What Mr Obama And The MSM Won’t Tell You: UK medical records database a $20 billion catastrophe
August 18, 2009
It started on Tony Blair’s sofa. No longer should the NHS rely on a hotch-potch of elderly computer systems, they told him. The days when patients had to repeat themselves every time they saw a new doctor would be over. They would build a new NHS computer system, a £6 billion grand-projet, and at its heart would lie a vast database that would make researchers salivate. They would build a new NHS. They would revolutionise everything.
And in twenty minutes, so rumour has it, the deal was done. Blair had bought it.
It hasn’t quite worked that way. The care record system, the bundle of patient information on which everything else would be built, was meant to arrive in 2004; five years later it is still five years off. In 2007 Accenture, one of the four ‘local service providers’ (LSP) hired to deliver it, abandoned the project; last year Fujitsu followed it out of the door. After seven years, most hospitals still haven’t got their new computer system, and those that have are struggling to make it work. Most striking of all, the price of the whole project is now estimated to exceed £12 billion.
This week, the Tories have promised to save the day. In a report published on Monday, the party pledged a comprehensive overhaul of the programme. It promised to renegotiate the mammoth LSP contracts that had failed to deliver. It would allow hospitals to buy whatever software they wanted, providing it met certain standards. And it would scrap that faintly sinister national database, and replace it with alternatives as ‘small and localised as possible’.
The party pitched its plans as a radical shift. And to an extent, they’ve been greeted as such, largely thanks to a few under-developed ideas about allowing Microsoft or Google to host patients’ records.
Actually, though, the report is largely a statement of the bleeding obvious, and closely echo what those who actually work with NHS computers have been saying for years.
Designing a single patient record for everyone from GPs to brain surgeons is impossible, they say. And anyway, grand-projets move far too slowly to respond to changing needs. Much better to cobble together existing databases: that way, if a hacker got in – and hackers always get in – they couldn’t walk off with the lot.
The biggest shift of all, though, is that promise to renegotiate those monolithic LSP contracts. These, it has long been obvious, are anti-competitive and ludicrously inefficient, and have sometimes meant replacing perfectly good computers with new systems that don’t actually work. Some question whether they were ever deliverable: asking someone to create an entire NHS computer system from scratch is a bit like saying, “I’d like an internet. Go build one.” Better, say experts, to solve problems through trial and error, and for solutions to emerge through consensus.
All this has been clear for some time. Yet doctors who said so were regarded as wreckers, while suppliers who warned it couldn’t be done found they lost out on contracts.
So why has the government refused to fix this mess? Partly, one suspects, it’s the usual Whitehall control freakery, with mandarins convinced that they know best (“The programme,” notes the British Computer Society’s Ewan Davies, “was run by people who knew nothing about healthcare and didn’t think that was a problem”). Partly it may be simple embarrassment about the need for a u-turn. Or perhaps it’s just a deeply felt love of sinister sounding databases.
The idea that your medical history is safe with Google has raised a few eyebrows
Quietly, things have started to change. Doctors report a new willingness to listen. And hospitals are now allowed to pick their own ‘interim’ computer systems. But the tanker is turning slowly, and, officially, the course remains unchanged: should the national system ever arrive, hospitals are told, they must abandon their own carefully designed systems and use the blasted thing.
The Tory plans aren’t without their problems. It’s not clear how easy it will be to renegotiate those contracts, or how much money would be wasted by scrapping that database now. And the idea that your medical history is safer with Google than the government has raised a few eyebrows.
But those who don’t admit to their mistakes can never hope to correct them. And the current government has shown no sign of admitting to this mistake.