Granger: NHS troubles hyped up
NHS IT boss Richard Granger defends the track record of the world’s biggest civil IT project and insists its shortcomings are not down to him.
“Despite what you might read instead of concentrating on not spilling your cornflakes over breakfast, we have had successes,” Granger told the audience at the National Outsourcing Association (NOA) conference in London. “How many people have copy of their medical records? How many believe that the next person in the chain of care knows pretty much what the previous person knew” The presumption of care is somehow passed on magically to the next person. In fact there is a complete lack of assured information liquidity which is what I’ve spent the past four joy filled years trying to fix.
“We are not spending $12 billion on IT services. If you are a friend of [outspoken critic] Richard Bacon MP, then sorry, we’re not spending $50 billion. You see all those amazing numbers circulating about what we’re doing as though we’re squandering billions of pounds that could be spent on doctors and nurses,” he complains. “But we’re doing 5 billion electronic transactions that cost 3 pence each that would have cost 12 pence under the previous approach.
“Choose and Book is being used, but there is a significant organisational resistance. But the IT system works. It gets incorrectly portrayed as not working. The resistance to electronic transmission of prescriptions is quite interesting. There is a lot of money involved in the pharamaceutical industry. It’s Big Pharma. It’s remarkable how difficult it has been for chains of chemists to deliver systems of similar compatability. The bricks and mortar businesses are sacred of what will happen when you can fill out your prescription at home. But there’s an Amazon style market change coming to the high street chemists. Up to 100 bodies are piled up in the mortuaries due to transcription errors every month but you don’t get an outcry about that!”
“Most people will have used the NHS in the past year or experienced it through their family or friends,” he argues. “In its first five decades the NHS tried to focus on doing the best for you, but the risk never transferred from you to the organisation. The organisation was not centred around your needs. The NHS is finding it quite traumatic to make that shift towards the organisation carrying the risk. The unions and the suppliers are expressing their ‘disgusted of Tunbridge Wells’ routine at the transfer of the risk from us to them.
‘small organisations used to buy their systems themselves. It was joyful for suppliers as the buyers only did once every ten years or so and so they never got as good at it as the suppliers did. As a results the systems they bought were incompatible. By March 2001, only 6 trusts had EPR systems, by March 2002, only 14 had PACs. Some 99 per cent of GPs had been computerised but they had no interoperability with other GPs or hospitals.”
“We have taken a new approach to procurements. In January 2003, we published a set of procurement principles. We were really trying to set up more effective supply chain or eco systems in the NHS than that which had existed in previous decade. We decided that some organisations that would have supplied us directly before would now have to work with third parties.
“There were third party software firms that just weren’t mature enough for us to deal with directly. For example, IDX decided that they wanted to do cookie cutter software, not complex medical software as the market wasn’t big enough for them. But we had a mitigation plan in place to cope with the risk. These principle were published before we got into the procurement itself. They are still good things for the NHS.”