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Meanwhile, the US information technology group
Accenture, a prime contractor for two of the five regions in the
project, has refused to rule out replacing iSoft and industry observers believe Accenture is negotiating to exit from the programme.
Two members of the influential Commons public accounts committee have called for the programme to be decentralised and for more control to be given to hospitals locally. The call comes in a
paper issued today by Richard Bacon, the Conservative MP for South Norfolk, and John Pugh, Liberal Democrat MP for Southport. Under the MPs’ plans, hospital chief executives across the country would be given personal responsibility and funding for purchasing systems locally according to national standards.
Extracts from the MPs’ paper:
“The government is convincing no one that the situation is under
control. The National Programme for IT in the NHS is currently
sleepwalking towards disaster. It is far behind schedule. Projected
costs have spiralled. Key software systems have little chance of ever
working properly. Clinical staff are losing confidence in it. Many local
Trusts are considering opting out of the programme altogether. These
problems are a consequence of over-centralisation, over-ambition and an
obsession with quick political fixes”.
“Since its inception, the cost of the National Programme has risen to an
estimated £15 billion – enough money to run thirty hospitals, with all
their doctors, nurses, drugs and operations, for five years”.
“The fundamental error made when setting up the programme was to assume
that centralised procurement of single systems across the NHS would be
more efficient than local decision-making guided by national standards”.
“The complex, extremely expensive and high risk local systems
replacement project should be reformed so that local hospital Trusts can
purchase locally systems which link into the national framework”.
“A reformed programme can still be rescued. Recent publicity and the
shake-up already underway among Local Service Providers and key
contractors provide an opportunity to do this, which must not be missed.
What is required is to create a proper balance between central standards
and central procurement where this offers demonstrable benefits, and
local autonomy and responsibility. IT offers enormous potential benefits
to the NHS, its staff and above all its patients. It is not too late to
make sure that these benefits are properly delivered”.
The public accounts committee took evidence on the NHS computer
programme on 26 June, since when there have been a number of
revelations.
Richard Bacon MP said: “Since we completed the committee hearing at the
end of June, there is much new information now publicly available. I am
concerned that the public accounts committee may not have had the full
facts available at the hearing”.
“Two of the prime contractors, CSC and Accenture, have stated that the
largest software supplier to the NHS computer programme, iSoft, has ‘no
believable plans’ for future releases of its key product, Lorenzo, while
iSoft is itself under investigation for possible financial
irregularities. An opinion poll showing declining support among NHS
staff was not made available to the Committee”.
“This programme is costing taxpayers a King’s ransom but it is
descending into chaos. Our paper proposes a solution which would reduce
the scale, cost and risk of the National Programme and accelerate the
delivery of benefits to all NHS staff”.
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You can read a copy of the paper by clicking
here.
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There are four chief reasons why the National
Programme for IT in the NHS is in trouble:
- It has little support from anyone outside the National Programme and the
suppliers delivering the systems. According to a IPSOS Mori poll
commissioned by Connecting for Health and completed in February 2006
(but not released until 21 July, after the PAC hearing on 26 June), the
more people know about the programme, the lower their level of support.
Doctors are up in arms about patient confidentiality, many leading
academics are expressing serious concerns about the programmes
architecture and a growing number of NHS trusts are voting with their
feet and withdrawing from the programme.
- More and more instances are being reported of the system compromising
patient care. The programme left eighty Trusts entirely without
computers for 4 days in the largest system crash in NHS history.
Vaccination rates in London dropped by up to 19% following failures in
BT’s child health system. Patient records disappeared throughout the
North West region following a series of software errors. The Nuffield
Orthopaedic Hospital in Oxford lost track of so many patients that this
single small hospital increased national breaches of Government waiting
list targets by a factor of 8.
- The programme is running impossibly late. Of more than 100 acute
hospitals that were supposed to have a system installed by April 2006,
only 12 did so. The iSoft product Lorenzo has not been called installed
anywhere.
- The supplier community is in chaos and Connecting for Health is
jumping from fire to fire. Accenture has written off $450 million US
dollars against the programme; IDX, the primary software supplier for
the South, has been replaced by Cerner and is rumoured to be in the
process of being replaced by Cerner in London. Two and a half years
into the Programme, BT has achieved so little that it has earned only
£1.3m against its £996 million London Local Service Provider contract.
Fujitsu/Cerner failed to deliver the eight Trusts they promised by
Easter 2006 and have already missed a number of delivery dates given to
the PAC just weeks ago in June 2006. iSOFT, the primary software
supplier for 3/5th of England, has slipped its development schedules by
years and is on its knees financially.
30 August 2006
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PARLIAMENT: