Three months ago, a circus of MPs frantically probed the representatives and main suppliers of the National Programme for IT in the NHS about the delivery of the care records system.

On Wednesday the Public Accounts Committee published its predictably damning report painting a bleak picture of the whole programme, with its most significant findings being that the detailed care records service will never deliver what it promised, that the money spent so far has not delivered value for money, and that the remaining budget is unlikely to be spent any more effectively.

The report does little to revive credibility for the programme nor the local service providers, CSC and BT acting under it and not only asks the Major Projects Authority to exercise “close scrutiny” over the Department for Health’s continuing negotiations with CSC but also says that the DH is “clearly overpaying” BT to implement systems.

But despite the pressure and some of the blame being put on the suppliers, on second reading, all eight conclusive points in the report relate strictly to the failings of the DH.

More remarkably, these points focus greatly on the failure of NHS chief executive, Sir David Nicholson, as senior responsible owner for NPfIT, who repeatedly clashed with MPs at the hearing in May.

Sir David Nicholson, who is about to lead the powerful new NHS Commissioning Board as part of the NHS reforms, is criticised for “weak programme management” and the report claims that given his “other responsibilities, he has not fully discharged his responsibilities as the Senior Responsible Owner for this project”. This has resulted in “poor accountability for project performance,” it says.

The report is also highly critical of the DH’s ability to provide “timely and reliable information” and says it has “neglected its duty”.

But despite the LSPs being singled out and pushed to exit the programme or to provide a significantly better deal, there is little mention of what consequences the DH should face for its own failure, which has clearly been instrumental in NPfIT’s shortcomings.

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Perhaps most striking is that the PAC has even requested Sir David Nicholson to remain in place as the SRO to ensure a “clear line of accountability and responsibility for performance as well as continuity in managing the substantial risks that remain”.

So, while the PAC report consistently says that the parties involved should not be “rewarded for failure” it begs the questions whether all parties are being treated the same or whether civil servants and government departments are protected from repercussions purely because they are not a commercial entity.

The PAC report can be found here: http://www.publications.parliament.uk/pa/cm201012/cmselect/cmpubacc/1070/107002.htm

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