No avoiding the truth
In effect, two major software suppliers have concluded the project can't be done. On any rational basis, this should signal the end.
Ever since we began BOM, the grandiose top-down plan to create an all-singing all-dancing NHS computer system (the NPfIT) has featured regularly (see here for just some of our posts). It should be chalked up as a monument to the arrogance and incompetence of Labour's Big Government approach to public services. Conceived right at the top, authorised at a No 10 "summit" personally chaired by Blair, and dropped down on frontline practictioners against their intense opposition, it was never more than a commissariat fantasy.
Fantasies like this never deliver anything useful. But they do cost huge amounts of our money. Just as a reminder - so we can all remember next time some politician comes up with a similar brainwave - here are the key numbers:
- Original "budget" - £2.3bn (The DoH's official NPfIT brochure asked "how will the National Programme be funded?" and answered: "Central funding of £2.3 billion for the National Programme was announced in December 2002.")
- Latest official estimate - £12.7bn (last NAO Report, although that's at 2004-05 prices, so we should bump it up for real cash - £14bn would be six times the original figure; and remember - unofficial cost estimates run from £20bn right up to £50bn)
- Time over-run - 4 years (latest NAO estimate, but since it's not finished, in reality we have no idea... it could turn out to be 24 years)
Nobody was ever going to make this work, and Richard Granger, the project's big-talking supremo, jumped last year (see this blog).
When the Public Accounts Committee reported on the fiasco in April 2007, they made some very familiar points (see this blog). Let's remind ourselves of the headlines, because they are the checklist for all such Big Government money pyres:
- Meaningless delivery timetable- "The delivery of the patient clinical record, which is central to obtaining the benefits of the programme, is already two years behind schedule and no firm implementation dates exist"
- Shambolic cost control- "The Department has not sought to maintain a detailed record of overall expenditure on the Programme and estimates of its total cost have ranged from £6.2 billion up to £20 billion"
- No cost benefit appraisal- "The Department’s investment appraisal of the Programme did not seek to demonstrate that its financial benefits outweighed its cost"
- No delivery capability- "There is a shortage of appropriate and skilled capacity to deliver the systems"
- No user involvement- "The Department has failed to carry an important body of clinical opinion with it"
- Driven by technology hype not practical business needs- "The Programme has focused too narrowly on the delivery of the IT systems, at the expense of proper consideration of how best to use IT within a broader process of business change"
- Muddled responsibilities- "The Department should clarify responsibility and accountability for the local implementation"
- Failure- "At the present rate of progress it is unlikely that significant clinical benefits will be delivered by the end of the contract period"
Of course, the government has consistently denied such problems, and has done its damnedest to hide the bad news (see C4 video above for the outrageous nobbling of an earlier National Audit Office Report).
But taxpayers must not be fobbed off. This ridiculous centralised monstrosity must be terminated. As stalwart PAC member Richard Bacon put it last year:
"One size does not fit all. The obvious solution is something similar to that which worked very well for GPs in the mid-1990s. Hospitals should be allowed to choose the systems they want, provided that those systems meet national standards. The role of the centre should be confined to setting those standards and allocating budgets. Hospital chief executives should have the freedom to buy what they want for their hospital, in consultation with their own clinicians and also be given contractual responsibility for delivering it."
And indeed, this is the direction in which the DoH has belatedly moved, which is the key reason Fujitsu has walked - because the centre is no longer going to force frontline health operators to take the standard Fujitsu package.
But the commissars are still trying to hide the truth. Rather than openly admit the Supercomputer is now dead, and formally pulling the plug, Whitehall prefers to continue the fiction that eventually it will somehow rise from the slab. Which among other things, means they are now asking BT to pick up the Fujitsu contract... at whatever price BT care to name.
Long-term life support: just wait til we see the bills for that.
(htp areader, Stephen D)
PS As you may recall, last year the head of Fujitsu's healthcare consultancy practice, Andrew Rollerson, blew the whistle on the Supercomputer. He said "It isn't working, and it isn't going to work. There is a belief that the national programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up." For his pains he was not only suspended by Fujitsu, but hauled before the PAC and subjected to a horrible mauling by Labour MP Sadiq Kahn, who accused him of being nothing more than a publicity seeker (we posted the vid here). Kahn has since been given a junior ministerial post. We don't know what's happened to Mr Rollerson.