Between 100,000 and 250,000 jobs have disappeared from the UK IT industry over the past five years, said Granger. A shortage of talented people was causing "big, big problems", he said.
Speaking at the HC2005 healthcare informatics conference in Harrogate last week, the NHS IT chief said, "There are real difficulties getting high-quality, properly leveraged teams to deliver complex programmes."
Granger told delegates the traditional succession from analyst to team leader, junior project manager and inter-programme director was "falling apart".
The NPfIT is overseeing development work offshore but is facing "cultural differences" with the West Coast of the US, he said.
As well as revealing a rebranding of the NPfIT and the possibility of the dropping underper- forming suppliers, Granger remained upbeat about the NPfIT’s prospects while highlighting a series of other challenges facing the programme.
He said it needed to do more to engage clinicians and the NHS’ management community, particularly the boards of trusts and strategic health authorities.
These boards can have an influence on when and if the NPfIT is a success because they are involved in decisions about how much to spend on IT locally and when to deploy NPfIT systems.
"Few of the [senior NHS managers] base their decisions on how IT will support their businesses," said Granger.
He suggested that the performance of trust chief executives be measured in part on their understanding of how IT can make a difference to their organisation.
In the face of these difficulties Granger remained confident about the future. He said no major programmes had achieved as much as the NPfIT in its first two full financial years, and he showed slides listing examples of systems which are due to go live.
In separate speeches Granger and government chief information officer Ian Watmore talked of a dip in the NPfIT.
Granger said, "I think it would be fair to say that, in the past few months, the NPfIT has wrestled with an awful lot of very complex issues and we have been in that dip." Watmore said the dip had yet to reach its lowest point, but said the scheme was set to emerge successfully on the other side.
The government CIO described the programme as at an "amber" light, on the way down the slope of a dip. He said this was a stage of "informed pessimism" about the project. A normal project would also go through a natural stage of being "red", and "that is OK", he added.
Watmore said the national programme was focused on patients, helping healthcare processionals and administration staff, cutting costs and on improving front-line resources and the privacy and confidentiality of systems.
"I am very positive about the whole of the NPfIT programme," the government CIO said. He added there will be huge bumps along the road before the NPfIT begins the climb up the other side. "The next 12 to 18 months will be quite pivotal but it is set to do that [climb the other side]," he said.
Watmore told the conference that he aimed to improve the image of government IT but "not by spin-doctoring our way out and redefining success… we are going to own up to our mistakes".
Lack of skilled staff hits every industry
Employers will face increasing difficulty recruiting skilled IT professionals over the next 12 months as demand for staff rises in the public and the private sector.
Project managers and IT staff with business and industry sector knowledge and integration skills will be in particularly short supply, recruiters have predicted.
"People say ‘we can get the technical skills but we need people with the right business sector experience’," said Alex Charles, business development manager at recruitment firm the Skills Market.
The latest Computer Weekly/SSL Quarterly Survey of Appointments Data and Trends showed a 20% jump in the number of advertised job vacancies at the end of last year from the third quarter of 2004 - more than double the jobs advertised at the end of 2003.