Sir, Nigel Harper (letter, Feb 4) suggests using university computer science departments for large public sector IT projects, together with a collaborative use of open source software. While this would lead to better-engineered software and a correspondingly lower risk of code failure, there are remarkably few IT projects that are simply computer code. IT systems today are a complex mix of technology, commercial principles, business processes, human nature and interactions, legal contracts, people and money. Whether in the public or private sector, these are frequently affected by politics, personal ambition, financial pressures, accountability and the desire to deliver and achieve. No amount of software engineering can address these variables.

Few IT projects fail because of technology. IT falls victim to overexpectation, unco-ordinated decision making, lack of clear objectives and relentless cost paring without a corresponding and realistic reduction in the desired outcome. All these are driven by those setting out the needs for planning, managing and approving the project. Today’s IT professional has to be far more than just a computer scientist. He or she has to be skilled in psychology, business matters, diplomacy, project management and politics.

Alan Pollard

President, British Computer Society

Sir, It is not the case that the costs of the NHS National Programme for IT have “spun out of control” (report, Feb 2). The original cost covered the first three years of a project that was expected to take at least ten years to deliver fully. The National Audit Office has made clear that the total cost — £12.7 billion — has increased from £12.4 billion in 2006 because of extra services required. So far £3.5 billion has been spent, as suppliers are paid only when they deliver fully workable systems.

This investment has enabled every acute trust in England to have digital X-ray communication systems, for more than half of patient referral appointments to be booked online at a time and place convenient to them and for more than 300,000 broadband connections to be made between primary, secondary and community healthcare. The summary care record is being piloted successfully to help patients in emergency care by enabling access to information out of hours.

The NHS is delivering something that no other comparable health system in the world has managed. Most people using the health service, or working in it, agree that high-quality, safe patient care depends on shared patient information. The commitment to achieve this remains paramount.

Christine Connelly

Chief Information Officer for Health, Department of Health

Sir, I am writing this from my surgery from where I have been an observer of the scandal that is the momentous waste of NHS money on the ill-considered NHS IT plan. When the enormity of the figures involved are weighed up against what little has been achieved, and the way in which we in primary care are constantly having to penny-pinch and live with under-resourced services, then the true picture, if it wasn’t so serious, is ripe for farce. Enough money has been used on this white elephant to pay for 60,000 nurses for ten years and another £58,000 a day is to follow over the next five years. All we in the surgery can show for this expenditure is an appointment booking system that, when it works, would be the envy of a small business’s web page.

In the meantime I have been asked by my PCT to alter the way in which we prescribe 20 types of medication. This work will involve myself and staff some hours in the scrutiny of the medication and patients’ notes and then writing to the patients to inform them of the changes, some of whom will be needlessly concerned by the alteration. If we achieve all the changes suggested we will have saved the NHS a grand total of £1,206 over the next year.

No wonder I am keeping a close eye on my own blood pressure.

Dr Martin Bell

Great Baddow, Essex

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