Mick James focuses on the ongoing saga that is the Connecting for Health project and asks whether the consultancies involved are really to blame? Could it be that some of the largest consulting firms on the planet were brow-beaten into being suppliers for the ill-fated project...
Connecting for Health – a project turned sour?
By Mick James
I’d sort of promised myself to stop writing about Connecting for Health, but I just can’t tear my eyes away. Latest revelations include a story from Computer Weekly that the National Audit Office's report was changed before publication to present the programme in a more positive light. Kudos to Weekly for digging up the text, but shouldn’t some credence have been given to the notion that the final draft was an accurate reflection of the NAO’s final verdict, rather than immediately branding it a “cover up...which reads as if it were a defence of the programme composed by the Department of Health”.
If I were the NAO I would immediately take umbrage at this stain on my honour and refuse to leave the dressing room. Not that it makes much difference – the final report, now castigated as sycophantic, was construed in the most negative terms anyway.
More serious is the continuing financial uncertainty surrounding iSoft, one of the major sub-contractors. No-one has made the case that
But I still think we’re missing the wider picture. This is not only the biggest IT project this country has ever attempted, but also a completely groundbreaking piece of procurement. That’s a rather volatile combination, but a fascinating one.
If they could only stop invading foreign countries, this Government’s reputation would stand or fall by its contribution to the reform and revitalisation of public services. Connecting for Health is one of the biggest investments in that project and represents a massive leap of faith in the idea that the health service can be seriously improved by information technology. I find that rather touching. And what, really are the alternatives? Personally, I feel as if I have been transformed into something of a demi-god just by the advent of the internet (and would be worshipped as such if everyone else hadn’t got it). Were we really going to sit back and let this transforming force do wonders for Tesco’s but not our hospitals?
Unfortunately for this
dream, the Government has a pretty unenviable record when it comes to procuring IT. It’s said to be the mark of lunacy if you keep doing the same thing and expecting different results. So this time the procurement was conducted on a radically different and much more confrontational and competitive basis. The stringent terms and high level of risk made so many contractors walk away that one has to wonder on what basis the remaining players stayed in the game.
I suspect some may have had very little choice – to have walked away from a government IT project of such a scale, and such a major part of health IT spending may have been too damaging to the image and reputation of some of the firms involved.
Did the Government bank on this, and effectively blackmail its own suppliers? I’d hate to say so definitely but it’s beginning to look a little bit like it. And in that case, is this the way to do procurement? It might be a vote winner to build government infrastructure with the wealth of consultancy
shareholders and partners, but I’m not sure if it’s a recipe for a long-term healthy relationship between the Government and its suppliers. One wonders on what terms these firms will engage with HMG in future? The Government may think it has the whip hand, but the number of firms that can successfully carry out projects on this scale is very small indeed. What if none of them want to play next time?
Of course, the question of how exactly you do procure infrastructure is still unresolved. Most of the companies that originally built our canals and railways went bust, and we didn’t even get the Channel Tunnel onto a stable footing. In the meantime, we should be getting a massive piece of infrastructure on the cheap, whether we want it or not. It may not be on time, but at least it won’t be haemorrhaging money. Perhaps we should all shut up now until it’s finished.
this is in some way the fault of either the NHS or its head contractors, but the story seems to keep getting thrown into the mix as if to illustrate the general rottenness of all things to do with IT and government.
As further illustration of the negative mindset surrounding this project, even the fact that BT has only been paid a miserable million quid so far is being seen as a bad thing.
Of course, there are serious questions to be raised about Connecting for Health. I’m not a fan of big, centralised computer projects (or big, centralised anything for that matter), and find the British Computer Society’s suggestion that a distributed architecture would work better intriguing, as well as the suggestion (apparently omitted from the final NAO report) that such systems work well in other countries.
