John Hudson

Computing magazine reports that:

The NHS will shave £330m from its software licensing costs following the signing of a nine-year deal with Microsoft, according to the National Programme for NHS IT (NPfIT).

Jack Schofield, of the Guardian, reckons this works out, roughly speaking, at about £1 per computer per week.

Meanwhile, the BMA have issued fresh warnings about looming IT disasters in the sector, arguing:

We hope that improvements to IT systems will reduce the administrative burden on doctors so they can spend more time treating patients. This goal will only be realised if the national programme can provide systems that are at least as effective as those currently in use. Clinical staff must be consulted. There is no point investing billions of pounds in systems that do not have the confidence of users. [...] Large-scale public IT projects do not have a good track record in the UK and so it is paramount that the NHS learns the lessons of history and engages with the frontline staff who will be using the new systems. So far the level of engagement and consultation with the medical profession has been wholly inadequate.

More about this on The Register.

The Register had an interesting article a couple of weeks back reporting that spending on e-government is set to exceed $US1 billion by 2008. Figures on government IT spending are remarkably difficult to pin down; at the Social Study of Information Technology seminar at the LSE in April, Patrick Dunleavy estimated that over 1% of GDP was accounted for by government IT spending - quite phenomenal given that this is (according to OECD figures) 3 - 4 times what we spend on unemployment benefits.

Given this, I was interested in tracking down the research on which the Register’s piece was based to check their figures over. Having found it there is an insight into why so much is spent on IT: one paragraph of snippets for free then a staggering $5,175 to buy the 39 page ‘U.K., Government Sector, 2003-2008, eGovernment IT Spending Plans’ and the same again for the reports on France, Germany, Italy and Spain that accompany it. Crazy…

Over the summer the Commons’ Work and Pensions Select Committee produced a report examining the DWP’s use of IT in service delivery - Department for Work and Pensions Management of Information Technology Projects: Making IT Deliver for DWP Customers - that blasted the department and EDS for failures in connection with Child Support Reform (CSR). Its introduction offers a thinly veiled critique of the current situation:

Much of modern life is dependent upon IT systems reliably processing vast amounts of data speedily without major incident. When they work, reliable and stable IT systems can deliver new services and efficiencies to the benefit of all. But too often, the actual experience can be the very opposite of that. Defective IT systems can cause serious problems and distress to thousands of people. These problems are compounded when IT failures involve the delivery of crucial public services, especially, as in the case of the Department for Work and Pensions (DWP), where IT programmes directly affect people who are in low-income households and claiming benefits and paying or receiving child maintenance. Defective IT systems may result in: a DWP customer discovering that a regular benefit has been reduced only after the payment is received; thousands of non-resident parents making the wrong maintenance payments; and failure to calculate entitlement properly when people apply for benefit. Customers’ telephone calls may go unanswered, or are finally put through to a member of staff who has no knowledge at all of the particular case and, because of faulty IT technology, is unable to access any relevant files electronically. It is a lucky caller who gets put through to somebody that can actually retrieve the relevant files onto their screen, and extract the necessary information before the computer screen crashes. Defective IT can also have an adverse effect on staff morale and turnover, which is especially damaging in an organisation, such as DWP, that already suffers from high levels of absenteeism and staff turnover compared with some other Government departments and the private sector

Interestingly, the report also raised the question of whether or not IT driven business process redesigns should be regarded as policy issues and therefore subject to prior (and more open subsequent) debate within Parliament. They also suggested that while CSR was sold on the basis of a simplification of policy, the fact that it was to be delivered by an increase in the complexity of IT systems was crucial and should have been debated by Parliament; that it was not raises a question over the mis-selling of the policy. To avoid such situations arising again they argued for greater openness in the future :

Our main recommendations for improving the success rate of IT systems centre around improving accountability. We believe that greater openness is important in its own right, but should also lead to a higher success rate. CS2 demonstrates the lack of accountability that exists, even for defective systems. Although CS2 has been subject to a number of reviews, we have not been given access to these reviews on grounds of confidentiality- which is certainly convenient for the Department and makes us suspicious.

Last week, the government’s response to the report was published and it refused to budge on this issue, arguing:

The implementation of policies requires countless decisions on a range of issues on a daily basis. The Government values its interaction with Parliament on the broader issues around implementation of policies and its approach in general to these issues. It sees individual decisions as a matter for the Department and its Ministers.

The committee chair - Archy Kirkwood - issued a stinging press release in response, in which he argued:

Overall, we are very dissatisfied with the Government’s response. The Government’s record on IT projects needs to get better. We produced a well-argued report into how the Government’s record on IT projects could be improved. Our report was widely recognised throughout the media and industry as a solid piece of work with a set of impressive recommendations. However, we have received a response from the Department that all too often does not fully engage with the letter or spirit of the report’s recommendations. In particular, the Committee sets out an overwhelming case why Parliament and the public require more detailed information about IT projects, including the business case. But instead of addressing the Committee’s concern, the Department defends its secretive approach on grounds of commercial confidentiality and says that it will make information available in the context of the Freedom of Information Act. This isn’t good enough. We will not let the matter rest here.

Some of the specialist press have picked the story up, including Public Technology and The Register (with an hilarious URL that ends eds_is_pants!). The Register have been running on this one for some time, producing a piece slamming EDS after the initial report was published and an earlier article outlining some of the key failures of the new CSA system including that some CSA staff ‘are using pocket calculators to work out what people owe, thanks to the comprehensive failure of its IT system from EDS’ and that ‘less than half the 320,000 applications received since March 2003, when the system was launched, has been processed’.

Obscured by all the general politicing at last month’s Labour Party annual conference was a commitment by Blair - in his set piece speech - to end the digital divide. Outlining ten key policies for a third term in power, the seventh of these future goals was to see:

Our country and its people prospering in the knowledge economy. Increasing by £1 billion the investment in science, boosting support to small businesses and ending the digital divide by bringing broadband technology to every home in Britain that wants it by 2008

Of course, the government has already pledged to end the divide in terms of internet access per se, committing to the delivery of universal access by the end of next year. On this subject, an important new report, enabling a Digitally United Kingdom, was published by the the Digital Inclusion Panel - an umbrella group of public, private and voluntary sector groups established by the Cabinet Office earlier this year - last week. It examined progress in tackling this dimension of the digital divide and made recommendations for future action too.

Amongst the items of interest in it was the announcement of a new body for taking the issue forward:

In order to generate scale and to focus effort, major industry players, in conjunction with the charity Citizens Online, have established the Alliance for Digital Inclusion (ADI) – the founder members are AOL, BT, Intel and Microsoft [...]
The ADI will promote the use of information and communication technologies (ICT) for social benefit. It is independent, but is supported by and seeks to work in partnership with government, as well as
industry and the voluntary sector.[...]
The role of the ADI is to:
• create an industry-led umbrella initiative that will encourage collaboration;
• provide targeted, scalable and sustainable solutions;
• encourage new players to become involved; and
• engage with and influence government on key policy issues.

In addition, it very strongly came out in support of the UK Online centres:

The national network of 6,000 UK online centres is an important resource that has the potential to encourage digital take-up across a wide range of government services. It is also recognised that trusted intermediaries that have a deep understanding of their client group are often better equipped than government to deliver services for hard-to-reach groups. UK online centres are also an important community resource, providing the necessary lift to enable often hard-to-reach groups of people to become digitally engaged. Innovation in these areas should continue.

However, as Michael Cross notes in the Guardian this week:

These are often run by community groups, which are better equipped than government to communicate with hard-to-reach groups. Central government, however, footed most of the cost, and that money is now running out.
No one seems keen to pick up the bill, which may explain why the whole digital inclusion agenda is a bit of a policy orphan. This is reflected in the strategy document, which is introduced not by a minister or even the Cabinet Office head of e-government, but by Andrew Pinder, the last e-envoy.
He supposedly left public life in August (four years after being hired as a temporary stand-in). While it is nice to see Pinder’s picture again, using yesterday’s man doesn’t send the right signals about tomorrow’s agenda. Where is the e-minister?

One of our graduate students has been doing some interesting work on the UK Online centres that very much echoes this point about the insecurity of funding hampering their work. Interestingly, she also found there was, at times, perhaps something of a disconnection between what the centres might be doing and the government’s broader e-agenda. This was particularly so with respect to promoting e-government services and there was a strong feeling that staff at some centres knew very little at all about e-government services that might be of benefit to centre users. This links back to another of the themes in the Digitial Inclusion Panel’s report because they were keen to plug e-government as potential driver of ICT uptake. One of the problems with using community groups rather than public sector agencies to tackle the digital divide is that they are much less likely to be ‘on message’ with regard to issues such as this. Indeed, one feels that there is a lot of ‘joining up’ that needs to be done with respect to the e-inclusion agenda.

In the summer it is was reported that the NAO would be probing the new NHS IT modernisatlon programme. If a report in Computer Weekly is anywhere near the mark then their report (due next summer) is going to be a blockbuster:

The IT-led modernisation of the health service could cost a minimum of £18.6bn - at least three times more than the announced figure - with a large part of the bill falling locally, on NHS trusts.
The estimated 10-year cost of the NHS’ national programme for IT (NPfIT) raises questions over whether trusts, some of which are in the red, will be able to fund all their commitments to make the initiative a success.
Trust staff and GPs throughout England want the programme to succeed. But some trusts are warning that money for the NPfIT may eat into local budgets that are for direct patient care.
Computer Weekly has learned that officials at the Department of Health have estimated the total implementation costs of the national programme at between £8.6bn and £31bn. The programme includes a care records service to give 50 million patients in England an electronic health record, Choose and Book to allow people to select hospital appointments from a choice of dates and locations, and new local IT infrastructures.
After the programme was announced in 2002, the government allocated £2.3bn central funding for the national systems over three years. Since then the procurement figure has risen to £6.2bn over 10 years. But now it has emerged that a further £12bn to £24bn may need to be spent, a large part of it locally. Much of this extra money has yet to be found and there is no clarity over whether it will materialise.
If the resources are not found, and trusts cannot afford local implementation costs, there is a risk that some of the £6.2bn procurement will be spent on advanced systems that go largely unused by doctors and nurses.

Meanwhile, a survey of GPs shows many have grave doubts about the programme and many feel they haven’t been adequately consulted.

Haven’t we been here before?

The Head of e-government, Ian Watmore, is interviewed today by BBCi:

“The getting 100% of services online target is something I inherited and the job is pretty much achieved. The real question is ‘where do we go from here?’”
The answer, he says, is moving on from the glut of information currently available to fewer and better targeted services.
“Let’s make them as good as we can and, most importantly, let’s move to the point where most people are using them rather than some people are using them.”

This follows on from an interview in the Guardian a couple of weeks back - his first since taking up the post:

Watmore said he is more interested in getting people to use e-services than in dogmatically ensuring that every single service goes online. “What we want to do next is to get a high take-up and high impact of services that really matter and which touch people’s lives.” But he said the 2005 target is still “business as usual” - and in any case, it is not in his power to change a directive from the prime minister.

And another in Computing magazine where he outlines the differences between his post (the ‘CIO of government’) and that of e-Envoy.

All this is laying the ground for a major new e-government strategy document due at the end of the month.

Much of interest on the e-government front in the recent Spending Review and Gershon’s supporting efficiency review.

In outlining targets for annual efficiency savings of >

Have just returned from the Social Policy Association annual conference at the University of Nottingham. Some papers are available online: those that stood out for me were two given by Michael Hill and Hugh Bochel on the policy process; a couple of interesting papers on e-local government by a team from Newcastle; and a series of comparative papers from a team headed by Peter Taylor-Gooby. The conference ended with a lively plenary on ‘Where Next for Social Policy?’ featuring Paul Spicker, Adrian Sinfield and Nick Ellison; this will be taken forward in the next issue of the SPA newsletter that I’ll blog about nearer the time.

There was also a formal launch of The Policy Press’ new Understanding Welfare book series, including the text penned by myself and Stuart Lowe: Understanding the Policy Process.

Some of my colleagues at the University of York have been receiving quite a bit of press coverage for the research on ‘e-health’. Their project - part of the ESRC’s Innovative Health Technologies programme - has concluded that GPs have little to worry about with respect to so called ‘netty patients’ for most patients use health care information found on the internet in a very rounded way. They also argue that simplistic arguments about the digital divide should be treated with caution as e-health users spanned income groups in unpredictable ways. Reports can be found on the Times and BBC websites. More too on the ESRC’s site.

The Department for Culture, Media and Sport are trialling a new service - delivered by phoneanything.com - designed to make their web site more accessible:

DCMS Becomes First Government Department To Open Its Website To Non Computer Users

New initiative also helps open up Government information to the blind and partially sighted

Our website, containing details of DCMS activities, changes in the law and job vacancies has been made available by telephone, to people without access to a computer. The DCMS is the first Government department to do so.

The blind and partially sighted, around 90 per cent of whom do not have computers, will also benefit.

From 4 May anyone will be able to ring 0845 333 0850 (local rate charges) to gain voice access to the entire content of the DCMS website from any telephone. The service will begin with a three-month trial.

The story is covered on publictechnology.net