Health Secretary on the future of NHS IT

An article in The Observer yesterday was a reminder that the Cabinet Office, in seeking to take an independent look at CSC's £3bn worth of NPfIT contracts, has its work cut out.The Cabinet Office's Major Projects Authority has sent its...

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An article in The Observer yesterday was a reminder that the Cabinet Office, in seeking to take an independent look at CSC's £3bn worth of NPfIT contracts, has its work cut out.

The Cabinet Office's Major Projects Authority has sent its recommendations on the future of CSC's NHS IT contracts to the Department of Health and to No.10. In any disagreement between the DH and the Cabinet Office, David Cameron would take the decision.   

Over the future of the NPfIT contracts the Health Secretary Andrew Lansley is in no doubt that CSC's contracts should not be cancelled. The Observer yesterday quoted part of what Lansley said in a BBC interview last week.

"Are you locked into contracts?" asked the BBC interviewer Charlie Stayt.

"We are . We are," replied Lansley. 

"You will have to spend that money [billions has yet to be spent on the NPfIT contracts] even if it’s going to be wasted?" asked Stayt. 

"We will not have to spend all of that money. We have already reduced the cost of the [programme] by £1.3bn. What we are setting out to do is to arrive at a place where we get value for money out of these contracts. It’s a not a situation where we can simply walk away and abandon the expenditure and abandon contracts.".

Lansley went further, by defending the benefits of the NPfIT.

"There have been a number of advantages so far," he said. "The NHS has now acquired N3 a national communications network within the NHS. That works for the NHS. It does enable people within the NHS on a secure internal system to communicate right across the service. It has helped us to arrive at a place where digital images can be archived and transferred across the NHS."

Stayt made the point that digital images are not detailed care records.

Lansley replied: "La st year when we came in we re-established confidence in the programme in building electronic care records - the Spine records  - that GPs are building in a number of areas across the country."

Stayt asked how many  hospital have systems that are "simply not compatible with the generic nationwide system that was being envisaged". How many hospitals now have systems that cannot link up even if you carry on spending the money, asked Stayt. 

Lansley: "Well a number of hospitals ave patient administration systems that serve their purposes that aren’t the ones that theLabour government intended them to have. …we do intend to arrive at a place where through the national networks the basis care record can be transferred. You need in a locality for people to talk to each other. 

"You need the GP computer system and the records held by GPs in the community ot be able to be sent to the hospital and for hospital records to be sent to GPs. It is absurd if you cannot have this. Most of us are treated in a locality and we don’t expect there to be barriers between the hospital and the community services in dealing with our electronic records.” 

Is Lansley right?

Lansley is right about the need for GPs and hospitals to exchange records. But is he right that the CSC contract needs to be continued? 

The Cabinet Office's Major Projects Authority has a difficult task in taking an independent view of the CSC contracts. If it has recommended cancellation - and we don't know it has - it will be opposed by Lansley and by Sir David Nicholson who is Chief Executive of the NHS and the NPfIT Senior Responsible Owner. On the other hand, any decision of the Major Projects Authority is likely to be backed by David Cameron. 

So what will happen now? Conservative MP Richard Bacon says the CSC contract should be cancelled, and he has emailed his suggestions to the Cabinet Office and to No.10. His email could influence No.10's decision. 


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