Tuesday, April 17, 2007
NHS IT System Costs Taxpayer £12 billion Without Benefits
Lots of things get called a public scandal, but THIS really is. Imagine spending more than £12 billion on a new IT system for the National Health Service and then being told by the parliamemntary spending watchdog that it won't provide any benefits to patients. Simply astonishing. Patricia Hewitt's background in handling IT project research for Andersen Consulting stood her in good stead didn't it? She makes Des Browne look competent.
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It's unfair and wrong to blame Ms Hewitt for everything. She did not start this monstrous project. Nor did she start its implementation: it's being going for years and years..
I expect some fair criticism: to criticise her is just plain wrong. (but typical of ploticians I suppose:-(
But she has been there for several years and could have at least recognised there was a problem.
Hewitt is just the oily rag, (albeit a particularly incompetent, dishonest one) but it's the organ grinder who's to blame.
Speaking of Gordon Brown,some important economic news out today which could prove very embarrassing for him.
The inflation rate (fiddled CPI) has gone above 3.1% which will force the Governor of the BoE to write an open letter explaining why he has allowed this to happen. RPI now at 4.8% and rising.
The reason, of course, is that Brown has deliberately allowed inflation to let rip to fuel his pyramid scheme economy with more debt and spending. He has also filled the BoE's Monetary Policy Committee with his stooges preventing interest rates rising high enough to counter inflation.
Brown is the man to blame for inflation getting out of hand so I wonder if Mervyn King will point that out in his letter.
Anyway, interest rates to rise next month and 2 or 3 times thereafter. What's the betting on 6% by the year end?
House price crash here we come, followed by recession. Thanks to Brown.
http://newsvote.bbc.co.uk/1/hi/business/6562723.stm
Private Eye a month or two back had a special supplement on the NHS IT fiasco, and it was a masterly demolition of the whole project, its management and the people involved. Every MP should be obliged to read it before the debate.
Have a I said this before - but from what I heard they bought some GP software from a company to run on a single PC - and tried to scale it up by running multiple Virtual Operating Systems - rather than rewrite it. The system then couldn't scale up because the limitation on scalablity then became the power supply to the blade servers, and they had to have people on the roof with hoses stopping the Data Center from overheating - just a rumour of course.
Boom and busted said "pyramid scheme economy" - very good description. Longer booms and bigger busts.
To my mind this is the biggest problem with governments at the moment - they dont care about the money. The spend 50 million to get back 40 million in wrongfully paid benefits; yet they can spend money how they wish with no critism; they can waste billions and billions and billions and nothing happens.
Why? Becuase people just dont care; if you want a society where there is respect why dont politicans start showing taxpayers some by respecting our money.
At best they are being told by IT companies that this new system can do all these wonderful things; at worst they are just stupid.
People moan about Tescos - but I dont have to shop there tomorrow if I dont want to. But I have to wait upto 5 years to make my democratic and even then they might still get back in.
If we paid for our own health care, education, national insurance etc - and the provider annoyed us (or another strong word!) we could cancel our policy and move it. But with a state providing for us - talk about a contridiction in terms - no one wins - except the directors of the IT firms who provided the system.
Most women who went to Newnham College in Cambridge wince visibly when they are reminded of the fact that Hewitt is an 'old girl'. It seems that most women decidedly do not like other women (eg like Hewitt)patronising them.
Given the state of the NHS IT system (to take just one topic), one wonders what Hewitt's ability was to run a Newnham tea party - the female equivalent to 'organising a p**s-up in a brewery'?
Iain, "She makes Des Browne look competent."
You have got to admit that is some achievement.
Its quite unfair to blame Patricia Heitw for this one - although she should shoulder some responsibility.
The cock-ups here are spread over many groups:
- the IT software companies providing it. These don't have a track record in building true enterprise ready systems on this scale. As a result, the software they've produced has taken a lot longer to stabilise - and isn't actually ready yet
- there is a distinct lack of vision over what some of the software needs to do, and where there is vision its not always consensual. This means that what some hospitals like, others detest. It would be helpful if the software providers actually had a decent vision too. This is perhaps the single biggest issue.
- the LSPs have taken a lot longer to get to grips with many of the legacy issues each hospital presents, and with sometimes awful legacy data. Add ot that the software they're trying to implement isn't stable, its no wonder they have issues.
- hospitals have underinvested in IT and in IT staff for years. This means that the quality isn't always there. In particular, hospitals sometimes behave like SMEs buying bespoke software, not organisations signing up to enterprise ready software. There are some good people out there - but not enough. Its unfair to criticise the rest - they've done well at dealing with the jobs they had. However, in CfH-land , hospitals need people used to dealing with enterprise scale sofware and processes to get the most from it.
- CfH seem not to have the vision to define what is required or is good for the NHS. The monolothic approach adopted may have worked if many of the other issues hadn't occurred. Given them though, whats being attempted is well nigh impossible. A different tac is required.
- some of the basic issues don't yet have consensus in the medical profession, such as patient confidentiality. I've heard some outrageous comments on the radio from people who really should know better on this. If the medical profession can't sort this one, then the public will loose confidence in them, not the IT. Thats bad for all of us.
There are lots of good ideas around CfH. Its amazing to see so much of it wasted though. A rethink is required on how to achieve it. And all those involved should first acknowledge their share of the blame. Then perhaps we might get some progress.
and apologies for my appalling spelling and punctuation in that last post.
"Oh it's not Hewitt's fault"
Well I dont know the ins and outs of how the NHS buys a computer system.
But whose fault is it. Oh so some people were "doing their best"
Are we at school trying to give some encouragement to the under performing kid. No this is about running the country.
Someone signed-off on this system therefore someone is to blame.
Or shall we have an investigation to make sure it doesnt happen again... but it will and it does.
I went to Dover last weekend, walked to the beach and saw all the rats packing their suitcases and swiming off into the sea. As they went mentioned something about deserting and a sinking ship. Anyone know what they mean??
Patricia makes my cat look competent and I haven't even got a cat. Working as an Android is no badge of honour, believe me, but a indication of lightweight arrogance.
It would not be surprising if the system was scaled up PC hackware or that most of the people working on it knew no better and built such a thing anyway. I can book my airline seat on a system that is basically decades old and does it fail? No. So why is the hospital system such a mess? Well, look at the structure of Statist government and see why.
As "lesser-greater" said, it is also about carelessness with money, but how do you expect a population ever more dependent on the state teat to wish for cutbacks? 900,000 new paper shufflers. Countless millions on jobswervers/disabusers and Tax credits etc., over 1m working in the NHS, all manner of parasites hovering about angling for PFI and State contracts and the mindset is "don't kick the trough that feeds you".
The UK needs IMHO a shift to a more minarchist state. NHS needs to be unhitched, Education likewise and a drastic reform of the Welfare State.
In what sense is this IT project atypical of the concept and management of the NHS as a whole?
In democracies, government operates within short time horizons. Some things cannot be done properly and comply with this concept. They are simply too complex and take too long.
A long time extending into many months should have been expended initially by many teams analysing the requirements; this means talking to the prospective USERS and analysing their existing paper based and computer based systems. At the end of that, the technical requirements in terms of computer and network hardware and software with necessary scalability could be assessed for cost and timescale. This would form the basis of a Feasibility Study from which decisions could be taken logically in terms of Cost Benefit and Priority.
The problems which have been encountered indicate that none of this was done. Does the NHS directorate contain anyone who knew that this was what needed to be done? I have my doubts.
There is af course an alternative. Just give the hospitals autonomy and let them decide. Who knows; they might even get some things right and they certainly wouldn't get away with spending such vast sums of money.
The problem is surely the, Government's fixation with all things IT, believing computer systems can resolve broader problems. Blair admits to Luddite tendencies, but one would have hoped the civil service would act as an intelligent client.
Worth remembering also that i) Hewitt's Andersen Consulting rebranded as Accenture, walked away from their £2bn NHS IT work; and ii) Ian Watmore, formerly Accenture, now heads up the PM's Delivery Unit. There are very close links between the government and top consultancies.
There's a lot of opinion on this subject, Anonymous 11.18 makes some very good points, and the Private Eye report was spot on. The Guardian also reported pretty accurately on it as well but the Times and Telegraph didn't. There was also an analyst at Bridgewell Securities who was accurate. Always interesting to see various views and points in the media when you actually know what's really going on because you're on the inside.
Doctors have been saying that this is a monumental waste of money and that it will never do anything useful for several years.
Why is it suddenly news?
And yes, Hewitt, with her management consultancy background, should have recognized the problem and pulled the plug eighteen months ago. (one cannot blame Milburn because he was too dim to know what was going on, and reid wasn't there for more than five minutes)
I was involved in the project on a local level some years ago and I have to say we were saying then it wouldn't work, we could see no benefits and the fact it was split regionally across the country with different coimpanies running different areas was a joke.
There was no feasibility study, insterad we were givena book of rules and told...get off and do it.
Garbage.
Like the dim milburn joke...he is our mp and he is a total joke.
This exemplifies the universal problem of momentum. Once a project is under way governments (indeed, all large organisations, including the armed forces) find it impossible to say, "This is all going terribly wrong, it was a big mistake, and we must pull the plug on it NOW."
They couldn't say it with the Dome, they can't say it with the Olympics, they can't say it with casinos, they can't say it with the NHS computer: the list is endless. It seems, you just can't halt the juggernaut, once it has been "rolled out."
With private enterprise the problem eventually solves itself. If you screw up big time you go bust. But governments rarely go bust. They just send us the bill.
I suspect the NHS never needed a monstrous new system. A souped-up capacity for sending e-mails and attachments would probably have delivered most of what was needed at a fraction of the cost.
if you tink THAT's expensive, wait for the ID cards and vehicle tracking scams - I mean schmes - no I don't.
When people are dying from MRSA (or its side effects) contracted in hospital and old and vulnerable people are catching vomiting disease in hospital, spending a small part of this money on basic hygiene enforcement would seem to be a much better way to spend our tax money. Weeps .....
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