Feature Information Technology

There IT goes again

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5317 (Published 02 September 2011) Cite this as: BMJ 2011;343:d5317
  1. Michael Cross, freelance journalist
  1. 1London, UK
  1. michaelcross{at}fastmail.fm

As the government considers its new information strategy for the NHS, Michael Cross assesses what has gone wrong in the past and the chances of future success

For nearly two decades, the National Health Service has had a public reputation for incompetence with information technology. A recent report by the House of Commons Public Accounts Committee into delays in the multibillion pound effort to computerise acute hospitals in England1 is the latest in a series of scathing parliamentary reports and press investigations, stretching back a generation.

As the government prepares to launch an “information revolution” to underpin its English NHS reforms, it is worth examining whether this reputation is justified, and, if so, whether the causes of failure can be overcome.

Disaster narrative

The perception of NHS failure is only part of a wider narrative of waste and incompetence in public sector computing. While anecdotes date back at least to the 1970s (the first episode of the television sitcom Yes Minister, filmed in 1979, featured a hushed-up scandal about word processors), the issue became a political cause célèbre in the early 1990s. It was triggered by revelations of three separate sets of events in the NHS: revelations of waste, conflict of interest, and alleged criminal behaviour associated with large scale computerisation at Wessex Regional Health Authority; mismanagement at a services company set up by West Midlands Regional Health Authority; and the failed implementation of a computer aided dispatch system at London Ambulance Service.2

In a pattern that would be repeated, only one of the “IT fiascos”—that at London Ambulance—could truly be blamed on IT problems, and then only in part. Indeed, hospital systems installed under the Wessex programme at two sites performed well.

However the narrative of disaster became firmly established in the political and media agenda, with news …

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