Really rather glorious argument here.
That means that NHS reform should concentrate as much in ensuring that there really is progress in ensuring front line services get to people at least reasonable cost. So the next reform I have to proposes has this goal in mind.
IT reform in the NHS has concentrated on big data issues, the NHS spine, and such issues. Well, that was the land of Tony Blair fantasy (he who had never touched an email).
OK, centrally planned, imposed, IT reform is really not what we need.
But there’s no central direction in the NHS to demand this.
That’s the price of the absurd policy of local decision-making – it leads to massive local inefficiency as best practice is not shared and has to be re-learned locally, time after time again.
Start a basic IT revolution in the NHS, I say, and do it nationally, now.
Therefore we need centrally planned, imposed, IT reform.
We also have another description of that best practice being shared. The creation of best practice is also known as invention and the spread of it as innovation (see William Baumol for more). And invention can happen in any system, but we know very well that market based systems foster innovation much better than planned systems (Professor Baumol again).
So Ritchie is actually arguing for, central direction and planning of IT, exactly the opposite of what will gain his desired goal, the spread of best practice in IT in the health care system.
Quite remarkable really. Is there no beginning to this man\’s wit, erudition and competence?