Could there be another ‘NHS IT programme’ failure?

We featured the other day the critical NAO report on the NHS National Programme for IT, and our own thoughts on some of the key underlying procurement issues and problems.  Today, we’re looking into the future, and asking – could this happen again? As we said in the last post, it may be that we’ll never see quite such an ambitious IT programme before; but there will certainly be other ambitious public sector programmes of different types.

So it’s interesting to consider the role of civil servants, consultants and commentators in all this. We've heard quite a lot recently about frustrations in Government at lack of progress in some areas because civil servants are not co-operating enough with Ministers’ agendas. The excellent Ben Brogan, for instance, in the Telegraph:

The Department for Education, suggest increasingly riled ministers, is becoming the biggest single obstacle to improving the woeful attainment of children languishing in what Alastair Campbell described as "bog standard comprehensives".

Now much of this may be down to the fact that departments are going through headcount reductions of 20-40%, so it wouldn't be a surprise if people are a little distracted, as they consider whether to take redundancy packages; and resource is obviously constrained in this environment.

But the point really is this; how far can, and should, civil servants go to point out to Ministers the negatives of their initiatives and projects? Because no doubt there were some people in the Department of Health back in 2002 who felt that the NHS IT programme was going to fail. And I know civil servants who were horrified by the aircraft carrier decisions being made in the last Government; and others who always felt that the ID Card programme would never work and was a huge waste of money (even if it hadn't been killed off).

Civil servants therefore have to strike a fine balance between giving their opinions on these matters, and doing their job, implementing their Minister’s policies. Frankly, the industry side, consultants and suppliers, have a vested interest in not pointing out the problems - they'll just take the cash.  And even the media, or at least the commercial media, have to be a little careful, as no-one particularly wants to antagonise those in power too often!

So, we can probably assume something in its early stages now will turn out to be another disaster – like the NHS IT programme. Which project or initiative? I don't know.  But somewhere, a senior civil servant is doing something (s)he thinks will waste a fortune, because the Minister has told them to.  Might it be the high-speed rail link? Or GP commissioning (although that may never happen of course)? Or some major IT programme in DWP or HMRC?

It's always easy to be wise after the event. It's more difficult and challenging to be the person standing up at the early stages, saying "this won't work", and then being branded uncooperative or worse.  I'd like to think senior procurement people in Government would do that where appropriate, but it's a tough balance to strike, as I know from personal experience.

First Voice

  1. Hugh:

    My hunch is that the £33 billion high-speed rail link will be the next “NHS IT programme”. Even though it’s not yet been formally approved, the Government’s already set aside £750 million to spend on it this Parliament, funding HS2 Ltd’s fulltime staff of 54, plus armies of consultants.

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