Tories promise transparent procurement

Tags: A emergency Information iS Labour London

09 Jun 2009

Shadow health minister Stephen O’Brien has called more localised and transparent procurement in the NHS and an end to Labour’s “obsession with confidentiality.”

Speaking in London this morning, O’Brien laid out four principles for procurement under a Conservative government, while holding up the National Programme for IT in the NHS as an example of Labour’s “failed” “top down” approach.

“NPfIT is a clear example of a centralised procurement strategy, which has stalled time and time again,” he said. “Purchasing goods and services is more effective from the bottom up than the top down.

“Labour’s focus has been more on purchasing power than on the patient. It’s one size fits all procurement strategy has done more harm than good.”

O’Brien told the Smarthealthcare event, which is focusing on procurement, that the four lessons to be learned for better procurement were: the need for transparency, the need for more patient-driven procurement, the need for more innovation and the need for more choice.

“The public has a right to know how and where their money is spent. Labour has an obsession with confidentiality,” he said, adding that trusts should make information about their activities more widely available.

O’Brien commissioned a review of healthcare IT last year that was due to report this spring. This morning he said the review had been completed and would be published later this summer.

He refused to be drawn on its contents, although he did say it would not only analyse current problems but propose solutions and alternatives.

In response to questions, however, he put some detail on another area of Conservative policy, saying that its commitment to scrapping NHS targets would extend to the 18 week wait and four hour accident and emergency wait.

“The 18 week and four hour target benefits have now long since passed. They were helpful to force change, but they are now driving people to do things they usually would not do,” he said, arguing that ‘gaming’ was a real concern.

Sarah Bruce

Readers Comments

Transparent lack of clarity

09 Jun 09 15:06

Without the benefit of hearing all that Mr O'Brien had to say, this does sound like the usual bundle of meaningless platitudes. More 'patient-driven procurement' means what exactly? Would more patient involvement have really improved the procurement of LSP contracts? Advocating 'more innovation' could be construed as a licence to waste money on even more vapourware.

Of course, local NHS organisations will feel the warm glow of ownership, and they will be free to make their own mistakes, rather than having to live with one big one foisted on them by someone else. Oh, and there will be even more of a market for management consultancy to support all the tinpot local procurements. Now that really will be money well spent, won't it?

Pot and kettle

09 Jun 09 20:28

So let me get this right. The publication of Mr O’Brien's spring report has been delayed and is now coming out later in the summer - Pot and kettle come to mind and he's only writing a report!

procurement

12 Jun 09 09:51

I can only think that the first poster works for CfH.

My own experience of IT procurement is that we did better before the national programme. OK, some trusts made a few howlers, but the majority got on with IT procurement and some did really well. The biggest problem was a lack of funds.

If the money that has been thrown at CfH and the LSP's had been thrown directly at NHS Trusts to go out and procure directly we could have done much better with it.

Oh, and before the national programme kicked off we had in house staff, drawn from our organisation with real local knowledge to procure and implement systems. Since NPfIT we have had a steady stream of "management consultants" foisted on us.

Learning lessons

15 Jun 09 10:35

I can only think that poster number three was lucky enough to work in one of the large well organised NHS Trusts that managed IT well. Myown experience of working across a number of local NHS organisations was that for many, IT was a pretty low priority. Procurement was done badly, if it was done at all.

That low priority translated into a lack of IT investment across the board, including in sufficient numbers of quality staff. Procurements undertaken in these conditions were likely to be influenced by the particularly prejudices of key local staff often an irrational abhorrence for anything mainstream), and a preference for idiosyncratic solutions. At best, systems were procured to meet narrow organisational needs with no consideration to wider service benefits.

The resulting landscape was an incredible patchwork of ill matching systems, often incompatible within the same organisation. No wonder GP IT has always been seen as the cutting edge.

I'm not going to pretend that CFH comes out of things very well, and I'll happily acknowledge that there were probably better responses to the generalised failure of NHS IT prior to NPfIT (much easier with hindsight). But the philosophy that underpins NPfIT was a reasonable response to the NHS IT landscape at the turn of the millennium, particularly when throwing money at the problem (through Information for Health) had so obviously failed.

If the Tories want to go back to the days of local autonomy, then they will need to find a reliable way of establishing and enforcing standards, ways of ensuring good quality procurements, and ways of ensuring that local organisations don't siphon off IT investment for what they perceive to be more pressing priorities.

Not learning lessons

16 Jun 09 22:50

Differing world views.

Quite a sizeable chunk of our Information for Health monies were snaffled ('borrowed or brokered') by the health authority to shorten waiting lists, not squandered on inappropriate IT. The problem was access to money, and an increasingly complex and burdensome approvals process, with many bodies wanting to scrutinise the case, but no-one brave enough to take responsibility or decisions.

Our PAS and Clinicals procurement went right up to Treasury, and took 5 months for financial approval. But it was clear that the local Trust Chief Executives were the ones in the firing line if it all went wrong.

The procurement went pretty smoothly, as did the implementation, and the product has served us well, despite 5 years planning blight waiting for the CfH white elephants to replace it.