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MPs question health chiefs over troubled NHS computer programme

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3298 (Published 24 May 2011) Cite this as: BMJ 2011;342:d3298
  1. Michael Cross
  1. 1London

Cancelling the NHS’s multibillion pound information technology (IT) contracts might cost more than continuing with the troubled £11bn programme to computerise health records in England, NHS chiefs warned this week.

In a turbulent hearing of the House of Commons Public Accounts Committee, David Nicholson, chief executive of the NHS, and Christine Connelly, chief information officer at the Department of Health, told openly sceptical MPs that contracts with “local service providers” signed by the previous government were delivering results—and that cancellation might cost hundreds of millions of pounds in penalties and transition arrangements.

The committee was taking evidence on a highly critical report by the National Audit Office into a key component of the programme, the attempt to create “detailed care records systems.” The National Audit Office concluded that the programme represents poor value for money and is unlikely to succeed (BMJ 2011;342:d3125, 17 May, doi:10.1136/bmj.d3125).

In a two and a half hour hearing, MPs from across the house demanded to know how the already controversial programme had allowed such a situation to develop. One supplier, BT, came under fire for the price tag of its Rio system for community and mental health in London, while Computer Sciences Corporation (CSC) was criticised for delays in implementing its Lorenzo health record software in the Midlands and northern England.

Professor Nicholson said that the future of the CSC contract was already under review but that the health department was not planning cancellation “at the moment.”

Ms Connelly said that cancellation “for convenience” might lead to extra costs and the risk that the supplier “could come to us to seek damages.”

The argument attracted scornful replies from the committee’s chairwoman, Labour’s Margaret Hodge, and the Conservative backbencher Richard Bacon, who said that he had been following the programme for 10 years. When he pressed Ms Connelly on CSC’s failure to meet implementation deadlines, she replied that the contractors “do not accept that.”

Mr Bacon said that the company had the NHS “over a barrel,” a situation the programme had supposedly been set up to avoid.

In what came close to a free for all, Mr Bacon raised questions about the rushed origins of the programme, conceived by Tony Blair in 2002; its alleged failure to take into account warnings about its high risk; and the potential threat to confidentiality from issuing 800 000 smart cards allowing clinicians to log in to the system.

Professor Nicholson defended the centralised structure of the programme by saying that the technology for networked systems—the current government’s stated preference—did not exist in 2002.

Ms Hodge repeatedly asked whether the IT investment might have been better spent on employing more nurses. Summing up, she implied that the committee would recommend immediate cancellation of legacy contracts, saying that “there is a huge question mark” over how much can be salvaged from the £4.3bn (€4.9bn; $6.9bn) unspent by the programme.

The future of the already attenuated programme is likely to be one element of NHS information and IT strategies that are due to be published this summer. Ministers are likely to feel under pressure to make decisive gestures—whatever the cost.

Notes

Cite this as: BMJ 2011;342:d3298

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