Everybody lost in NHS IT disaster
A degree of ironic congratulation is due to the Department of Health (DoH) and Cabinet Office minister Francis Maude for finally extricating the NHS from its disastrous contract with CSC.
The supplier, which was meant to deliver patient record systems to 160 NHS trusts, has ended up with just 10 trusts to complete.
The DoH says it has saved £1bn by renegotiating the original £3bn deal with CSC, but is reluctant to disclose how much it will ultimately spend with CSC. Let’s hope it’s not the apparent balance of £2bn – that would give 10 trusts a £200m patient record system each, which would probably be the least value for money IT projects in global healthcare history.
The irony of the congratulation comes in light of the billions that the DoH has spent over 10 years on the National Programme for IT (NPfIT) with such a poor return. There have been success stories – the Choose & Book appointment booking system (eventually), the PACS imaging system, NHS-wide email and the N3 broadband network – but based on the major objective of a national electronic patient record system, NPfIT was an abject failure.
According to a National Audit Office report last year, £6.4bn had been spent on the programme, with a further £4.3bn earmarked. Presumably, the £1bn saving with CSC is simply a reduction in that figure.
But it’s not only the NHS and the taxpayer that has lost from NPfIT.
Two of the originally contracted suppliers, Accenture and Fujitsu, quit or were thrown off the programme at significant cost to each after they found they couldn’t deliver their commitments and were losing money.
BT was forced to write off £1.6bn in 2009, due mainly to its NHS contract. BT at least had an early opportunity to renegotiate its deal before Maude’s austerity-led supplier renegotiations, and is probably feeling pretty smug now as it watches CSC’s woes.
CSC itself wrote off $1.5bn – effectively its entire investment in NPfIT – making a substantial loss on the contract, not to mention the reputational disaster it has been for one of the world’s largest IT services providers.
When the NPfIT contracts were first awarded, I was told privately by IBM and EDS – then the two biggest outsourcers in the world – that they wouldn’t touch the deals with a bargepole because the risks were weighted too heavily against the suppliers.
The architect of those deals, former NHS IT director-general Richard Granger, famously said he would “hold suppliers’ feet to the fire until the smell of burning flesh is overpowering.” Accenture, Fujitsu, BT and CSC certainly got their feet burned, even years after Granger quit.
Granger set out to reverse the historic perception that IT suppliers had Whitehall over a barrel when negotiating contracts, but hindsight shows that his combative style pushed the balance of risk too far the other way.
Therein lies the only real lesson that can be taken from the whole humiliating history of NPfIT.
It’s become a cliché, but major projects have to be a genuine partnership. That requires an intelligent buyer, with sufficient in-house skills to assess suppliers and hold them to account. It also requires suppliers who stop selling products and boxes and packaged services, and understand what it really means to deliver business outcomes. Sadly you would struggle to name a single major IT supplier who would fit that description, even today.
The government’s reaction to NPfIT – and other major IT disasters – is to loosen its reliance on big system integrators entirely, trying to find ways to make it easier for small IT firms to do business with Whitehall. There’s a long way to go with that one too, and we will be reading about mega-contracts going to global system integrators for a while yet.
CSC, meanwhile, gave the most entertainingly positive spin on the culmination of its negotiation with the NHS, calling it a “a significant milestone in our relationship with the NHS” and “a renewed commitment by the NHS and CSC to a long-term partnership.” Certainly it’s a significant milestone, and those 10 trusts are stuck with CSC’s Lorenzo patient record system for the long term.
CSC will compete on an equal footing with rivals for every other NHS trust as the NPfIT is dismantled and devolved to local IT purchasing decisions. On that basis alone, the only way is up for CSC.
Everybody lost in the NHS IT debacle. We can only hope everybody learned from the experience.
Proposed charity watchdog chief defends Britain’s non-government schools
The Conservatives didn’t appoint a Commander of the Royal Victorian Order (CVO) to the job without knowing what they were doing!
Independent schools should not feel under threat over their charitable status, the man set to take over the charity watchdog signalled yesterday.
William Shawcross, the biographer and journalist, defended the work of public schools such as Eton, where he was educated, insisting they provided “considerable public benefit”.
During questioning from MPs, he brushed aside calls for private schools to be stripped of their special status – which brings millions of pounds of tax breaks – insisting that education should in itself be considered a “charitable purpose” as much as the relief of poverty or the promotion of religion.
He also signalled that so-called “chuggers” could face new regulations and insisted that charity law should not be used unfairly against churches.
Mr Shawcross, who has been named as the preferred candidate as chairman of the Charity Commission, was being questioned about his plans for the £50,000-a-year post during a hearing before the Commons Public Administration Select Committee.
Under the leadership of Commission’s previous chair Dame Suzi Leather, private schools fought a sustained campaign to retain their charitable status.
It followed new legislation introduced by Labour saying that organisations must demonstrate “public benefit” to justify their position as charities.
Following a legal challenge, the Commission recently drew up new guidelines saying only that they could retain the privileged position as long as they provided some services to poorer pupils.
During the hearing the Labour MP Paul Flynn told Mr Shawcross it was a “nonsense” that public schools whose fees preclude poorer children from attending provided the necessary public benefit.
But he replied: “Education has always been a charitable purpose.”
He accepted that he had a privileged upbringing but said he was “very lucky” to have gone to Eton.
The ‘last chance saloon’ for Britain on immigration control: Landmark debate will discuss pressure caused by unprecedented levels
David Cameron will be ‘saying goodbye to the country we inherited’ if he doesn’t get a grip on immigration, MPs will be told today.
Labour’s Frank Field and the Tory backbencher Nicholas Soames will say the UK is in ‘the last chance saloon’ in a landmark debate to discuss the pressure on society caused by unprecedented levels of immigration.
They will urge the Government to slash net migration – the difference between those arriving and those leaving – to 50,000 a year.
The debate was called after more than 143,000 people signed a Downing Street e-petition last year urging Mr Cameron to prevent the UK’s population, currently 62.3million, hitting 70million.
Official forecasts say that, at current rates, that level will be reached in 15 years.
In a joint statement, Mr Field and Mr Soames said: ‘This really is the last chance saloon.
‘If the Government were to lose its nerve and fail to press on with reform we would be saying goodbye to the country we inherited’.
The two respected MPs joined forces to form a group campaigning for ‘balanced migration’.
They will table a motion, based on the e-petition, which calls on the Government ‘to take all necessary steps to get immigration down so population is stabilised as close to the present level as possible’.
The e-petition campaign, organised by Migration Watch, smashed the 100,000 signatures barrier required to trigger a Parliamentary debate in less than one week. At one stage it was being signed by one person every three seconds.
Last week, the Office for National Statistics said net migration in the year to December 2011 was 216,000 – down from 252,000 the previous year.
Immigration minister Mark Harper said: ‘I’m looking forward to this debate where I will be outlining this Government’s commitment to bringing immigration back to sustainable levels. ‘Reducing net migration to the tens of thousands is vitally important. ‘Recent policies are starting to make a difference.’
Still no answer: Why was this British couple locked up for three days?
There was clearly no likelihood of their conviction and no risk of them absconding. It’s just police bullying. British police are scum these days
The couple arrested for opening fire on intruders who targeted their isolated cottage will not face charges, the Crown Prosecution Service announced last night.
Andy and Tracey Ferrie had been held on suspicion of grievous bodily harm after dialling 999 to report that they had discharged a shotgun when a four-man gang broke in to their home in the middle of the night.
The couple spent almost three days and nights in custody until they were released on bail late on Tuesday night.
Yesterday, hours after two men appeared in court charged with burglary in connection with the raid on the Ferries’ 200-year-old cottage, prosecutors said it was ‘clear’ the couple ‘did what they believed was necessary to protect themselves, and their home, from intruders’.
Judith Walker, chief crown prosecutor for CPS East Midlands, said the department had advised Leicestershire Police to release Mr and Mrs Ferrie from their bail. Mrs Walker said: ‘I am satisfied that this is a case where householders, faced with intruders in frightening circumstances, acted in reasonable self-defence.’
At Loughborough Magistrates Court yesterday, Daniel Mansell, 33, admitted burgling the Ferries’ rented home.
She said stockily-built Mansell – who appeared to have his arm in a sling under a grey sweatshirt – was injured inside the property and arrested later at hospital in Leicester.
Mansell, from Leicester, was remanded into custody and the case was adjourned until September 25 at Leicester Crown Court.
Joshua O’Gorman, 27, gave no indication of plea and was remanded in custody to appear before magistrates on September 14.
Two other men, aged 23 and 31, who were arrested on suspicion of aggravated burglary, have been released on bail pending further inquiries.
Toddler died of methadone overdose after social workers failed to take him away from heroin-addict parents
Britain’s Marxist-trained social workers invent all sorts of reasons to take away children of decent parents but ferals can do no wrong. To bad that some of their kids die
A toddler died from a methadone overdose after social workers failed to take him into care, a damning report revealed today.
Jayden Lee Green, who was just a month short of his second birthday, was found dead in his parents’ bed after overdosing on the heroin substitute in August last year.
The toddler, who was given the drug to sedate him, lived with his crack cocaine and heroin-addicted parents Jamie Green and Sonia Britton in a filthy flat in the St Georges area of Bristol.
A serious case review, commissioned by Bristol Safeguarding Children Board, found there was a lack of co-operation from Jayden Lee’s parents with all involved in dealing with them.
This included drug agencies, midwifery, housing, health visitors, social workers and there were also regular failures to keep appointments or be at home when visits were made.
The report stated: ‘What was lacking was the authoritative challenge to this lack of co-operation, there was a lack of enforcement of consequences. There was a lack of challenge by practitioners across the range of agencies.’
The report, which referred to Jayden Lee as ‘Child K’ throughout, continued: ‘The extent of the parents’ lack of engagement, avoidance and dishonesty grew over time and although this was recognised by practitioners there was insufficient challenge by professional and no sustained, planned approach to protecting the child.
‘The only way that Child K’s death would definitely have been prevented was if he had been placed away from his parents.
‘The opportunity to do this was lost due to the failure to follow through on the initiation of care proceedings. However, a better-planned and authoritative approach to the family may also have prevented his death.’
It was revealed today that Jayden Lee suffered two head injuries – one at seven weeks and one at 11 weeks – and his parents gave the same explanation. The report stated that this should have raised concerns that the injuries were not accidental.
The boy also sustained injuries to his face at 21 and 23 months old and again the same explanations were given when he was seen by medical professionals.
Britton, 35, and Green, 33, were accused of killing their son by giving him the drug that they were both prescribed by doctors.
After a three week trial at Bristol Crown Court, Green was convicted of manslaughter and causing cruelty to a child and jailed for nine years.
The jury cleared Britton of manslaughter but convicted her of child cruelty and causing or allowing the death of a child. She was jailed for four years.
The trial heard that there were bags of rubbish lying around their one-bedroom ground floor rented flat, as well as drug paraphernalia kept in cupboards and crack pipes under the sink.
A rolled up cigarette was found in a child’s cot and there were also dirty potties.
Both his parents were prescribed methadone and scientific tests showed the fatal dose administered to Jayden Lee was not the first time he had been given the drug.
During the trial the court heard that several different agencies were monitoring Green and Britton in caring for their son but they were able to pull the wool over their eyes.
‘Sonia Britton and Jamie Green were aware that health care professionals, drug workers as well as social services were monitoring their behaviour as well as trying to help them,’ prosecutor William Mousley QC told jurors.
‘They created an image with those professionals that they were looking after Jayden Lee. Of course nobody knew they were giving methadone to Jayden Lee. ‘While both of them cared about Jayden Lee, he was not their priority. They were drug addicts, whose need for drugs came before Jayden Lee.’
The serious case review said there were a number of ‘missed opportunities’ for health and welfare professionals to ‘fully understand the circumstances’ of Jayden Lee’s home environment.
Before he was even born there were concerns that Britton was regularly injecting heroin while also taking methadone during the pregnancy.
Following his birth he became subject of a child protection plan but that was discontinued. A second child protection plan was commenced but moves to take Jayden Lee into care were never initiated, the review said.
During this time Green and Britton continued to use heroin and methadone and were also were falsifying regular urine tests. They pair later admitted they ‘knew the tricks to get around screening’.
‘None of the professionals involved with the family had foreseen the possibility of either child being given methadone by one or other of their parents,’ the serious case review said.
‘There is some evidence through other serious case reviews and research that administration of methadone and other substances including alcohol to children by their parents may not be uncommon.
‘Although the death of Child K could not have been predicted there were indicators that the long-term outcomes for Child K may have been negatively impacted by his parents’ lifestyle.’
Prof Jones also called on the Government to publish guidance on the testing of children for methadone. ‘One of the issues we are grappling with is when methadone is being prescribed, it is not being misused,’ he said. ‘In particular not being used as a tranquilliser or sedative with children.’
Prof Jones added: ‘We are looking for the Government to determine what ought to be the national position in relation to the testing of children.’
Annie Hudson, the city council’s strategic director for children and young people’s services, said: ‘Bristol City Council fully accepts the recommendations made in the serious case review into the tragic death of Jayden Lee Green.
‘The administering of methadone to Jayden Lee was a deliberate act and one for which the parents are now serving a custodial sentences.
‘However, at the time of his death there was no evidence of immediate risk to Jayden Lee. ‘With hindsight, if we had known he was being given methadone, we would have acted immediately to place him away from harm.
‘Many of the recommendations outlined in the findings of the report have already been implemented, including a new working group on substance misuse, revised guidance and protocol for practitioners, a review of services for drug-using patients and arrangements for prescribing methadone.
‘Two events to improve and strengthen communications are under way. ‘Our legal team has introduced new guidelines on how legal advice is given and improved monitoring of the progress of cases.’