Derek Wanless, architect of the government's NHS spending plans, has called for a comprehensive audit of the health service's 12.4 billion pound (AU$30.2 billion) National Programme for IT (NPfIT).
Wanless drew up a 2002 report to the Treasury, where Gordon Brown was chancellor, outlining the spending required to take the NHS forward. Among his recommendations was that investment in IT -- then around £1.1 billion a year, or 1.5 percent of all NHS spending -- should be doubled to more than 3 percent of NHS spend to support either "solid progress" in healthcare or an improved "fully engaged" scenario.
IT investment was "a major priority which will have a crucial impact on the health service over future years", the landmark 2002 review said.
Actual spending on modernization of the NHS IT infrastructure has followed neither the solid progress nor the fully engaged spending trajectories set out ion the original review, the new report says.
It adds that NPfIT "has not been without its difficulties, with most progress tending to relate to systems that were not originally part of the modernisation plan."
Wanless warned: "The well-documented problems and delays that have beset the NPfIT have the potential to undermine seriously the productivity gains envisaged by the 2002 review. Future commitment not only to implementing core ICT systems but also to realising patient benefits and productivity gains is vital."
The program must be "audited comprehensively to ensure that benefits will outweigh costs and to assess the precise impact on future productivity," he said.
Connecting for Health, the body that runs NPfIT, "should be subject to detailed external scrutiny and reporting so that forecasts of long-term costs and benefits can be made with more confidence", the report recommends.
The UK government has strongly resisted calls for a review of NPfIT, ruling the option out again last month in a response to a damning report by the Commons public accounts committee. The response document was slipped out quietly during the parliamentary recess.
In his new report, Wanless notes that implementation of NPfIT "has been slow, with its main anticipated benefits not yet achieved."
"Although the IT programme has contributed to the introduction of [hospital appointments system] Choose and Book (albeit behind schedule) and to improvements in diagnostic performance, its main anticipated benefits have not been achieved," the report says.
Wanless estimates that the resources for IT recommended in the 2002 review should be sufficient to meet the estimated at £12.4 billion cost of NPfIT over 10 years, but lack of progress on the program meant it was "not surprising" that actual spending on the plan - where payments to contractors are tied to delivery of systems - had yet to reach the recommended levels. Planned spending of just under £2.9 billion in 2006-07 would "come closer to that assumed in the solid progress scenario", however.