Never let it be said that information technology experts are incapable of melodrama. Last week Andrew Rollerson, the head of Fujitsu’s health-care consultancy practice, gave an illustrated presentation on the challenges faced by major contractors in the £12 billion NHS computerisation project known as the National Programme for Information Technology (NPfIT). He depicted his company as a supertanker, and its task as a rogue wave in a swirling ocean, dwarfing and eventually swamping the ship. That he also chose a bizarre image of mud-wrestling women to highlight the theme suggests an active imagination if not impeccable taste. The accompanying remarks were even more alarming. The attempt to tackle a uniquely ambitious project with methods proven only on smaller ones “isn’t working”, he said. “And it isn’t going to work.” Politicians might hope that the NPfIT will help to deliver long-awaited improvements in health-care, but “nothing could be further from the truth. A vacuum, a chasm, is opening up.”

It is five years since the national programme was launched. Eight months ago the National Audit Office offered its first tepid support for ministers’ claims that progress was being made – for instance, in usage of the “choose and book” system that gives GPs and patients a broader choice of specialists. But the experts hired to build the NPfIT kept their counsel. That one of them has now spoken out so bluntly is immensely significant. He clearly has an interest in reminding his client that his work is tough, but if the reality inside the biggest nonmilitary IT project in history is even half as bleak as he suggests, the next few miles along the highway to an electronic NHS are likely to be rough indeed.

The national programme’s fiercest critics – numerous GPs among them – have called it a disaster from the start. In fact, its premise is sound: it would be unthinkable, in 2030, not to have exploited information technology to shorten waiting lists, streamline the prescription process and make patient records and the best doctors’ analyses available wherever they were needed. The question that ministers must face now, however much pride has to be swallowed in the process, is whether the grandiose vision of one standardised system for the entire NHS is the right one, and whether it is achievable.

Supporters of the NPfIT say that critics fail to see the new system’s benefits over paper-based medical records. A more pertinent comparison is with electronic systems in France and Greece. Both store only patients’ most basic data and only with their consent. Both are widely used by doctors and accepted by the public. Both are vastly cheaper than the NHS version, and the Greek system in particular saves time and money by using the most highly evolved computer network in existence – secure servers, high-speed broadband connections and the internet.

The national programme has quietly “descoped” its electronic records plans. They will hold much less information on each patient than was initially envisaged. But key questions of patient consent and data security remain unresolved and the whole system may have to be redesigned. Linking 30,000 GPs and 50 million sets of patient records to 300 hospitals with one computer system is an unprecedented aim. It may be impossible. The political mud wrestling will no doubt continue, but the Government must come clean about a computer project that may have been doomed from the outset.