With the British economy haemorrhaging £180 billion this year, mostly caused by the banking bailout, but not just the Banks are causing the problem. The National Health Service
(NHS), the 3rd largest employer on the planet and an annual spend of £100 billion (that is 100 thousand million pounds to you and I, or £1,666 per Man, women and child in the UK per annum !). Just to add to this budget the UK government decided back in 2002 (and it's not due to complete until 2014) to create a "central spine" of IT for the entire NHS for:
- Patients' records to be electronically available to any GP or hospital in England, thereby replacing local NHS computer systems
- Other services include electronic prescriptions, an e-mail and directory service for all NHS staff, computer accessible X-rays and a facility for patients to book outpatient appointments online
- It is the largest single IT investment in UK - costs are expected to hit £12.4bn over 10 years to 2013-14
Can you a) believe the costs involved here, and b) believe that the 3rd largest employer on the planet does not have email services across all its employees?
I'm sure Microsoft or Google would have provided a stand-alone secure service to them if they'd asked! Tell me one other major business that does not have their employees reachable via Email? No wonder changes in policy and efficiencies are rare if they cannot quickly communicate to their staff. But just this week they have announced that because of the budget deficit they will need to cut this £12.4 billion budget down by £600 million.
My view is that no commercial business could afford this kind of project and more importantly if they did, it would have to be delivered well within 12 years. Now the saying goes that a week is a long time in politics, but 12 years is a really long time for an IT project, especially considering how quickly this industry evolves and progresses. I imagine that if this plan were to be considered today, cloud computing would be considered, which, again in my opinion, would speed the roll out and connectivity of all the major suppliers and NHS divisions.
Whilst I agree all this access to connected data across the NH Service makes sense to avoid the slow paper trial and minimise errors in typing and re-tying, it also raises the issue of privacy of data. Abuse of this information could be rife, with pharmaceutical companies willing to pay vast sums to access the data for analysis to determine which drugs they sell should be targeted at what audience.
Insurance companies wanting access to determine risk and exclusions whereas today most people are entitled to medical insurance without even a check-up. Would the Police Service gain access for DNA matching, thus circumventing the debate over a central Police DNA database?
The list goes on.
Some "selling" of the data if approved by the NHS client (the public) could actually go some way to recovering the cost of the project, a business (nasty word in Government circles!) plan.
Now, I believe, that we in the IT Service industry should get involved in these debates, perhaps through bodies like the ITSMF, British Computer Society etc . we have a lot to offer in terms of experience and insight. These large multi-year projects need to be reviewed and revised annually to ensure that they keep up with technological advances and prevent the completed project being outdated and almost inoperable. IBM's market capitisation today on the Nasdaq is around $166billion, approximately the size of the NHS annual budget and with less employees. Perhaps they could provide infrastructure and service advise based on their own internal connectivity and I'm sure they did not spend 12years to obtain it at a cost of £12.4 billion!
Government really do live in a world of their own with no concept of business acumen or reality, if only they were held accountable by the people to the same extent that shareholders hold businesses accountable, we may actually achieve value for money, in a timely, cost effective manner. Look out America, if you go for Health reforms, consider who will run it, and those hidden costs and data debates!