Tories promise to scrap “top-down, bureaucratic” NHS IT programme

The Conservatives have said they will dismantle the central NHS information technology infrastructure that Labour has been building for the past seven years if they gain power at the next general election. Instead they will promote more localised systems where patients have greater control over their personal health records.

An independent review of IT for the NHS and social services, commissioned for the Conservatives, acknowledges that the NHS national programme for IT, conceived by the government in 2002, has the potential to “bring about significant improvements to the delivery of patient care” and should not be abandoned altogether. But it should be “adapted and recast to better meet the needs of patients,” says the review.

The Conservatives say that they will halt and renegotiate the contracts that Labour has signed with IT service providers, to prevent “further inefficiencies.” Although there are no official figures of the total cost of the NHS national programme for IT, estimates have ranged from £6.2bn (€7.2bn; $10.3bn) to £20bn.

If they gain power the Conservatives promise to allow healthcare providers to use and develop the IT they have already bought and developed rather than have a system imposed on them.

They would also open up the market to the private sector, with use of data platforms being offered by companies such as Microsoft and Google. These will operate “within a rigorous framework of interoperability” so that patients can access their records in different places and can edit their records online, say the Conservatives.

Stephen O’Brien, the Conservatives’ shadow health minister, said, “Labour’s handling of NHS IT has been shambolic. Their top-down, bureaucratic plans have been hugely disruptive to the NHS and have been plagued with delays and cost over-runs. The Conservatives will not let patients pay the price for the government’s inaction.”

However, a spokesperson for the Department of Health said that the programme had always had a mixed economy of suppliers and had recognised the value of existing systems.

“The report highlights nothing new. We already know that quality health care can be delivered through the effective use of IT,” said the spokesperson.

“Patients are now directly benefiting from the modernisation of NHS IT, including being able to make their first outpatient appointment through Choose and Book, new digital images, and a new electronic prescriptions service.

“The programme is already being delivered locally. For example, detailed care records will continue to be held locally in an electronic form, enabling hospitals and GPs to easily access information in order to deliver the best service for patients.”

The BMA expressed support for the principles of local decision making and of patients having greater control over their records. But it said that the review left many questions unanswered. The BMA had concerns about the security of web based systems held by the private sector and possible restrictions on access of healthcare professionals to records, which could have implications for the safety of patients, particularly children.

Vivienne Nathanson, head of science and ethics at the BMA, said, “There have been major problems with the national NHS IT programme, and we support the principle of greater local decision making.

“However, it is unclear where the funds would come from to ensure the smooth integration of new online patient records with the systems currently used by hospitals and GPs. Many trusts in England are waiting for new electronic systems to replace paper based processes. This review does not provide a solution to that problem.”