Monday, March 08, 2010

Will anyone ever get IT and the NHS right?

When will the Labour Party finally admit they're totally crap at delivering Government IT projects and just scrap them? OK, so it's a stupid question, I know that. The Labour Party, be it their official website, or through their retarded useful idiots on Twitter, will never admit they've failed at anything, it's all about the so called "change we see" that applies doublethink to the failure everyone else can see.

Take the NHS IT programme as a classic example. A project with plans to give us all electronic health records of a superduper flashy national system. Original delivery date? 2006. Original budget cost? £1bn. Current delivery date? 2015. Current budget? £12bn. Has it delivered anything? Well, Labour ministers will tell you it has, they'll say there is now "Choose and Book" which, in the words of Andy Burnham "provides choice and convenience for patients". Except it doesn't.

The system has been slated at a technological level, doctors have catalogued it's deceitful illusion of choice, and patients have detailed how it's more "take what you;re given else go to the back of the queue assuming we don't lose you on the system of course" than choosing when to see someone. The fact is it's not change for the better, it's a website that promises you jam and gives you only butter and it cost you and me a small fortune to pay third parties to build it over-timetable and over-budget.

And yet, they continue to plough ahead with the big goal of a national central single-point-of-failure system, and now they're even trying to excepbind the hands of the next Government into private contracts with suppliers who are coining it whilst creating, to put it a bluntly, a clusterfuck system. I've said it before and I'll say it again, we need to have a Whitehall-wide department dedicated to the management and driving of IT projects run by IT professionals not old-school civil servants who get bamboozled by people like Accenture et al.

Don't get me wrong, I actually think that the NHS should have an IT system that allows for someone that lives in Derby to walk into a hospital in Truro and have their records accessed. The problem is that Labour have done what Labour do best, and accepted a centralised solution when a decentralised locally driven solution using and open standard framework for the record structure would have been a better means of achieving it.

Instead of a centrally driven, centrally controlled budget, the many PCTs throughout England and Wales should have been free to develop their own systems using a basic framework that allowed other PCTs to interact with their data. What has been forgotten in the project is that whilst the eventual goal of the Derby/Truro situation is desirable, most people get treated where they live and don't move around the country from one PCT to another.

Instead of creating the central link from the outset, and the central hub/spine, the approach should have been to get it working locally first using an agreed framework for record formats. Do the linking up afterwards. Let the PCT choose it's own contractor locally. Every PCT does not have to have the same system architecture and structure in order for the systems to integrate and communicate as a larger whole.

Of course, I'm really just "pissing in the wind" when I say all this. Labour have committed themselves to the flawed centralised and inelegant model. The Lib Dems have committed themselves to scrapping it and have not, as far as I know, offered any alternative for what ought to be a long term goal. As for the Tories, I think they've have committed themselves to, errr... well I'm not 100% sure, scrapping parts of its, keeping other parts?

The use of IT by Government could be wonderful. The problem is the politicians rarely know what they're doing and the consultants they contract just take the piss by exploiting the politicians ignorance. Throw into the mix that politicians will continually change the scope of a project to satisfy short term political ends, and it's fair to say that it will probably never change.

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