The National Audit Office’s report on the NHS National Programme for IT (NPfIT) should be the start, not the end, of independent scrutiny of the UK’s largest ever IT investment.
The report was expected to be the centre of discussion yesterday (26 June) at the House of Commons Public Accounts Committee hearing and is certain to feature strongly in hearings expected to be held by the Health Select Committee into the project this autumn.
But the purpose of the NAO report, or an independent technical audit like that called for by 23 academics and supported by MPs of all parties, is not to provide a club to batter an opponent. Nor is it to act as a fig leaf to hide the shame of individuals or organisations that have not delivered on time or to budget.
It is to give real practical guidance on how to get the best for patients, for NHS staff and the taxpayer, while giving a fair rate of return to the suppliers involved in such a high risk project.
By its own admission the NAO did not look at the programme’s technical feasibility. So the plan to enable doctors to access online the health records of everyone in England remains untested.
The NAO report is effusive in its praise of some aspects of Connecting for Health, particularly the way it has dealt with suppliers. But overall it is too safe. It is all but devoid of criticism of the project and there are material omissions (see The rosy view of NHS IT progress and associated articles).
It is unfortunate that the NAO is reporting within an NHS culture that is inordinately hostile to criticism. Honest dissent is viewed as disloyal subversion.
Without an independent review the NPfIT will carry on much as it is now, with most NHS stakeholders, Parliament and taxpayers in the dark about what the scheme is ever likely to achieve.