The chief executive of the NHS, David Nicholson, says he is exploring ways of giving NHS organisations more power and choice over their IT decisions, while keeping the potential benefits of the National Programme for IT (NPfIT).
Nicholson, the overall senior responsible for the £12.7bn NPfIT, was answering questions from MPs yesterday over articles in The Times on government IT and the NPfIT in particular. The articles were the result of a joint investigation by The Times and Computer Weekly.
At a hearing of the Public Accounts Committee, Conservative MP Richard Bacon asked Nicholson if he would be happy for hospital trusts to have more choice and autonomy in their buying decisions, though if that happened the main IT suppliers, BT and CSC, could walk away from the National Programme.
Nicholson's reply made it clear he wanted to give more choice to hospitals but keep the contracts with NPfIT local service providers and other suppliers because there would be benefits of £4.5bn to the taxpayer - though only if the contracts "all work".
He said: "I have made no secret of the fact that the National Programme for IT, in the way it was set up originally, did not take into account the development of the NHS as a whole [such as] the reform programme, the decentralisation, the setting up of foundation trusts, all of that sort of thing.
"The idea that you could by attrition drive a national programme into an NHS that was unwilling to accept it simply is not deliverable. So we have been looking at ways in which we can decentralize and give more power to the NHS, so we get much more of a pull to the system, rather than just push
"That is why we set up NLOP [NPfIT local ownership programme], which shifts more responsibility for the first instance to strategic health authorities, and I want to explore ways in which we can give individual organisations more power and choice - but the issue is for us is that we know that, because of the contractual arrangements we have agreed, across the country as a whole, there are benefits if they all work of about £4.5bn to the taxpayer."
Bacon questioned the assumptions on which the £4.5bn estimate of potential savings was based - a point Nicholson did not answer.
He said that if hospitals urgently need a replacement system while they wait for the NPfIT Lorenzo product, and they decide to buy interim technology for two to three years, and then install Lorenzo when it becomes available, there should be no additional cost to the NHS. But if trusts buy their own choice of system and reject Lorenzo the system's supplier CSC may be compensated - what Nicholson called a "cost to the NHS".
The compensation would be because the Department of Health has given Lorenzo's supplier CSC a contractual commitment that trusts will install the system.
Nicholson conceded that "some organisations have got computer systems which really do need replacing - desperately need replacing - and in some circumstances hospitals are making a judgement about taking an interim solution".