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Granger's macho approach to negotiating with suppliers has also been criticised. Dealing with a company over ten years requires a relationship to be nurtured - not just posturing.

Hart also favours a local, bottom-up approach: "Maybe they should have eaten this elephant in small chunks. That would be better for smaller, local businesses."

Asked why the civil service has such a dismal record on IT projects Hart said: "There are two main reasons. Firstly there's much more scrutiny - you've got the National Audit Office, the Public Accounts Committee and politicians all looking at it. In the private sector it has to become a mega mess before anyone hears about it.

"Secondly it's the way the civil service works internally. It's a blame culture and a question of check lists - you're safe if all the boxes are ticked, even if it doesn't make any sense. There's a pressure to conform - it is very difficult to stand up and say no."

Hart said there was also the issue of "tour of duty" - senior civil servants are typically in post for two or three years and politicians for even less time. Civil servants also need to understand that suppliers exist in order to make a profit - if you force a supplier to cut costs every year then their revenue will fall. If revenue keeps falling the project manager is likely to get moved or sacked.

Norman Lamb, shadow Health Secretary for the LibDems, said: "This is yet another example of a hopelessly flawed, centrally imposed project that has not been properly thought through from the start and was never subjected to a proper cost benefit analysis."

John Pugh, LibDem MP for Southport, told The Register: "Fujitsu's departure shows that despite the government's best efforts at dismissing all concerns there are serious problems with this project."

Pugh sounded the alarm for the project in the future: "Fujitsu have pulled out because they cannot make it work for the price which is on offer. It puts great power in the hands of the remaining suppliers. No doubt someone will step in but they'll step in at the price they want. We're in for further delays or substantial financial overshoots."

The government was likely to try and make virtue out of necessity, he warned, and re-badge the project in some way and spin the different approach as a reaction to doctors' concerns.

Even a change of government was unlikely to make much difference, said Pugh, because so many civil servants are behind the project - classic "Yes Minister syndrome" - that change would be like turning around a supertanker. The Tory party did not respond to Register enquiries. ®

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