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The final cost of the NHS National Programme for IT could top £30bn, and local NHS Trusts will have to find the bulk of the extra cash.

The NPfIT is a multi-billion pound overhaul of the NHS' IT systems. The government first announced £2.3bn of central funding for the project over three years. This has now risen to £6.2bn over ten years.

However, the Department of Health estimates that implementation costs are likely to add between £12bn-£24bn to the bill, according to Computer Weekly, and some Trusts are warning that the NPfIT will eat into funds meant for patient care.

The government says that because spending is being centralised, the NHS will benefit from economies of scale when replacing its old IT equipment. Once implemented, the new systems will also save the NHS a considerable sum. It wants the trusts to fund the implementation with this extra money.

The trusts, in turn, argue that the implementation will need up-front investment and that the savings are by no means guaranteed.

A spokesman for the NPfIT told Computer Weekly that "significant financial benefits will accrue, but in addition, the national programme will support NHS modernisation. Hence the benefits will be seen in improvements to NHS services and therefore improved patient care and safety."

The implication here is clear: even with the savings taken into account, there is a cash shortfall, and opposition parties are lining up to ask where the money will come from.

Liberal Democrat shadow chancellor Vince Cable said that local trusts could be forced to make tough decisions if they want to use local funding to support the objectives of the NPfIT: "This could mean cuts in other frontline services if the project is to be delivered," he said.

Richard Bacon, Tory member of the Public Accounts Committee, said: "If trusts are not given the money to pay for the national programme, how on earth are they going fund it? Will this mean patients waiting even longer for treatment while billions of pounds are spent on unproven systems?" ®

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