Tuesday, June 27, 2006

The NHS database

The ever-reliable Wat Tyler is once more blogging about the coruscating fuck-up that is the NHS database.
The costs are way higher than originally advertised. That's because the now estimated £6.2bn spend on the central core project takes no account of the massive local spending on implementation. If all goes to plan, the NAO puts the total at £12.4bn. But Lord Warner puts it at £20bn, and others have put it as high as £50 bn. The bottom line is that nobody knows, and the financial burden on local health authorities is open-ended

Overall, we were left with the same picture: this massive programme has been imposed on our battered NHS by pig-headed commissars and husky killers who are convinced they have "The Answer", and will use all means at their disposal- including our money- to drive it through. Cowards and rumour mongers will be shot!

Our advice remains the same: keep up those BUPA payments and be sure to ask your GP for a hard-copy print out of your medical record.

Something that even Wat seems to have missed however—and it was something that certainly surprised me—is that Scotland already has a working system. This was reported by Right For Scotland, who worked as the senior consultant on the project for 4 years.
The NHSiS commissioned a number of projects to deliver on the Government’s commitment to the Electronic Patient Record. One is a Results Reporting system that is currently installed in every NHS Board area into which every GP has the potential to access it (web based so only prereq is IE). Every hospital had an Outpatients system that, while the section has not been implemented everywhere, has the potential to provide electronic appointment booking. And every hospital has a secure messaging gateway to allow communication of referral and discharge information. Every GP surgery can have a product called GPASS installed that is their information system, it will do almost everything (keep patient demographic details, copies of their results, referral and discharge letters etc). For full disclosure it should be noted that GPs are free to use any system they want and although all do use some kind of computer system not all of them use GPASS.

While this system is still in its infancy it has almost total penetration with almost every health worker in Scotland capable of accessing it.

Now you are reading this and you realise that this is literally years ahead of the English project (and a good couple of billion cheaper) but that the work has already been done so why not just sell the product set to the English and help them out?

I wonder if you can guess what the answer is? Well, it couldn't be because there is a rivalry between NHS Scotland and NHS England which means that the Scottish NHS is unwilling to save British taxpayers tons of cash, because that would be a futile waste of everybody's money, wouldn't it? Er...
Yes the NHSiS have sank about £40m into this project but having a simple payment system to allow the NHS in England to licence the product set would present the best value for money. But they don’t offer it. Indeed they actively resist it.

On more than one occasion I suggested helping the English out but each time I was informed that the Scottish had their toy and they were going to use it to beat the English over the head with.

Rather than help out the English service and get the best value for tax money senior managers and even Executive ministers have used this project to crow. Not for them the egalitarian principles of “were all in this together”. No, this system allows the head of the health service in Scotland to look better than the head of England, and the Health “minister” in Holyrood to look better than the real one in Westminster.

So, there you are: £6billion (and counting) down the fucking panhole because of pusillanimous, parochial cunts in the civil service are trying to steal a march on one another. It's fucking pathetic.
As much as our left-leaning press would like it to be otherwise the real villain in this piece is the Scottish Health managers who refuse to help the English deliver value for tax money.

And this, and stories like it, are why despite massive increases in spending the NHS is impoverished. It needs reformed and those managers sitting on a working prototype in Scotland need to be called to account for their inactions.

That's right; sack them and then fine them so hugely that they will have to sell their children for medical experimentation. These people are the fucking dregs, they really are.

Much as I loathe politicians, and this government in particular, increasingly the real villians of the piece seem to be the managers in the civil service, the "public servants" who will do anything but actually serve the public.

Personally, I want to beat all of these fuckers with a piece of two by four, screaming, "that's my fucking money, you fucking bastards! Now give me my fucking money back!"



chris said...

Devoid of the eeeevil profit motive they have absolutely no reason to sell their software to the English. In fact they have an incentive not to, as it means that they can justify claiming the same next year as what they need to operate. Don't you just love bureaucracy?

Anonymous said...

NHS Medical Data Base - Government plans to put medical records on a national electronic data base. My personal view is that psychiatric files should inform the appropriate agencies if a person was genuinely potentially dangerous (to themselves or others) or if the person was in danger from others. Documentation should also inform the appropriate agencies as to the person’s level of vulnerability and need of assistance. I have very great concerns about the proposed new data base. I have seen huge amounts of paperwork concerning myself, most of it is inaccurate, misleading and open to interpretation. .

Complaints - One of the main problems service users have when complaining about mental health authorities is that the authorities decide the rules of their complaints procedure. In my experience there is also a tendency to penalize the complainer and be-little the complaint as being part of a psychiatric dysfunction. This site will campaign for greater accountability from psychiatric services. Their exists no independent authoriety, to protect the rights of mental health service users. No board of vistors, no independent complaints commision etc. This is clearly wrong and un-democratic, it is very easy to dis-couredge a mentally ill person from complaining. www.ticketytock.org

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