MP Bacon grills NHS over IT programme

Richard Bacon, the Conservative MP for South Norfolk, has written to the director general of informatics at the Department of Health asking for further clarification on the value for money, renegotiations, and the future deployment of systems as part of the National Programme for IT.

In a letter to Christine Connelly on 13 January, Bacon - a member of the Public Accounts Committee - speaks of several concerns he has, not least the contract renegotiations with BT and CSC in relation to the National Programme for IT. "I am very concerned about the evidence now emerging about the details of the contract negotiations," he writes in the letter (which was also copied to Amyas Morse, Controller and Auditor General at the National Audit Office), "specifically about whether proposed spending reductions are being achieved by permitting BT and CSC to make disproportionate cuts in planned deployments and in the functionality of systems on offer."

Bacon goes on to list a series of 15 points he requests Connelly to "confirm or comment" on, including several questioning the implementation of the Cerner Millennium system in London, which under original plans would have been in place for the past six years.

A new contract in April cut £112m from the original £1.1 billion 2003 contract, at the expense of canning half of the planned Cerner deployments in the capital, a reduction in the number of community trusts scheduled to get the RiO system, the cancellation of 1,500 new GP systems, and the dropping of new software for the London Ambulance Service. "This would seem to amount to delivering half the original contract for a small reduction in charges.  In your opinion, is this really delivering value?" Bacon asks.

The delays and difficulties facing the rollout of the Lorenzo system is also called to question in the letter, together with the apparent guarantees of 'substantial payments' even if NHS Trusts choose alternative products. "As you know, the Lorenzo system has repeatedly missed announced deadlines since the 2005 iSoft Annual Report, which stated that it was 'available from early 2004'," Bacon writes. "Most recently, in April 2009, you set a deadline of March 2010 for Lorenzo, stating: 'If we don't see significant progress ... then we will move to a new plan for delivering infomatics in healthcare'. Yet again, this deadline was missed"

Comparative costs

He points to the problems faced by Trusts that have received the current version of Lorenzo, such as the high-profile case at Morecambe Bay NHS Trust. "The Trust [Morecambe Bay] failed to go-live with Lorenzo in March 2010, finally went live in the summer, and has been subsequently working on a 'stabilisation plan'. By December 2010, there were believed to be hundreds of remaining bugs in the system." Bacon also cites the implementation at NHS Bury, which has "yet to sign off the deployment verification for the implementation of Lorenzo Release 1.9 - a year after going live with the system". 

"Does committing the NHS in this way to payment for systems that may not be delivered represent good value, given the repeated failure of iSoft to deliver a working product to deadline? In these circumstances, why is the NHS still contractually bound to minimum volumes?" he asks Connelly in the letter.

An inquiry into the developments in the National Programme is just in its early phases, something Bacon is keen to point out in his letter when he raises the question of how the cost of systems including Lorenzo, RiO, and Cerner Millennium compares with 'indicative costs' by suppliers "as part of the ASCC [Additional Supply Capability and Capacity] market testing for acute and community systems (taking into account, of course, the costs of the various key milestone payments)".

Bacon unveils his concern over the appearance that potential providers of the £100 million community and child health systems at 13 Trusts in the South of England under the ASCC have been "deterred from bidding because of what they have called 'onerous' requirements and 'untenable terms and conditions', which bias the process in favour of existing lead suppliers under the NPfIT". He asks, "Is it correct that suppliers able to deploy systems at a fraction of the cost of the LSP solutions have not been given a fair opportunity to compete?"

Finally, Bacon requests a series of reports indicating the pricings of NPfIT systems over "traditional deployments", indicative pricings submitted for the ASCC, and a breakdown of running costs at each of the seven sites in the South of England.