O’Brien, MP for Eddisbury and Shadow Minister for Health, questions the future of the supercomputer programme in light of Fujitsu terminating its contract.

In September 2003, Patricia
Hewitt said:

“The principle, the civil liberties and the practicalities
of great big IT projects and databases have a horrible habit of going

Yesterday it transpired that the
Government are terminating the contract with Fujitsu to deliver the
NHS IT programme to the South East and South West of England. It seems
that in the Government’s attempt to ‘reset’ the contract (code
for ‘pouring more taxpayers’ money in’), Fujitsu have decided
that they cannot deliver what is asked at the price given to them, and
they intend to cut their losses, after what will no doubt be an ugly
legal scuffle.

The question before us is,
does this put in jeopardy the whole ‘supercomputer’ programme – the
core of which is to create a national electronic patient record database,
to enable hospital appointments to be booked electronically, and prescriptions
to be created and administered electronically – and how much of a problem
is that?

Despite New
Labour embracing an internal market in the NHS, and welcoming the private
sector ‘at a local level’ (i.e. imposing it from above) after the
(more) disastrous early years, the NHS IT programme remains a monolithic,
soviet-style mechanisation project (which is why, no doubt, it has survived
Mr Brown’s purges). What is more, getting to the truth of any matter
is near impossible, as tractor production figures remain the order of
the day. In fact, so
obfuscating is the quango that runs it, ‘Connecting for Health’,
that it was recently criticised in a Government sponsored report for a “defensive and controlling
approach to the release of information”. Even the Labour-dominated Health Select Committee had to deal with “vague and inconsistent”
officials when they reported on the electronic patient record.

So, for example, Connecting
for Health routinely tells us that “x” million bookings have
been made to date, whereas against the target that matters (i.e. 90%
of GP referrals to first consultant-led outpatient services should be
made through Choose and Book by 31 March 2007), the Government
are running at 44%

Or on electronic prescriptions
– the target is that 100% of all sites should be capable of issuing
Electronic prescriptions by 31 December 2007:  the Government are doing
better against this target: 64.1% of sites are able to issue Electronic
prescriptions. However, EPS is being used for only 1% of daily prescription
messages, and only about 0.05% of prescriptions are actually dispensed
electronically (assuming 773 million prescription items per annum).
Furthermore it is submitted in parallel with a paper prescription, neutralising
any anti-bureaucratic benefits.

The Care Records
Service itself was supposed to be, albeit tentatively, ready by December
2007. Under this system everyone in the country will have their demographic
data held on a central database accessible across the NHS, in a ‘summary
care record’. Those of us who do not opt out will also have details
of allergies and prescriptions added, and whenever an individual is
treated, that information will be added to the record with their consent.
This will complement ‘detailed care records’ held locally by the
providers who treat us. Aside from the security concerns, progress is
slow – the first pilots only went live in March 2007, and we are still
awaiting a timetable for full roll out. At March 2008 153,188 Summary
Care Records had been uploaded to the Spine in the pilot areas, circa
0.24% of UK medical records.

Last week the National Audit
Office confirmed that:

“Current indications are that
it is likely to take some four years more than planned – until 2014-15
– before every NHS Trust has fully deployed the care records systems.”

Today’s exit
by Fujitsu follows Accenture’s departure in September 2006, after
they had written down $450m losses against the programme. Serious questions
loom – with only two of the original four suppliers left in the market,
will either take on Fujitsu’s contract at the original price? Furthermore,
on the one hand the duopoly increases the negotiating power of the suppliers,
and on the other if these suppliers fail, the Government will be forced
to sacrifice either the project, or swathes of taxpayers’ money. 
But that two
suppliers have now quit brings in to question whether the programme
can ever be delivered.

Make no mistake, Information Technology could
be bringing huge benefits to patient care, frontline healthcare professionals
and informing patient choice. Tony Blair was right when he said in 1998
that ‘The challenge for the NHS is to harness the information revolution
and use it to benefit patients’. The mistake he made was to try and
meet that challenge from his sofa, rather than allowing the hardworking
staff and knowledgeable users of the NHS to solve it themselves. Information
Technology should be used to meet local need, and tailored to local
geo- and demo-graphic situations – the State should step back, support
local innovation, and enable diverse systems to talk to one another,
not build a one-size-fits-all structure from Whitehall – but with
a ‘control freak’ Prime Minister, is that likely to happen?

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