture. Indeed, it is pretty much in the public domain that BT would also have been happy to take over.

I wholeheartedly agree that the best user-supplier relationships are where both parties are winners and the supplier makes an acceptable profit. I have always considered litigation as a statement of failure by both parties.

Again, I think Granger understands and complies with that. As far as I know Granger has not actually litigated against any supplier yet - preferring the kind of arrangement which led to Accenture's exit.

Of course, I too can write much about the mistakes made in this project. I have long criticised the lack of early involvement and commitment from the medical profession something which the project was far too slow to address.

The plan to sweep out all the existing systems and suppliers was also misguided. Again something which has since been addressed. I could go on.

The government too must accept criticism. It was naïve to believe or announce that the only costs of the project were those related to its procurement. Training and implementation has cost much more than the initial procurement costs in every IT system I have ever been associated with. The timescales imposed on this project, as ever, were initially for political expediency rather than having any relationship to common sense.

I completely accept that I am biased and conflicted. But maybe my view is actually more relevant for that.

Richard Holway is director at analyst Ovum

Read article: ...but not at the expense of patients or of the media's independence

Read article: NHS IT watch

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