It's a national disgrace

Marc Cetkowski PIPC

Public Finance, May 2011

It makes for jaw-dropping reading – ‘no grounds for confidence’, ‘not value for money’, ‘far below expectations’. If these comments were directed at a listed company, shareholders would be baying for boardroom blood. But they are about the Department of Health’s National Programme for IT, and the chances are no heads will roll.

It’s not as if we haven’t seen it coming. This is the third time the National Audit Office has looked at this project and found it wanting and, almost since its inception back in 2002, there has been a steady stream of bad news.

Today’s report, triggered by MP Richard Bacon, is quite rightly damning and must make the powers that be face up to what many in IT have been saying for years – the programme is a joke and government should consider abandoning it all together.

Meanwhile, his parliamentary colleague Margaret Hodge, chair of the Public Accounts Committee, publicly raises the question of who should carry the can. A sideshow that will be interesting to follow but will not make a jot of difference to the outcome: a wasted opportunity and a disgusting waste of taxpayers’ money.

Implementing one of the world’s largest IT projects was never going to be easy, but basic mistakes have repeatedly been made. The focus has always been on the technical delivery of the IT, not managing the change and the multitude of stakeholders.

As a result, the problems that came out of the lack of management, supplier accountability, the failure to proactively communicate, along with cultural challenges, have been allowed to persist and combined have brought the project to the brink. All could and should have been addressed long ago, but there was no one to do it.

In the private sector, any scheme worth even a fraction of this one would have employed proven project and programme management expertise to sit on top, to oversee such an important transformation and manage all the stakeholders.

Given the complexity of this project, it was crucial to have independent programme management with industry experience of large-scale transformation – who were not involved in the technical/operational delivery and who could execute the plan and drive progress. Instead, the suppliers were advising government and therefore had control of both the programme and operational delivery.

In addition, an independent firm responsible for delivery of the whole programme would have put considerably more emphasis on a robust and overarching framework for managing stakeholders, change and culture, engaging users such as the clinicians early on. From this, a sound communications and engagement strategy would have flowed.

Lastly, the way the centralised procurement was undertaken also begs significant question. While a noble intent, it was a mistake to put a commercial value on the programme before specific requirements were finalised. You can’t quantify a cost without knowing what you’re buying.

This has only resulted in downstream problems in executing technical delivery together with damaging supplier partner relationships with the client. So, almost £3bn later, we’re left in the position where the taxpayer is still footing the bill, but receives far less than was promised in return.

Hodge’s desire to bring to account those responsible for this national failure is laudable. Sadly, there are too many to name and they are in the end only bit players. It is also worth keeping in mind that no country has found it easy to create an electronic patient record, but that is no excuse for the state of the IT programme.

Marc Cetkowski is head of government and public sector at PIPC, a global project management consultancy responsible for high-profile business and IT transformations.