I’ve seen some defensive posturing in my time in this game.
One of the longest mornings of my life was watching Apple CEO, Gil Amelio, ramble through the most ill-prepared, under-rehearsed keynote addresses I’ve ever had to sit through. The experience was made all the worse by the knowledge that Amelio was a dead man walking and his executioner was waiting in the wings in the form of Steve Jobs. More recently the grandstanding and posturing of PeopleSoft’s Craig Conway was an unedifying spectacle.
But nothing quite prepared me for sitting through a keynote address by Richard Granger, the NHS IT director, days after the National Audit Office report into the increasingly expensive – and seemingly increasingly out of control and underachieving – Connecting For Health project. You know, the one that the national newspapers have declared is a waste of time, money and effort. For the Daily Mail, it’s another mark of New Labour’s failures; for the The Mirror, it’s money that could be poured into nurses’ wage packets; and so on.
The one thing they all agree on is that Connecting for Health is a waste of money that could be better spent elsewhere. The one person who disagrees with this, of course, is Granger who is insistent that there are success stories to be pointed to. Why haven’t you heard about them? Well, that’s my fault apparently. And the Daily Mail’s. And The Mirror’s and oooooh, just about every other messenger that needs shooting.
There are many ways in which Granger could defend the progress or otherwise of Connecting for Health but complaining about his media coverage is not one of them. It smacks of paranoia and insecurity as well as diminishing the man and his achievements to date.
So how did we get here? Well, it was the ultimate New Labour ‘big idea’. It’s difficult to remember now but there was a time when Tony Blair carried the idealistic hopes of a large tranche of the tax-paying electorate behind him. He could have done just about anything, however radical, and he’d have almost certainly carried a majority behind him. Maybe that’s where the first mistake was made. Something had to be done about the NHS. This was something. Better still, it was bold, expensive and ambitious – plus it had an added bonus of the alluring sexiness of information technology. For a Prime Minister so achingly keen to be ‘with it’ but who by his own admission can’t send an email, it was irresistible.
But if we’ve learned anything from decades of failed IT projects it’s surely this: if you just throw technology at a problem, all you do is automate the problem, not solve it. The NHS is broken. Its original mission statement has been bastardised and corrupted over the decades since the war. The first thing that should have been done with the NHS IT Project was the ultimate business process re-engineering exercise. But it wasn’t, so we set out to spend billions of pounds throwing technology at something that was fundamentally not working properly to start with.
Then there was the lack of follow through. The ideas were big and eye catching but where was the joined up thinking? It’s not just the NHS that’s guilty here. The Criminal Justice IT Project aims to speed up the prosecution and conviction process to get criminals off the street but if the rate of convictions goes up as planned, where exactly are all these new prisoners to be housed? It’s classic public sector IT thinking. Get carried away with the glamour of the technology bit and forget to build any new prisons to house the results.
So too with the NHS: electronic appointment systems are all good and well but how many people on sink estates or over a certain age are going to use them?
Mired in politics
The other problem Granger has is that this is ultimately a political exercise. The real gains from automating NHS processes will come from eprocurement systems and back-office rationalisation and improvement. But Tony won’t pose for photos on the steps of Number 10 with an e-procurement system. Making it cheaper and easier to buy bed pans is what will help but if it’s a choice between that and a photo opportunity with Bill Gates then there’s little doubt which one will take priority.
I’m not about to go along with the tabloids that declare that Connecting for Health is dead but it is showing disturbing signs of needing intensive care urgently. Over the next few months, we’ll be looking closely at the most recent developments. One thing Granger seemed particularly twitchy about was being under too much scrutiny and questioning; well sorry Richard, but you’re spending my money and the money of every reader of MIS UK. I think we’re entitled to know where it’s going.