Society & Culture & Entertainment Society & Culture Misc

We Fired the Doctors to Pay For the Computer

As the British NHS stumbles from one crisis to another, it's time to pay tribute to the unsung heroes of the farce of New Labour's 'modernisation of healthcare'.
These are not the doctors, they're not the nurses - they're the armies of management and IT systems consultants that New Labour have unleashed on our long-suffering health service.
Under New Labour, hundreds of millions of pounds have been taken away from frontline patient care and given to management consultants.
With their smart new ideas of targets, efficiency and competition, these management gurus seem to create chaos and waste wherever they go.
Hospitals that are doing well are judged by the experts to have 'overperformed' and are forced to close wards and slow down the rate at which they are taking in patients.
Whereas 'hitsquads' of management consultants are sent in to hospitals that are accused of 'underperformance'.
Huge, expensive new PFI hospitals are being built and then standing almost unused as operations are transferred away from them to supposedly 'cheaper' private-sector healthcare companies.
Meanwhile surgeons are sitting around doing crosswords as their operating theatres stand idle.
And the introduction of 'contestability' and 'competition' has meant an explosion in the number of managers and bean counters.
This month the NHS could boast a truly shameful achievement - under New Labour, the number of managers and senior managers have increased from around 20,000 to over 40,000.
So there are now more managers than there are medical consultants (31,993).
Meanwhile, 10,000 newly qualified nurses can't find jobs.
But the squandering of resources caused by the management consultants is pocket money compared to what the disaster the IT systems consultants are giving us.
The NHS's new computer system, once called the National Programme for IT and now sexily rebranded as Connecting for Health, was originally budgeted at about £2bn and planned to take around three years.
It has now been underway for about seven years and NHS management say it will cost over £12bn, though estimates of £30bn have not been convincingly denied.
So what are we getting for all these billions? Healthcare systems that will be the envy of the world? Or just another massively ambitious and expensive government IT systems disaster? So far the signs are not too encouraging.
The first part of the programme, the simple Choose and Book system allowing GPs to make hospital appointments, is about two years late, was budgeted at£65m, has cost over £200m and doesn't work.
The next bit, electronic patient records should now be working in around 100 acute hospitals - a very minor part is running in less than ten.
Meanwhile, after years of discussions, doctors and IT experts still can't agree about what information to put on the system.
Moreover the system infrastructure is now so complex that a tiny upgrade recently needed around three million manhours of work - this alone would have cost over £240m, in fact, enough to pay for the 10,000 nurses who couldn't find work.
Most failed computer systems projects go through 4 well-known, exasperatingly predictable phases.
First there is Ambition - Connecting for Health certainly gave us that "we will deliver a 21st century health service through efficient use of information technology".
Then comes Pride as the leaders mistakenly equate huge numbers of people using a lot of our money as progress.
We've had that too "we have mobilised a skilled workforce capable of meeting the challenge".
After several billions have been spent, the leaders realise it's not going to work and the Secrecy phase sets in.
At one press conference, the project management refused to admit journalists from the UK's leading computer magazine.
Finally as more billions disappear and little to nothing is achieved, there comes Blame.
There have been a series of undignified spats between the Department of Health, the management of Connecting for Health and the main suppliers - all naturally blaming each other for the impending meltdown of this great venture.
The systems that Connecting for Health should give us are all useful and should vastly improve healthcare delivery and reduce administration.
However, these systems are being developed in exactly the same way by the same people who have already wasted tens of billions on so many previous New Labour IT systems disasters.
For the sake of our health service, we need to change the way this monster is being managed otherwise we will see tens of billions of pounds siphoned off from frontline patient care with the all too familiar spectacle of more closed wards, cancelled operations and widespread redundancies.

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