All in the Name
I think you should standardise the name you are using for the new coalition government. So far we have had ConLib, LibCon & ToryDems. With all the cuts they will be making my vote would be "ConDem(ned)"
Dell is urging the coalition government not to cut the world's most expensive civilian IT project - the NHS's National Programme for IT. Parts of the £12.7bn scheme are in the firing line for cuts, not just because of the absurd cost but also because of its unpopularity with doctors and patients. Harry Greenspun, Dell's " …
That we are dealing with a Tory-Whig coalition. We should call it for what it is, I'll be sticking with Tory Whig.
Oh, and for the commenter pointing out about cuts, please do feel free to explain how the UK is supposed to afford its bloated state without cutting some things. Remember, last year was by far and away the largest borrowing that Britain has ever needed to do (about £200bn in rolled over and new debt had to be sold). The only way Britain got that debt sold was by getting the Bank of England to print an extra £200bn and buy debt with it. There is no appetite in the markets for the UK to sell hundreds of billions of debt, there is no way Labour could have sold that much debt, so their big plan was either to print money to pay for no cuts, or cut themselves. By the way, don't forget that printing money = hyperinflation. We can get away with it when the amount we print is relatively small, but we are already seeing the result of printing money with house price inflation back at 10%+. Would you like to buy a house at some point?
... ConDem(ned). Very good.
And while we're at it, let's conveniently gloss over the fact that the Fat Gawping Scottish one left us in the biggest financial shit hole this country has ever seen.
But never mind, eh? As long as we've got our rose-tinted 3D specs on, so we can fondly remember all of the goods things that that inept bunch of authoritarian war-criminals did over the past 13 years, and keep our cynicism fully intact.
The proposed system would only be effective if we all carried some form of ID around with us at all times that could be used to match a person to a record in the database.
Now.... I wonder what form of ID would possibly have been promoted as a solution for this under the New Labour Government, hmmmmm let me think.
The whole project was just part of the agenda driven "project creep" infrastructure being prepared for us.
Good bloody riddance. Although current fragmented systems are not ideal, in most cases there is no problem with various health professionals getting information to other health professionals even if they have to fax handwritten notes across.
There are probably 101 ways of improving the system at a substantially lower price than the £200/head that this ridiculous system was going cost.
Thats right, just let them email/fax/write down your name address condition dob etc, plus the other 30 sods that day x 500,000 staff, who cares about confidentiality, just "Tell Sid" and sell the data to a viagra seller. Get real. The whole point of the NPFIT is bring the NHS IT it the 21st Century, and protect us from the GMA Boys network who don't give a flying f*ck about patient confidentiality only who's turn is it at 19th Hole and who has the biggest budget to waste on gadget of the month. The NHS needs central management, ITIL and effective cost management. It needs the Consultants to be just staff and take a salary and not self styled management guru's, with personal slush funds to waste on what not.
These big firms full of inexperienced monkeys seem to fluff all the IT gov projects and give IT a bad name.
If they're going to go ahead with more SME IT firms doing gov contracts, then at least they'll have a chance of getting some quality instead of being milked for every penny.
Also gov contracts should be fixed fee with deadlines and penalties... none of this bottomless cash pot that they get away with now.
Appreciate the sentiment, but chances are a *small* group of real IT architects would probably underestimate the scope and scale of such a large project. Although it seems like it should be simple, especially to anybody with experience in large commercial organizations, it is easy to overlook some of the aspects.
Consider these points, - the huge number of access points, the multiple levels of access for different types of health practitioners, and indeed the number of individuals that need to be tracked, the audit trails, the huge number of transactions required per day, the varied nature of the data that needs to be stored, the different types of query that needs to be run, the *vast* data entry problem, the resilience that needs to be built in and a whole list of factors that I probably do not understand as well. The more you look, the more you see, and I think that that has been the major problem.
You can't just set up a huge Oracle database with Java front end web based applications. It just doesn't scale up to the problem.
I can assure you that there are plenty of IT Architects out there who have worked on successful systems at granularity above and beyond just large commercial organisations who are not part of the large consultancy gravy train.
We're usually the ones called in by large consultancies when they've completely screwed the pooch and need someone whose head is not full of corporate rubbish to dig them out of their hole. The first thing we do is tear up the consultancy rule book and do the job properly. Every now and then we get to do a project right from the beginning but the successful large scale projects never get reported.
I'm not sure what your point is. Are you saying that only these big companies are capable of doing a job like the NHS computer system? If so, why? What makes them more able to do it, and do it successfully, despite many examples of getting many large government projects VERY wrong in the past? Also, does this really need to cost £12.5 BILLION??
I was not saying that only large organizations would be able to do it, merely that casual observers and IT architects who have worked on small-to-medium scale projects would probably underestimate the work required.
I'm know that there are capable architects out in the real world, but this is an extra-ordinary project. The number of people who have successfully worked on things this big without making significant mistakes is probably very small.
No...not Steve but testing.
There's a damn good reason why this is one of the most constantly (and easily) available Software Testing jobs in the UK job market today.
I may want to jump ship from the shower of shit I currently work for but certainly not into another, far greater...shower of shit.
AC, for obvious reasons :0)
The IT project won't go away. It will fail and we'll learn from it. IT is here to stay. Though we may see the bad as good and those ideas will perpetuate through the iterations.
It would be nice to see a focus on the UK though. The NHS is UK through and through apart from its consultants and suppliers. The NHS is big enough it could develop it's own platform and have it made somewhere cheap.
However, Google will get its crack first. Our personal data will likely be stored outside of these jurisdictions for a time. Before the penny drops...
Harry Greenspun, Dell's "chief medical officer" '...there was a need to make the technology easier to use and manage'. Forgive me, but that suggests the original spec. was to make it difficult to use and impossible to manage? <sarcasm>your choice expression goes here</sarcasm>
IMHO, as soon as hardware vendors start crying about an IT roll-out, you *know* they're getting desperate for action. In more specific terms, given that Dell did more harm than good to my latest laptop*, I would rather keep them as far from the human medical systems as possible!
* "Hi, Dell support? My WiFi keeps blue-screening" Dell's response was to delete my VPN profile, telling me I didn't need it. I got a USB memory stick when I complained about their 'support' but no apology.
""hats right, just let them email/fax/write down your name address condition dob etc, plus the other 30 sods that day x 500,000 staff, who cares about confidentiality, just "Tell Sid" and sell the data to a viagra seller. Get real. "
Well an inter-site secure email system was a *major* part of the back infrastructure IIRC. I would like to think that *would* have included encryption as an *option* at least. The sub system that distributes imaging data *seems* to work well, is liked by staff and has had no security issues.
"The whole point of the NPFIT is bring the NHS IT it the 21st Century, and protect us from the GMA Boys network who don't give a flying f*ck about patient confidentiality only who's turn is it at 19th Hole and who has the biggest budget to waste on gadget of the month. "
So not talking to *any* frontline staff about what they *need* until roll out would stop any protest. Are you perhaps a graduate of the Huto Militia school of Project Management?
The NHS needs central management, ITIL and effective cost management. It needs the Consultants to be just staff and take a salary and not self styled management guru's, with personal slush funds to waste on what not.
We must "Collectivise" the data to improve its efficiency. The kullacks (sorry medical staff) will attempt to sabotage this, but we will use our "revolutionary sense of justice" to deal with them appropriately.
*If* you believe should put *every* record of *every* hospital, GP and nursing home on *one* database you might be right. You'd naturally conclude that a mainframe (or *very* large server farm) offered the lowest transaction cost and want to build the system to be as unique as possible from everything already installed to force its adoption.
This is complete nonsense. It totally *ignores* how fast people move around (*fairly* slowly by broadband data speeds) and *all* the existing (but apparently un-inventoried) systems installed at *most* large hospitals already. On that basis the *real* issues were more to do with assembling a *virtual* record IE compatible inter system querying, data transfer and security.
If you think my language and historical references make it seem that I think of this as rather *less* about improving services and rather *more* about a Stalinist style desire to impose *total* control on this (*highly* sensitive) data you'd be right. AFAIK the *only* major effect of this idea of *one* management system driving one *central* database is the monoculture of IE6, with attendant data loss and infection stories likely to continue for the foreseeable future.
I wouldn't like to comment on whether we should keep or reject the NHS IT system, there may be parts sufficiently mature to be useful.
They've been far too ambitious, and isn't that often the way, which then leads to the failure of the project.
My own view is that the UK would have been better allow the regional NHS authorities (or trusts as they call them now) to purchase off the shelf software products such as used by the Americans and standardize on an interface to enable the different regional trusts to exchange medical records.
Not so hard is it? Would have been a far lower risk approach.
How is the US software going to work with a UK specific health service?
You can buy numerous BI tools, but this NHS IT project is not a deployment of tools, it is a deployment of services and solutions.
You need to efficiently capture, store and analyse data. Why should NHS IT staff be left to cobble this together themselves?
Surely you can write it once and then deploy to all sites. That way you can employ one set of warehouse developers instead of a set at every site!
Maybe instead of just killing the project one should review its goals and only sack the top project leaders as they obviously lost sight of the goals (or were they never defined?!).
Maybe NHS should look at software created by doctors for doctors.
I am involved in OpenSource development and am aware of at least two projects.
GNUMED - an OpenSource project for medical records
NAIMATH - an OpenSource project for a medical expert system
I work for a NHS PCT
I've already lost my job because the idiots didn't forsee any of this.
Unfortunately - we did; including the Fujitsu cock-up but there is no feedback, no end-user experiences were acted on.
However that didn't stop the GP's from sucking all all the money for new IT hardware rather than fund the practice (they own) themselves; thanks very much chaps.
I'm surprised that I need to say this here: the spine, privacy, opt-opt, SCRs - all yesterday's news.
If your GP is running SystmOne (http://www.tpp-uk.com/) then *all* your personal data is already stored on a central server somewhere. If your GP's internet connection is down then they won't even know who you are, let alone care about your privacy concerns. They won't even have your paper records any more.
2 of my local 5 surgeries are already running SystmOne. The local PCT won't support switches to, or even upgrades of, *any* other supplier's system; everyone is being pushed to SystmOne. This is despite a legal requirement to support the existing systems.
I think Mr. Zuckerberg probably has an apposite one-worder for those of us who think this might be a problem.