Keir Starmer's Technofix For The NHS: Déjà Vu Disaster Or Brave New Blunder?

Keir Starmer's Technofix For The NHS: Déjà Vu Disaster Or Brave New Blunder?
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Beware of promising benefits and underestimating the complexity

Opinion Almost 20 years after the largest public sector tech disaster in UK history resulting in £12 billion in new hires, they're back…

'They' are workers and they promise to fix the NHS with the magic of 'technology'.

In an opinion piece published in the Guardian newspaper, the leader of the opposition lamented the state of the NHS after the ravages of the pandemic and years of controversial funding shortfalls.

But the Labor Party still exists. Although with a strong chance of winning the next general election, likely in 2024, he will have limited policy options for raising taxes to fund one of the world's largest healthcare providers, which in England already has an annual budget of £160.4 billion. devour and suffer. Chronic shortage of doctors and nursing staff.

"There is another change that could completely reform the NHS and the way it works and save money," said the Leader of the Opposition, looking dreamily into the distance devoured by visions of a better future that only he can see.

This change you ask? “Moving from an analogue system to a fully digital NHS. The NHS is at the forefront of reaping the benefits of advances in science and technology if ministers are taken care of,” Sir Keir said.

Yes Yes. If only a minister believed that in the 25 years since the internet boom had put the IT elixir at the top of the economic and political agenda, he believed that investing in technology could make the NHS more efficient. .

The problem is that they did. many times. And it didn't end well.

The National Program for Informatics (NPfIT), which began awarding contracts under the Labor government in 2003 with an estimated budget of £12.7bn, has fallen far short of its target of introducing electronic health records in the NHS.

In 2011, the National Audit Office (NAO) found that the £2.7 billion spent to date did not represent good value for money. It said: "Based on past performance, the Internal Audit Office (NAO) has no reason to believe that the remaining £4.3 billion of planned spending on care record systems would be different."

After the failure of NPfIT (there were many few successes), the Coalition and Conservative governments were more modest in their NHS IT ambitions but failed nonetheless.

In 2020, the National Audit Office warned that a lack of systematic learning from past failures means that “significant risks… across sectors” remain for the successful implementation of the government's digital transformation portfolio launched in 2014.

Since then, more efforts have been made. In early 2022, Britain's health secretary sought "state of the art" to clear England's 6 million waiting list due to the COVID-19 pandemic. Then, in June of that year, the NHS pledged to introduce electronic health records in all hospitals and group practices by 2025, at a cost of £2 billion.

Despite more than 20 years of initiatives, the shortcomings are evident. In December last year, a study by the British Medical Association found that in the UK healthcare sector alone, more than 13.5 million hours of work are lost each year due to inadequate systems and computer equipment.

To focus on just one example, it took two months to fully recover from the catastrophic outage of the eHealth system at Guy's and St Thomas' hospitals during the summer heat of 2022, which resulted in 371 complications in the eHealth system. IT legacy.

As if it wasn't all clear cut, Starmer promised "more choices for patients and the ability to better manage our health."

The commitment has a history that predates the national TI program. First planned in 2000, Choose and Book was funded in 2003 through a five-year, £64.5m deal with Atos business. Patients were promised the ability to schedule hospital appointments in consultation with physicians through an electronic booking system. It was canceled in 2014.

The problem was that there was practically no other choice. A 2014 study found that in GP practices, “hospital choice is never presented or presented to the patient as an external requirement (something a GP should do”) and headlines from doctors emphasize the absurdity of the situation. . Express humor or anger.

The study did not find a single case in which a patient chose to go anywhere other than the local hospital, nor a single case in which staff recalled (once) that such a decision had been made.

None of this means that technology can't help the NHS. Technology can improve and lead to efficiencies if properly identified. But expecting technology to solve complex and inherent organizational problems is foolish. And you can make things worse. ®

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