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Arman Vahidi: The NHS IT Project : 'paying for a Rolls-Royce, but getting a second-hand Datsun'

This was the view held by MP Richard Bacon, one of those sitting on the Committee of Public Accounts (“the Committee”), during the investigation of the NHS Information Technology contracts. The conclusions reached by the Committee were that BT Health and Computer Services Corporation, the two contractors involved, had overcharged the NHS for a service that was ultimately not delivered. The NHS senior staff involved in the project were criticised for their poor judgement and wasteful use of public funds. In summary, the Committee is appointed to hold the government to account for its use of taxpayers’ money. The Committee decided to focus its attention on the eight-year long affair between the NHS and the private contractors providing the new IT programme. Launched in 2002, the National Programme for IT in the NHS (“the Programme”) was an attempt at reforming the NHS IT systems. The Committee’s Report, published on 3 August 2011, examined one aspect of the Programme, namely, the attempt to create a fully integrated electronic care records system. This aspect alone has cost the NHS £2.7 billion thus far, and is set to reach a total of £7 billion. In so doing, the NHS entered into commercial contracts the details of which we, the public, and even the Committee, know very little. However, there were a few problems of which we are now aware:
• The objective of a establishing a new universal IT system has been abandoned;
• Severe delays in updating the IT system have taken place;
• There is little to show for the £2.7 billion spent to date; and
• The NHS decision makers are intent on paying the remaining £4.3 billion to go through with, renegotiated, contracts that were never apparently possible to satisfy. One private supplier, Computer Sciences Corporation (“CSC”), has not provided the product as had been contractually agreed. However, according to both Christine Connolly (Director General for Informatics, Department of Health) and Sir David Nicholson (the Chief Executive of the NHS in England), it will cost more to get out of the contract with CSC than to stay with it. The Committee learned that the costs of getting out of the CSC contract would cost “several hundred million pounds”. Additionally, Ms. Connolly, of the Department of Health, added that there is “the potential that the supplier may then come to us [the NHS] and seek damages based on the work in progress that they have on their balance sheet today…Again, that may be several hundred million pounds.” In essence, we as the taxpayer “are contractually committed and coming out of it would cost [us]…more than staying in” retorted the Chair of the Committee in disbelief. Despite harsh criticism from Andrew Lansley, the Health Secretary, he has recently appeared to hint that the NHS may continue with the CSC contract. One can understand the problems Mr. Lansley is confronting, namely, having to pay equally large amounts from public funds whether he chooses to continue with the contract or to bring it to an end. We can only hope that this is not what Mr. Lansley meant when he emphasized the role of the private sector in bringing “Choice” to the NHS. The other contractor involved, BT Health, describes its role as that of developing new technologies for healthcare providers. In agreeing to bring to fruition the Programme for the NHS, they too have failed to deliver on their contract. Now recognising the impossibility of satisfying the contract, the NHS has, it would appear, negotiated higher prices for fewer services from BT Health. The Committee’s incredulity was frequently noted throughout the investigation. They could not quite understand why BT was being paid £9 million to implement systems per site when the NHS Trusts could have directly purchased the programme at under £2 million each. The NHS Chief Executive, Sir David Nicholson, tried every which way to convince the Committee that the deal was not as bad as it sounded. The problem was that in-between such reassurances he also revealed that billions of taxpayers’ money was to be spent “going into a process where there literally is not a product to deliver”, which he, insightfully, described as “inherently risky”. The Committee’s report, published on 3 August 2011, presents a worrying image of the NHS entering into the murky world of commercial contracts, spending billions of pounds for products that do not exist, and being cornered into paying even more for less in what sound more like shakedowns than negotiations. Risk, nonexistent products, private profiteering, and a significant public payout – a formula that is becoming all too familiar in the relationship between government and market. Instead of investing in staff to ensure patients receive the best possible treatment and care and adequately compensating those who suffer the consequences of negligent treatment, the NHS Chief Executives and Department of Health believe billions would be better spent on an IT system, which, with all the optimism in the world, can only be described as “a second-hand Datsun”.Arman Vahidi is a Trainee Solicitor in clinical negligence in the London office of Russell Jones & Walker.If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email and one of our specialist clinical negligence team will be in touch.