Cameron says NHS IT must be local

Tags: A BT Cameron Google Government HIS Information Interoperability iS Labour Network Sales Servers

03 Jan 2008

Conservative party leader David Cameron has attacked the NHS IT programme and called for local ownership and innovation.

In a keynote speech at Trafford General Hospital to mark the 60th anniversary of the NHS, the opposition leader called for local NHS organisations to be allowed to innovate.

He singled out the IT team at Trafford NHS Trust for praise after they won a BT e-Health Insider Award last year for their web-based blood tracking system.

He described the troubled centralised NHS IT project as symptomatic of Labour’s wider failure to deliver modernisation of the health service, saying ministers and civil servants had fallen for the overblown promises of consultants and IT firms.

“I've said before that in their drive to 'modernise' the NHS, Labour haven't improved it, so much as ripped out its heart and installed a malfunctioning computer instead.”

Cameron’s attack on the NHS IT programme follows the criticism by shadow health secretary Andrew Lansley on 24 December of the national patient record database [summary care record].

He said the system should be replaced by “storage on local servers with interoperability between them”.

Cameron accused the government of naïveté in uncritically accepting the promises of big IT firms on how they could fix the NHS. “It's one of the most shameful and disgraceful aspects of Labour's record: the way they fall for the sales patter of the management consultants and the big IT firms, who make them think they can cut corners to success.”

The opposition leader said those running the health service had placed too much faith in the unproven schemes sold to them: “The NHS is suffering from the shoddy jargon-ridden schemes served up on PowerPoint and swallowed whole by the people who are supposed to be custodians of the health service and custodians of taxpayers' money.

He concluded: “The NHS is suffering from the hopeless gullibility of Labour ministers.”

Cameron went on to say that the health service had to move from monolithic, centralised structures, to decentralised, open systems, where knowledge and power are diffused and democratised. “Instead of the national mainframe, we are entering the age of the local network. This applies especially to health and healthcare.”

In the wake of the lost child benefit data by HMRC Cameron said centralised government IT systems have been shown to be risky, “Surely recent events have shown how dangerous government IT systems are - just think of the potential for disaster when everyone's health records are stored centrally.”

Instead he argued the case for decentralised, networked systems, based on common interoperability standards, which give patients control over access to their electronic record. “Of course we need different NHS professionals to be able to access medical records. But those records should be owned by the patient, and stored locally, under the control and protection of his GP. We need local servers with interoperability.”

Cameron said that the IT team at Trafford NHS Trust had shown the benefits of unleashing local innovation. “In this context let me congratulate the IT team at Trafford NHS Trust - they recently won an 'e-health' award from BT for the system they developed to track donated blood from donor to recipient. That's the sort of thing local specialists can do - why on earth do ministers and civil servants think they can do better?

He said the NHS needed to seize the opportunities of the network economy to enable people to take greater control of their health and well-being. He illustrated the point by contrasting the traditional model of medical knowledge being stored in “the great teaching hospitals”, to today’s reality where Google makes available far more medical knowledge available to individuals than any individual clinician could know.

In addition, he said with the rise of social networking and Web 2.0 technologies medical knowledge is being created by patients themselves. “The experiences of patients can be distributed horizontally, from patient to patient, through online networks, rather than vertically as before through doctors and hospitals.”

He related his own experience as the father of an ill child, searching Google for information on their treatment. “You join the international support group. You pick up ideas about drugs and treatments. All too often you then bombard your doctor with questions about these things - but often these are the right questions to ask and sometimes you might even pick up an idea before they do.”

“And it's this horizontal diffusion of knowledge that makes me so confident we can do better than the Government's proposal for a vast, centralised, NHS database.”`

Link

Opposition calls for rethink on data storage

Readers Comments

speaks a lot, says little

03 Jan 08 16:12

Typical political drivel, just from a different side, how are these seperate local systems supposed to swap information? More media in the post, or perhaps email? How about a dedicated network for the secure communication of data, and accessibility of vital medical information? Oh, hang on, stupid idea. let's go back to the situation of the hospital five minutes' drive from the patient's GP not knowing he's allergic to morphine derivatives and killing him with an allergic reaction after an accident.

Political drivel?

03 Jan 08 16:53

Having been exposed to most of the messages NPfIT / CfH have been peddling for the last four years, I suspect many of us have become quite adept at recognising drivel.

David Cameron's suggestions - though - look as if they might just be achievable. (Forget the seamless data sharing angle: it's unlilkely to happen with either a localised or a centralised approach because these aren't the real constraints).

Google-whacked!

nhstechie@btinternet.com

03 Jan 08 19:37

"Google makes available far more medical knowledge available to individuals than any individual clinician could know" - taken to its logical conclusion we could get rid of Medics and Clinicians altogether then! Think I'll stick to my GP, thanks all the same.

Seriously, this isn't just political drivel, it is dangerous political drivel (with apologies to M&S Food).

Political (foot)balls

04 Jan 08 09:01

Having previously suggested that the NHS shouldn't be used as a political football (see http://news.bbc.co.uk/1/hi/uk_politics/6032473.stm), here Cameron is guilty of doing just that. It's unfortunate that his comments about NHS IT that so clearly illustrate his (or his advisors) lack of grasp of the issues will be taken seriously by some. Most insiders will be laughing or crying at the comical ineptitude of these suggestions.

Re: Google-whacked

04 Jan 08 09:43

Dangerous drivel? It's likely that the only people to be endangered by Cameron's suggestions are those associated with NPfIT. Even the PACS "success story" appears to be basically a set of local implementations.

(post edited by EHI)

Interoperability

04 Jan 08 09:50

There are two ways to achieve the kind of seamless integration which our politicians promise, and we all want:

You buy one big system from one supplier which does everything. This is pretty much the NPfIT approach and it clearly doesn't work - despite billions being thrown at it.

Trusts are enabled to buy best of breed systems on a local basis and enforce tough technology standards to ensure they can actually talk to oneanother where this is appropriate. To do this you need an open, competitive, and innovative market in health care systems. NHS IT departments need proper funding to develope local systems that actually work in the real world. If we weren't spending billions on NPfIT we could do this...

Change of allegiance

04 Jan 08 11:27

Oh dear - I might have to vote conservative for the first time.

Re: Re: Google-whacked

nhstechie@btinternet.com

04 Jan 08 21:11

The people most endangered are vulnerable patients, this has nothing to do with NPfIT and everything to do with uninformed comments turning into government policy.

My point was that I'd rather trust my GP to provide medical advice and information than I would the unfiltered opinion disguised as fact which Google gives access to. As an experiment, try Googling the words "alt cancer treatments" and play spot the quack.

Anyone who thinks interfacing disparate non-standard systems is an easy option has never tried this exercise in the NHS. Look how long it took us to implement PMIP and GP2GP - on paper both pretty simple technical challenges but in practice very difficult despite the millions pumped in.

The BCS 23 suggested a pause and options appraisal - about the most sensible suggestion from any direction. Knee-jerk reactions led by ill-informed politicians of any party will probably give us the worst of all possible outcomes.

Re: Re: Re: Google-whacked

07 Jan 08 09:03

Generally, I agree with NHS-Techie's comments, but on this occasion I'd go for a higher-level interpretation of the Cameron comments.

Interfacing different systems is difficult at the technical level and the PMIP project was a good example of this. However, real "information systems" in-use have human components (the people that use them) and - in the NHS - these are very diverse (professionally, IT literacy levels, geographically, culturally, and a lot more besides). The idea that a nation-wide technical "hook-up" will somehow result in a useful integrated record service seems increasingly implausible.

I'd also take a wider and more liberal interpretation of the Google comment. The world outside the NHS (business, academia etc) continues to move on at a rapid pace in its receptivity to and exploitation of new technologies and Google is, perhaps, just an example of how an internet search engine helps improve information access across a range of domains including healthcare. The NPfIT approach - with component standards that were conceived in the 1980s or even earlier (e.g. clinical codes to capture knowledge) - looks badly in need of a 21st Century refresh.

Round and round we go

07 Jan 08 09:35

Back in 2000 we had the Electronic Patient Record Strategy, i.e. acute trusts should achieve EPR's to defined levels by 2003, 2004 etc. This Strategy was selected over the centralised approach as that wqs seen as unachievable. It was then ditched in favour of the centralised approach in 2004. Many trusts, like my own and Trafford, ignored NPfIT and carried on with their own EPR programmes that they started in 2000, we are now starting to deliver! Now I'm not against NPfIT, the vision is good, but the systems are not there and trusts need workable systems now, not promises of things to come.