After a request under the Freedom of Information Act, NHS Connecting for Health has published a list of its top 100 suppliers. At number 36 on the list was the BCS, the Chartered Institute for IT.
CfH paid the Institute, which has at times been a trenchant critic of the NPfIT, more than £1.3m in 2009/10.
Perhaps this level of payment should not be surprising.
The Institute is leading a campaign for the IT profession to be respected in the same way as older established professions, and it offers IT practitioners professional development and support in their careers.
CfH says its payment to the Institute was to “produce accreditation, testing, certification and support to the new IT Skills Programme in the NHS”.
The payment, however, raises a question that can be asked about many organisations from the media to pressure groups: can they have a truly independent voice when they are taking money from organisations they are scrutinising?
When a housebuilder becomes a construction magazine’s largest advertiser, does the magazine’s editor start to tone down - or even remove - criticisms of the building firm?
When the Government pays Friends of the Earth to do a study on the future of nuclear power, is the organisation’s independent voice modified gently by the Treasury’s cheque?
Do research companies, consultants and polling firms that are regularly hired by, say, the Department of Health, subtly modify their assessments to take account of what the Department wants them to say - and avoid saying what the Department doesn’t want them to say?
In short, critics be turned into allies by payments that can be justified as perfectly legitimate - especially when the payments are so large the recipient may become dependent on them.
It’s easy to nullify a criticism in a draft report by making it ambiguous, or giving it shades of meaning. Criticism can be deleted on the grounds that it lacks a consensus on its veracity. A final report can be full of specifics without any distinctive conclusions, and thus be ignored.
The BCS was once a sharp critic of the NPfIT
In the early years of the NPfIT, the BCS Institute was an important critic of the NPfIT. In recent times the Institute has been more helpful and constructive than critical.
I doubt it has been silenced, or turned into an ally of CfH, by a rising level of payments. Indeed its comments in recent years could be seen as a much greater service to the future of NHS IT than sharp criticism.
But can its voice be said to be truly independent when it’s such an important beneficiary of CfH funds?
It’s hard to see how any direct beneficiary of CfH funds could be perceived as a truly independent critic.
More worryingly, what’s to stop any government department or agency silencing its most authoritative critics simply by commissioning them to do research or other work, and by offering them confidential information and the ear of the powerful in return for signing a non-disclosure agreement?
And the departments know that.
NHS Connecting for Health's 100 main suppliers - Smarthealthcare.com
NPfIT - business as usual? - Henry Porter
NPfIT announcement is welcome news but more detail needed - 2020Health Blog