Scrapping the NHS IT system in the PBR would be a waste of money – and potentially lives

The Amanjit Jhund NHS Column

In tomorrow’s Pre-Budget Report we expect to see the government introduce a freeze on the development of some elements of the NHS IT project. The project was originally established back in 2002 after several Department of Health (DoH) reports on the future IT strategies for the NHS. In 2005 we then had the creation of the NHS connecting for health agency to deliver the strategy. Currently, the NHS IT system represents part of the wider National Program for IT (NPfIT) strategy.

Originally, we had a system that was budgeted to cost £2.3 billion over 3 years with a delivery date of 2010. Sadly, we have seen that cost base spiral to an estimated £12 billion with no current date for the full implementation of the system.

The aims of the project were both commendable and ambitious; the IT program aimed to combine all of the medical data and records in all NHS hospitals in a central database which could be accessed by 300 hospitals and 30,000 doctors across the UK. It would also allow online booking and e-prescriptions along with providing a faster link between NHS computers.

Not only would such a system, if successfully implemented, allow both patient choice and empowerment to flourish, but it could also help save lives through e-prescriptions and the opportunity that it presents to reduce the prescribing errors in the NHS. This is especially important when you consider that approximately 1 in 10 of all prescriptions in the NHS contain such an error.

The Chancellor’s Pre-Budget Report will include the announcement that part of the NPfIT will be shelved. The savings made will be expected to be in the order of £600 million. This only represents a small proportion of the total cost of the project but the cuts themselves are only proposed to cover aspects of the system which have been deemed not to be essential to frontline services. In our current “age of austerity” and with an increasing fiscal deficit it is of course vital that we look to make all of the savings that we reasonably can.

The Conservative Party has been proposing for some time that the entire system should be scrapped but, in opposition to this, many medical groups including the British Medical Association (BMA) have hit back. One spokesman for the BMA Dr Grant Ingram yesterday said:

“While the National Programme for IT was characterised by poor value for money in its early stages, cutting back now is not as simple as it may seem, given that contracts are already in place…We need to be clear that good IT, as well as being beneficial to patients, may save the taxpayer money in the long term. Many of the errors that take place in the NHS could be prevented through information systems.”

The position of the Labour government in this case would appear to me to be the correct one. Whatever our personal feelings about the initial planning, procurement or deployment of the system, to simply scrap it now – as the Conservatives suggest – would be to lose much of the money that has already been invested. This is money that may save us both money and also lives in the long term.

The danger now is that if we simply cut back on elements of the service where the contracts have expired, such as in the case of the Patient Administration Systems (responsible for the medical records element of the project) then we may end up with a system that is not fit for purpose. The main reason why some important elements of the system such as this may come under pressure to be scrapped is that contracts to roll out these services with large providers such as Fujitsu have prematurely ended and as such they may be easier to mothball than other less important segments of the system.

I will reserve judgement for now until I hear exactly which segments of the service are to be scrapped. But, by following the course of action spelt out by the Chancellor tomorrow it may be that we can salvage those elements of the system that are essential to the frontline services of the NHS and ultimately to patient care.