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NHS IT: what went wrong, what will go wrong

We draw up a handy list of excuses for civil servants

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This week Fujitsu pulled out of the £12.7bn National Programme for IT - the government's enormous project to introduce national patient records for NHS patients leaving BT, CSC and iSoft still involved.

How bad must things be for a company to walk away from just under £1bn of government money? And why are we writing yet another story about a government IT project heading inexorably for the rocks taking billions of pounds of taxpayers' money with it? This has happened so many times, and no doubt will again. We all know what the lessons are but for some reason government and civil servants seem unable to listen to even the simplest lessons from past failures.

When the project was started we were told that the use of several contractors meant that competition would drive down prices and the civil service would keep control of costs.

Now that there are only two contractors left for the south of England they can effectively dictate terms to Connecting for Health - the body charged with running the scheme.

One of the core problems of government IT projects - that no one individual is ever in charge - was supposed to be solved by the appointment of Richard Granger as director general. He left at the end of January, ground down and exhausted according to some.

So was the project doomed from the start or was a decently specified project kyboshed by greedy contractors and incompetent civil servants?

Start small

Simon Williams, director of independent consultancy DMW Group, said: "The idea of controlling risk by using several suppliers sounds good but with a shrinking list of suppliers it doesn't work. They should have started small - run a project in one or two small regions with one hospital and two or three GP surgeries in each. Run a prototype project, prove the functionality and show the staff the benefits of it - it is a simple and well trodden route for big projects." The project also failed to consult doctors and nurses who would be using the system, he said.

Williams added that having proved a small scale project works it can, if necessary, be handed over to a bigger supplier to roll-out nationally, once the functionality has been proved.

Martyn Hart, chairman of the National Outsourcing Association, was unsurprised at the problems and questioned whether there was even a need for a national programme. He said Granger gave a talk to the NOA several years ago and the audience was asked afterwards if they thought it would succeed - not a lot of hands went up.

Hart said: "If I live in south London how many times will I need my health records to be sent somewhere else? How many times does that really happen? And even if it does happen then data exchange is old hat - you need some agreement on formats and standards not necessarily a nationwide system."

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