NHS database: Digital disaster

A project that was supposed to transform patient care in England has achieved little.

The figures speak for themselves. Public accounts committee (PAC) report on the NHS national computer system uses moderate language, but ought to cause outrage. It underlines the calamity of a project that was supposed to transform patient care in England but which has instead achieved little except enrich IT consultants and waste billions.

The scheme was launched in 2002, with a budget of £11.4bn, of which £6.4bn has already been spent. "The possibilities are enormous if we can get this right," Tony Blair promised at the start, overlooking the possibility of getting it wrong. The aim was to replace paper medical records with a centralised national electronic database, allowing a patient from Hull to walk into a hospital in Hereford and find all their details ready at the click of a mouse.

It never happened. The scheme quickly degraded into a mass of regional and incompatible systems, provided by two companies, BT and Computer Sciences Corporation, who have been paid about £1.8bn. Neither has been able to deliver even the reduced capability specified in their contracts. BT is being paid £9m to install systems at each NHS site, although other parts of the NHS outside the national programme are paying the same company only £2m for the same systems.

There are lessons in the report for all policymakers. As the failure of the NHS private finance scheme has also shown, the government is an inept purchaser of private services: indecisive, ponderous, overambitious and wasteful. Mass centralisation does not reduce costs, but it kills flexibility. Under the national scheme, NHS professionals were given expensive systems with little discussion of what would actually help them do their jobs. The project was carried along by the momentum of its scale and the sense that having spent so much it would be wrong to pull out .

Most of all, though, the PAC report challenges the current government. The problem began under Labour but it has continued under the coalition. The committee suggests that £4.3bn might be better spent elsewhere and that perhaps the programme should be scrapped. It also warns that the planned NHS reorganisation will only make things worse, since it proposes abolishing the organisations currently managing the programme. Past failure, current failure and future failure: a warning for all governments that big ambitions and bigger budgets do not automatically deliver big success.

Source: www.guardian.co.uk

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