Cynics attack NHS IT cash boost plans

The high-profile Wanless report on the future of the NHS has received a cautious welcome following recommendations that IT spend within the health service be doubled.

However, industry insiders doubt the government's ability to spend the money wisely and use it to deliver real benefits to the NHS.

Yesterday's report from Derek Wanless, former CEO of NatWest bank, called for a massive injection of cash into NHS IT to help create a modern and efficient health service.

In a letter to the Chancellor outlining the report's main findings, Wanless said: "Current use of ICT is extremely poor, changes in the skill mix of staff can go further and there is significant scope for better management (and less bureaucracy)."

His answer to this is to double government money for IT, ring fence it to guarantee it is actually spent on IT, and further central systems and protocols to ensure compatibility.

However, those with experience of past NHS IT failures are cynical about the ability of the government to avoid past mistakes. Particularly, because increased centralisation is seen as a mixed blessing.

Dr Adrian Midgely, GP and IT specialist, said nearly all examples of successful NHS IT were built and developed at a local level: "Everyone accepts that what has gone wrong in the health service is an over-centralisation of decision-making, except, it seems in IT. This is the only area people are still calling for more centralisation, despite the past history of failures of large IT projects.

"I have seen nothing to suggest further centralisation will help."

Barry James, chairman of the New NHS Intranet and Internet Conference, voiced the same fears: "I'm wary of the usual suspects smelling the money and bidding for more enormous contracts and giving the same failures."

He added centralisation in the NHS often seems to hinder good practice, rather than encouraging it, by stalling IT innovation within layers of bureaucracy.

The government, and Wanless, says centralisation is vital to ensure compatibility of systems, thus allowing real improvements in service quality to be delivered.

Others doubt whether money intended for IT will ever actually to be spent on it, given the number of other demands on every penny of NHS cash. Wanless's recommendation to ring fence the money was welcomed in some quarters.

Grant Kelly, chair of the British Medical Asssociation IT Committee, said: "Without ring fencing, NHS IT is going absolutely nowhere. It is a welcome step."

However, others were more cynical. James added: "Just ring fencing these funds is probably not enough. The rest of the health service needs to be well-enough funded otherwise these funds will leach away."

A spokesman for the Treasury was today unable to say whether Wanless's proposals for IT will be adopted in full, but did strongly endorse his wider findings.