A healthier way to communicate

The IT industry equivalent of the politician's familiar cry "education, education, education" is "communication , communication,...

The IT industry equivalent of the politician's familiar cry "education, education, education" is "communication , communication, communication".

The officials and ministers running the national programme for IT in the NHS believe they are communicating with health service employees over this, the world's biggest civil technology project. And they are right, if the criterion for success in communicating is conveying the benefits of the programme. On this there are mountains of literature and gigabytes of Powerpoint presentations.

But there is little evidence that IT executives in the health service are being given the precise information they need to fully cost and plan local implementations of new national systems.

It may even be the case that ministers do not know all the most important facts. For example, we were surprised - as were IT directors in trusts - by the comments of the health minister John Hutton on BBC Radio 4's Today programme last week. Commenting on the costs of implementing the programme locally, in trusts, he said it would be "the same as we are currently spending - £1bn a year".

The minister has not been adequately briefed or he is being optimistic to the point of being unrealistic - the sort of thinking that led the writer PJ O'Rourke to describe getting fired as a midlife vocational reassessment.

Trusts cannot simply divert the £1bn they are spending on the salaries of IT staff and keeping hospitals running into funding local implementations of new systems from the national programme.

Many of the systems running in hospitals will have to be paid for - together with the salaries of IT staff - long into the roll-out of new systems under the national programme. Trust IT departments run finance, payroll, manpower, staff rostering and other systems such as procurement, stock control and local networks. None of these systems are core to the national programme.

There will be some savings for trusts as cheaper national systems replace expensive local patient administration systems. But still it is of concern that the minister appears to believe that the £1bn general IT spend in the health service can be redirected into local implementations of the national programme.

If the minister does not have a thorough understanding of the full potential costs of the national programme, and he is responsible for obtaining funds for it, does anyone else know?

Unless more reliable and precise facts are forthcoming, the watchwords of the national programme will be "uncertainty, uncertainty and uncertainty".

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