Leader: No to any NHS IT whitewash

Public spending watchdog the National Audit Office (NAO) may have been able to ignore many of the problems with the £6.2bn NHS IT programme in its surprisingly upbeat progress report last week but MPs have not been as accepting.

Indeed, at a packed and at times extremely heated Public Accounts Committee meeting at the House of Commons yesterday evening, MPs accused the NAO of giving in to bullying by Department of Health officials and producing a "gushing" and "universally positive" report into the Connecting for Health programme.

More interesting were the barbed exchanges between MPs, NHS IT director general Richard Granger and two of his now highly critical ex-colleagues, Professor Peter Hutton, who used to head the National Clinical Advisory Board, and Dr Anthony Nowlan, former director of the now defunct NHS Information Authority.

Hutton referred to the clinical consultation as a "sham" that has led to the procurement of systems that don't meet clinical needs, while Nowlan said the rush to sign contracts "trumped all other aspects of consideration".

Granger, not surprisingly, was quick to point to various statistics showing that parts of the NHS IT programme are up and running and being used on the frontline today, such as e-prescribing and the secure network that will support a patient record system.

But this doesn't hide the very serious problems with the core piece of the whole Connecting for Health project - the electronic patient record system. The grand plan for this was a central electronic record containing every patient's entire medical record, which could be accessed by authorised medical staff and GPs anywhere in the country.

It is a lofty and noble ambition that would be welcomed by everyone in the NHS but, unfortunately, it is still some way from reality. While the network that will support the system is up and running, the only patient information that can currently be electronically exchanged is name and address.

The care record system is now running two-and-a-half years late because GPs and the clinician community are unable to agree exactly which patient information should be stored on the electronic record - a legacy of the failure to consult properly before the contracts were signed.

Granger and NHS CEO Sir Ian Carruthers insisted that clinical engagement is being stepped up to address this but, as MPs at the PAC hearing rightly pointed out, isn't that all a bit late?

Granger has rightly been praised for drawing up IT contracts that avoid the mistakes of past government IT failures, only rewarding suppliers for delivery - and penalising them, rather than taxpayers, for failure to deliver.

But at what cost has this come? Has the rush to procure and fit the timetable set by the Prime Minister led to a fundamental failure to engage the very people who will have to use the new NHS IT systems?

Just this month we can see evidence of that in the £19m that some healthcare trusts in the south of England have had to pay to get out of a contract that could have seen them paying more than £50m per year in penalties to lead contractor Fujitsu Services for failing to provide IT resources to support implementation of new systems.

And the PAC meeting heard that NHS Trusts in the northwest of England may now also have to fork out £37m to CSC to get out of a similar contractual obligation.

The NHS IT programme is indeed a highly ambitious project and, understandably, with that will come risks and setbacks along the way. Yet while it is already delivering some tangible successes there are also serious causes for concern and simply trying to ignore that is a recipe for disaster.

The question has to be asked: is now the time for the government to admit there should be a fully independent review of the NHS IT programme?