Even The Guardian gets it now

There are lessons in the report for all policymakers. As the failure of the NHS private finance scheme has also shown, the government is an inept purchaser of private services: indecisive, ponderous, overambitious and wasteful. Mass centralisation does not reduce costs, but it kills flexibility. Under the national scheme, NHS professionals were given expensive systems with little discussion of what would actually help them do their jobs. The project was carried along by the momentum of its scale and the sense that having spent so much it would be wrong to pull out (pressures that have also wrecked the defence budget, as a report from the defence select committee reminded people on Wednesday).

Government just can\’t do these big projects. So let\’s not have government trying to do these big projects then, eh?

Of course, it\’s entirely possible that no one can do these big projects. Which rather means that we shouldn\’t be trying to do these big projects.

It was the Yorkshire Ranter who pointed out a few years ago that (I hope I\’ve got this right) there is actually an open source standard that can be used to do this. Developed by some American medics.

All that\’s really required is to insist that, as and when medical records are electronicfied, that they accord with this standard. Good, now we\’ve got the interface determined, you can build whatever local hospital or GP surgery system you like.

In much the same way that you can interrogate the internet from a phone, PC, Apple…….

6 thoughts on “Even The Guardian gets it now”

  1. A few years ago I worked on a child protection system for a local authority and that’s exactly how things were done. Each LA could create their own system, but if a child moved from one LA to another then they could transfer data across a well-defined interface.

    And over a decade ago (before all the alphabet soup of SOAP and REST), I worked on a system for when the electricity market opened up which allowed SWEB, Hyder, EMEB etc to interchange meter readings.

    It’s a well-trodden path. The key thing is that you start with the simple stuff that everyone agrees to as common, then as people get used to the system, you keep adding bits onto it.

    The problem, it seems, is that government went into grand projet mode. It rarely works with software development.

  2. I’m at this very moment trying to get three NHS web applications talking to each other with RESTful web services.

    It was always the original intention of the internet for computers to talk to other computers. All this Browser.eyeball.getData stuff was an unexpected result of HTML on HTTP.

    It’s only in recent web years that people have been properly harnessing the computer -> computer side of things.

  3. Government just can’t do these big projects. So let’s not have government trying to do these big projects then, eh?

    Exactly.

    Blair & co. weren’t interested in developing a minimum standard for medical records or using one that already existed. That’s boring. What Blair & co. wanted was a legacy, a grand projet as Tim Almond put it.

    It seemed about IT for its own sake rather than business change.

    And they ticked off every one of the OGC’s most common causes of government IT project failure:

    1. Lack of clear link between the project and the organisation’s key strategic priorities, including agreed measures of success.
    2. Lack of clear senior management and Ministerial ownership and leadership.
    3. Lack of effective engagement with stakeholders.
    4. Lack of skills and proven approach to project management and risk management.
    5. Lack of understanding of and contact with the supply industry at senior levels in the organisation.
    6. Evaluation of proposals driven by initial price rather than long term value for money (especially securing delivery of business benefits).
    7. Too little attention to breaking development and implementation into manageable steps.
    8. Inadequate resources and skills to deliver the total portfolio.

  4. he NHS is paying private hospitals £35m a month to treat patients – a rise of more than 60% in a year, figures obtained by the BBC show. The initiative was launched four years ago at a time when the NHS was getting bigger rises in its budget and was striving to get waiting lists down.But it is now being questioned amid concerns about how the health service will cope in coming years. I think this is good for patients and good for the NHS – it relieves some of the pressure and creates competition”

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