SOUTH NORFOLK MP Richard Bacon, a member of the Commons public accounts committee, has responded to answers to his detailed questions on the future of the controversial National Programme for IT in the NHS from Ms Christine Connelly, Chief Information Officer at the Department of Health.
In his response, Mr Bacon presses for an answer to his specific question over whether the contract renegotiations with BT and Cerner represented best value for taxpayers’ money, stating:
“Although I am grateful for your detailed reply, I do not see any direct answer to that question, which seems to me absolutely fundamental.”
In his letter of 13 January to Ms Connelly, Mr Bacon expressed concern over the value for money provided by BT's £546 million contract for the South of England and called into question whether, given the proposed reductions in the functionality and the number of software packages being deployed under the contract, Ms Connelly could still be confident that value for money was being provided.
Mr Bacon's letter of 2 March is below. You can read Ms Connelly's letter, in response to Mr Bacon's original letter of 13 January 2011, here.
8 March 2011
Ms Christine Connelly
Chief Information Officer for Health
Department of Health
Richmond House
London SW1A 2NS
2nd March 2011
CONTRACT NEGOTIATION IN THE NATIONAL PROGRAMME FOR IT IN THE NHS
Thank you very much for your letter of 24th January 2011.
In my original letter to you of 13th January 2011, I asked you specifically whether the contract renegotiations with BT and Cerner represented best value for taxpayers’ money. Although I am grateful for your detailed reply, I do not see any direct answer to that question, which seems to me absolutely fundamental.
Unless the question can be answered clearly in the affirmative, I can see no justification for concluding further agreements with these companies, at least until after the NAO has reported and the Public Accounts Committee has had time to consider its findings. I am disappointed that you have not given such a commitment and I would ask you again to consider doing so.
I would also like to address some of the specific points in your letter.
My point about the Cerner product in London was that originally planned deployments of GP systems, a London Ambulance solution and a number of systems in acute trusts were included in the original contract price of £1.2 billion and are not now being delivered. I note that you do not comment on my observation that only about half the original contract will be delivered, but that payments have been reduced by only £112 million. I cannot see how this can be value for money to taxpayers and I note that you do not claim that it is.
You say that I am “misinformed” about the level of Cerner functionality, which you say “has not been reduced”. I must refer you to page 23 of the June 2006 NAO report in which it is stated that Cerner Millennium was being supplied in four releases, covering the same functionality as the original five IDX releases. This included a Patient Administration System, a GP system, a web based referrer, a pharmacy system, and systems for acute departments, emergency care and mental health, all to be delivered as an integrated Cerner solution. Much of this has now been dropped, or replaced with cheaper departmental systems such as RiO, but I cannot see that taxpayers have seen an appropriate consequent saving.
You acknowledge that the history of delivery of Lorenzo is “very unsatisfactory”, a point on which we can certainly agree. My additional point is that there is no good reason to think that the long record of unmet promises, missed deadlines and in some cases outright misrepresentation is about to change. Therefore, I can see no good reason for the Department to persist with supporting the deployment of the Lorenzo system through the contract with CSC. I note that the Chief Executive of the NHS and the President of CSC were scheduled to meet to discuss this matter and I sincerely hope that this does not simply result in further unreliable promises and consequent failures.
In relation to the price of the RiO product, I would observe that the systems supplied directly by CSE Servelec seem to be functioning in practice as well as the LSP version, so I cannot see how there is a good reason for the price of the LSP versions to be around ten times as high. As you say, this is likely to be considered by the NAO. In the interim, I should be happy to supply a list of non-NPfIT RiO users if that would assist you in making the comparison. My concern about value for money to taxpayers is of course not related to whether the decision was made entirely by your Department or with some involvement by the Treasury.
Since my letter to you there have been further reports that raise doubts over the effectiveness of LSP systems, including:
These reports simply add to my concern that you seem to remain committed to the delivery of systems through LSPs that have been shown to be unreliable, subject to serious delays and, even after contract renegotiations, unreasonably expensive. Quite apart from the burden this places on taxpayers at a time of exception stringency in public spending, it is also surely not in the interests of the NHS and its patients.
I do sincerely hope that you will now feel able to give a commitment not to enter into revised contracts until the NAO has reported and the PAC has considered the matter.
Yours sincerely
Richard Bacon
MP for South Norfolk
Member of the Public Accounts Committee
See also:
PARLIAMENT: MP presses IT boss on NHS computer scheme
PARLIAMENT: Department of Health 'over-optimistic' on NHS IT
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