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I Told You I was Sick!

I’ve been asked to speak at an event on NHS procurement in Dublin next month and the first thing that springs to mind, is why anyone should be surprised at Computer Weekly’s prediction that the National Programme for IT (NPfIT) could cost the taxpayer more than the Channel Tunnel?

Just to remind you briefly The National Health Service is the second or third largest employer in the world (somewhere between the Chinese People’s Army and the Indian State Railway). Both of these have arguably shorter waiting lists.

The NPfIT is the largest computer project in the world in a country where large computer projects have an abysmal delivery record. It was launched to reform a progressively failing health service by using IT as a key theme or a magic wand – take your choice - in joining up relevant health and social care operations. Unlike the Indian State Railway, the NPfIT will become a time limited Executive Agency for three to five years and will incorporate the IT infrastructure functions of the NHS Information Authority (NHSIA) which will be disappear.

As I read through my PowerPoint deck, I’m struck by the breathtaking scale of the numbers representing a touching belief in the ability of public sector suppliers to deliver efficient, fully joined-up health services, on time and on budget. The NHS budget has risen from £33 billion to £67.4 billion, with average spending per head of population showing a 50% increase from £680 to £1,345and the NPfIT represents a £6 billion spending spree with four core projects: a universal system for electronic medical records, a hospital appointments system, a broadband infrastructure and e-prescriptions. Three examples of projects costs are the diagnostic imaging contract worth £196 million a £620 million contract to build the national patient record database and the national electronic patient records system worth £2.3 billion by 2010.

Computer Weekly’s IT Expenditure Report predicts the NPfIT will push NHS IT spending growth up by 61% in 2004 to nearly £3bn; in stark contrast with average growth of 8.4% in IT spending in the overall economy. Such a dramatic leap in the amount of government money washing around the IT industry and looking for good causes rather explains why companies across Europe are queuing-up to hear how they might be able to introduce their own products and services into the NPfIT, either through the government catalogue or through partnership with the larger system integrators, the usual suspects, increasingly obsessed with the avoidance of liability rather than delivery, holding the lions’ share of the projects.

With Computer Weekly predicting that the NPfIT will cost as much as £18.6 billion before it’s finished – almost as much as the new Scottish Parliament – one can understand why there’s an increased level of optimism across the UK IT industry. My own concern however that is this represents a false economy and one this country can hardly afford if such a figure is even partly accurate. Believe me; I want the NPfIT to succeed because like everyone else out there I’m sick of having to negotiate my way through an overworked and often inefficient health service. What I’m lacking however is confidence, confidence in the interoperability of solutions, confidence in the companies that are promising to deliver them and finally and from experience, confidence that like the ill-fated Scottish Parliament building, costs will steadily rise, leaving the government trapped between a rock and a hard place, as the awful truth slowly dawns on the Treasury.


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