Why PM's intervention on the NPfIT is welcome

Congratulations to the PM David Cameron and Conservative MP Richard Bacon for halting an attempt by officials at NHS Connecting for Health to sign a new NHS deal with CSC before it has been considered by MPs and the Cabinet...

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Congratulations to the PM David Cameron and Conservative MP Richard Bacon for halting an attempt by officials at NHS Connecting for Health to sign a new NHS deal with CSC before it has been considered by MPs and the Cabinet Office.

Perhaps the most important part of Cameron's statement was that a new deal cannot be signed with CSC until it has been reviewed by the Major Projects Authority which is a partnership between the Cabinet Office and the Treasury. 

The Authority has an enforceable mandate from the Prime Minister to oversee and direct the effective management of all large-scale projects that are funded and delivered by central government. 

It looks at projects from High Speed Two to the Rural Payments Agency's Accenture-supplied IT systems. 

In some circumstances it has the power to halt major projects, though for how long isn't clear. The Cabinet Office says that the Authority can "intervene directly, where appropriate, in any failing major projects". 

In a carefully-worded statement during Prime Minister's Questions in the House of Commons yesterday, Cameron said : 

"Let me reassure him [Richard Bacon] that there are no plans to sign any new contract with Computer Sciences Corporation until the National Audit Office report has been reviewed and until the Public Accounts Committee meetings and the Major Projects Authority reviews have taken place."

Another important facet of the PM's statement was his intention to hold NHS Connecting to Health to account. CfH has been trying to expedite the signing of a new Memorandum of Understanding with CSC which would keep the NHS IT scheme from sinking at a faster rate. 

Indeed CSC issued a statement last week that said it expected to sign an MoU with the Department of Health "within weeks”. This now seems optimistic. A thorough review by the Major Projects Authority could take some time. 

Cameron’s intervention in the talks between CSC and CfH is perhaps the first time in recent years a prime minister has acted to stop civil servants doing what they wanted to do on an IT contract. 

Somehow CfH has remained detached from oversight and intervention by the Cabinet Office which has a mandate to review all contracts over £5m and especially all contracts with a heavy IT component.    

But Bacon was determined to halt a new deal with CSC being signed. He has questioned CSC's performance on the NPfIT. CSC has NPfIT contracts worth more than £3bn.

Cameron intervention means that CfH must now submit to the scrutiny of the Cabinet Office over major deals. 

It’s also notable that Cameron responded to Bacon without mentioning the Health Secretary Andrew Lansley or his NPfIT minister Simon Burns who appear to have “gone native” - not challenging civil servants over the NPfIT. The NHS IT programme remains largely as it was under Labour.

Next week the National Audit Office will report on the NPfIT - and its strong criticisms are expected to be in line with Cameron’s concerns.

 CfH, though, responds to criticism in authoritative reports by highlighting the praise and skimming the surface of the criticism: its officials tend to accept praise as well-founded and criticisms as ill-informed or out of date. There is a danger, therefore, that the NAO report and the allied PAC hearing have little effect on the NPfIT.

Politically the difficulty for CfH is that it was set up by a Labour government largely to implement the NPfIT. Can it change its approach now? Perhaps it will be forced to change, in response to interventions by Cameron and Bacon. 

After Prime Minister's Questions Bacon said: 

“I am very pleased that the Prime Minister stated that no new agreement will be concluded before the NAO report is published and the Public Accounts Committee has had the opportunity to consider it. 

“It sounded very much as if all options are now on the table”.

**

These were Bacon's questions and Cameron's replies yesterday in the House of Commons:

Bacon (South Norfolk) (Con): What discussions he has had with the Minister for the Cabinet Office and the Secretary of State for Health on the performance of Computer Sciences Corporation in installing Lorenzo software within the national programme for IT in the NHS.

David Cameron: "We are very concerned that the NHS IT projects that we inherited were of poor value for money, an issue we raised repeatedly in opposition. According to the National Audit Office, even in 2008, delivery of the care records system was likely to take four years more than planned. 

"Since coming into government, we have reviewed the projects with the intention of making the best of what we have inherited. In part, as a result of our work, the Government have cut £1.3bn from the cost of the national programme for IT in the NHS, including planned savings of at least £500 million from Computer Sciences Corporation.

Bacon: Does the Prime Minister agree that the NHS IT programme will never deliver its early promise, that in particular CSC has failed with Lorenzo and that, rather than squandering £4.7bn that is still unspent, the solution is to negotiate a way forward that frees up billions of pounds for the benefit of patients?

Cameron: "I agree with my hon. Friend that we are absolutely determined to achieve better value for money. Let me reassure him that there are no plans to sign any new contract with Computer Sciences Corporation until the National Audit Office report has been reviewed and until the Public Accounts Committee meetings and the Major Projects Authority reviews have taken place. 

"The Department of Health and the Cabinet Office will examine all the available options under the current contract, including the option of terminating some of, or indeed all of, the contract."


**

The FT reports today that "Ministers are considering cancelling all or part of the biggest single contract in the NHS’s £11bn project to create an electronic patients record". 


Link: 

Prime Minister publicly warns CSC of contract termination

Richard Bacon comments on PM's statement.



 

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