Inquiry is vital for NHSsuccess

We hope officials at the Department of Health will be delighted to hear that public spending watchdog the National Audit Office...

We hope officials at the Department of Health will be delighted to hear that public spending watchdog the National Audit Office is to conduct a full value-for-money inquiry into the £2.3bn national programme for IT in the NHS.

It has taken a year of internal deliberation for the audit office to decide to launch an inquiry. It is a bold decision to investigate an IT project before it has gone wrong, been cancelled, exceeded its budget or not met expectations. This has been the case with previous NAO reports on computer schemes.

Some will say that the potential benefits of this, the world's largest civil IT project, are so great that the national programme should be left alone to modernise the NHS unimpeded by the scrutiny of the press, Parliament or the NAO. We do not agree.

Scrutiny and constructive criticism oil the chain of any major project. The once secretive Department for Constitutional Affairs suffered from a lack of external scrutiny and did not listen to well-meaning critics. This is one reason that magistrates' courts do not have compatible case management software 12 years after the first attempt to introduce it.

On the other hand, the Inland Revenue has gone on to have a striking success with tax credits after serious external criticism of the project. The same is true of a Siemens project at the Passport Office.

It will not be easy for the NAO to criticise. Its report is due to be published next summer, around the time of the expected general election. Ministers will want the NAO report to glow with praise.

Even without the general election the NAO may come under pressure from the Department of Health to delay the report by a year or more. In 1996 the NAO began an investigation into Read Codes, an IT-based thesaurus of medical terms. The highly critical report did not materialise until 1998, prompting MPs to condemn health officials for delaying the report. It seems that officials raised so many queries over facts in draft NAO reports that it delayed publication by about a year.

Another pressure on auditors is that some officials believe so passionately in the project that they are able to convert sceptics into disciples.

We want the national programme to succeed. It will be of no comfort to anyone if billions are spent with little improvement to the care of patients.

Unfettered scrutiny may help officials on the national programme to overcome opposition from some doctors and address, without defensiveness, some fundamental weaknesses in the project.

Billions of pounds, and perhaps even lives, may depend on the NAO's producing far-reaching, timely recommendations which are diligently acted on.

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