Abandoned UK National Health Service IT System Has Cost $16bn... So Far

dryriver writes with news of yet another major software project gone awry. From the article: "An abandoned National Health Service (NHS) patient record system has so far cost the taxpayer nearly £10bn, with the final bill for what would have been the world's largest civilian computer system likely to be several hundreds of millions of pounds higher, according a highly critical report from parliament's public spending watchdog. MPs on the public accounts committee said final costs are expected to increase beyond the existing £9.8bn because new regional IT systems for the NHS, introduced to replace the National Programme for IT, are also being poorly managed and are riven with their own contractual wrangles. When the original plan was abandoned the total bill was expected to be £6.4bn."

Comments

great deal

[beefoot]

That makes the $1B Ontario (Canada) government spent in E-health for nothing a great deal to me.

"Dayum!"

[wcrowe]

I cannot fathom any software system costing that much. I imagine even the people over at SAP are going, "Dayum!"

Re:"Dayum!"

[CastrTroy]

Yeah, It certainly is absurd. I can't even imagine it if you factor in the hardware to run it on. Assuming you spent half of it on hardware, you'd have $8 billion worth of hardware (which is just plain ridiculous). You now have $8 billion left over to pay people, assuming each person working on the project makes $100,000 a year, for $8b, you can get 80,000 person years. The project was launched in 2002, so even counting 12 years, that means they could have hired 6666.667 (nice how that works out) people to work on the project.

Re:"Dayum!"

[fustakrakich]

I cannot fathom any software system costing that much.

Padding... The money was/is being stolen, looting the treasury.

Re:"Dayum!"

[deusmetallum]

There's a lot to this kind of thing. I worked in a help desk once where a system was promised to be rolled out by X date. The contractor brought on all the staff based on that promised, kitted out the building with all the required hardware to provide the support and... nothing. The guys couldn't be fired, and there was no other contracts to move them on to, so they sat around waiting for the software to finally be rolled out.

In other words, it's not just the software that cost all the money, all the fuck-ups along the way compounded and inflated the price tag way beyond what it should have been.

Re:"Dayum!"

[petes_PoV]

I cannot fathom any software system costing that much

It cost that much because that was the amount of money available to pay for it. If there had only been £5Bn in the budget, the project proposals would (magically!) have cost that much - and would STILL offered the same results. And exactly the same final outcome would have been proposed if the budget had been doubled. Success or failure was not a function of the budget, nor of the requirements. Even back in the 2000's when this was still a comparatively young project, I was asked to work on it. I spent a day with some of the project people and knew even than that it didn't stand a chance of ever going live. Mainly due to the intransigence of the NHS workers, especially the doctors and consultants (who all believe the only function of the NHS is to keep them employed - any resulting healthcare is merely a bonus).

The sorts of companies who bid for this work, just like defence contractors, are masters at configuring their projects to consume all available resources for a constant output. The problem is that they are much better at negotiating than government employees (who have no personal investment in the project) and more highly motivated, what with their contuned salaries, bonuses and commissions.

Re:"Dayum!"

[ShanghaiBill]

I cannot fathom any software system costing that much.

It is easy to fathom if you look at how the program was structured. All the incentives were inverted: nearly everyone involved actually benefited from cost overruns (the contractors got more money, the bureaucrats had the prestige of managing more resources, and the politicians had more patronage to dispense). There was no accountability (no one is being disciplined or fined). There is not even any political fallout because the blame is smeared out over multiple administrations (Conservatives can blame Labour for starting the project, while Labour can blame the Tories for mismanaging the implementation). It is like it was designed to fail. A decade from now you will be reading about some other project that failed in the exact same way, for the exact same reasons.

Re:"Dayum!"

[sycodon]

Actually, if you put 6k+ people on a project, I'd fully expect it to go nowhere.

Re:"Dayum!"

[malkavian]

No, they had lots of people that said the system was unusable.. There were priorities of error, and a priority 1 was a showstopper.
The places that consistently tested showed that the system for the first several years (already way past expected implementation date) for the Care Records part was seriously broken, and not fit for live use (bear in mind, this system isn't just supposed to be able to hold your office files, and it's fine if it's down for half an hour now and then, and perhaps lose a few things along the way with only a grumble; it holds your medical records.. The things that make the difference between life and death in some cases).

With things not working out on either side (again, for the Care Records parts; some parts, like PACS [Picture Archival and Communication System;the digitisation of your X-Rays instead of using film] work fine and are in almost universal use now, vastly changing the nature of care in the NHS.
The big problems with it were:

A) Tony Blair not having a clue what was wanted, but saying it should be done in a year.

B) Setting a guy in charge of it that failed his computing degree.. One Richard Granger. It was pretty much his ideas that doomed the Care Records part of it, and allowed out a spec that was more a back of a cigarette packet sketch than a real spec.

C) Failing to have a real spec. Now the companies all bid for a very nebulous thing that said "You give us a lovely system that does what we want, and we'll give you billions.". Of course, they produced what they thought the NHS wanted, but the NHS discovered that it wasn't what they wanted. You know, basic Spec documentation you cover on computing. Which Granger failed.

D) There was also fault with the companies who leaped at the cash without a real spec.. They should have known that the contract was WAY too wooly and actually tied it down to real deliverables.

At renegotiation time, some of the vendors (like Fujitsu) worked out the cost of really doing what the NHS asked for (which was all the project management of the first round, plus a semi accurate spec). Which was a truly staggering figure. More than the NHS could stomach. The two are still in a legal scrap.
Some vendors still kept the lights on in the data centres, and hosted what was there, but those installations are likely going to have to move out of those data centres by about 2015, as they're too expensive to maintain for the few installs.. And none of the vendors want to renew the system contract.

So, the price tag covers all the allocation (it was scaled to host EVERY NHS hospital in the UK, which is most of them), training, consultancy, migration of data (a high precision activity that needs zero data loss on a vast amount of very complex information, coming out of a vast quantity of different databases, and being shoehorned into one uniform schema. Doing this while still providing clinical care (you don't get to shut a hospital down for ripping out the heart of its data systems and replacing them with a new; it's all done while still treating patients and making sure nothing gets mis-recorded).. Training of a huge number of clinical staff (doctors, nurses, and anyone else who needs to use the system inside the NHS), the feeds.. Interfaces between that system and the various disparate ones that it needs to communicate with inside a hospital..

When you look at it, it's a breathtaking proposal, just nobody on high seemed to recognise that, and expected fast results because they said so and waved a fat wallet around. Unsurprisingly it went awry. The current UK government looked at the figures, the legal position and the chances of getting it sorted from a more businesslike side, and canned the bits that wouldn't work (the care records area).

As for the data protection side, that was one of the most heavily guarded I've seen anywhere.. It was pretty robust. The few 'leaks' that happened (people looking at records they shouldn't) were spotted by access audit, and people lost the jobs.. That simple, that strict.

Lost cause

[Anonymous Coward]

My father was contracted a few years ago as a consultant to help update the NHS's infrastructure. After a year working there for a year he ended his contract. He said that it was impossible to get anything done because the higher ups didn't listen to the engineers and project managers on the teams. There was also a lot of unmotivated and lazy people working on the teams that slowed everything down. Politics also played a big part and people cared more about keeping their comfy job that never really had an end date than finishing the project.

Re:Lost cause

[Anonymous Coward]

On the NHS projects I was working on, most things were working nicely on Sun systems. Then came this big idea that they should change everything and use Microsoft windows. Chaos ensued. I did what I could for about 2 years, but could just see the change going nowhere. In the meantime, the old systems just kept running.

This is what Ronald Regan protected us from

[TWiTfan]

Thank God that here in the U.S. we're protected from this kind of system. Sure, getting sick here without insurance can bankrupt you, drive you into lifelong debt, etc. But at least we don't have to put up with any red tape in our health care system!

America, America, God shed his grace on theeeeee!

Re:This is what Ronald Regan protected us from

[intermodal]

Unfortunately, what we're seeing is a preview of what I expect with Obamacare.

Re:This is what Ronald Regan protected us from

[MickyTheIdiot]

The thing is that every post on every site you see about "Obamacare" is an accusation with no facts to back it up, just like the post you replied to.

Fox News did two identical polls recently, the only difference being the term for the program "Affordable Care Act" or "Obamacare" was used. When there was a significantly higher percentage of people that liked the act when it's called the ACA than when it is called Obamacare.

The debate against Obamacare has been the most fact free debate that the U.S. has seen in years. It's a screen for every projection of every annoyance we have about healthcare in the U.S. The people that are preaching against it the loudest have no idea what it really is and they show it daily.

Re:This is what Ronald Regan protected us from

[IanCal]

The US has a higher per capita cost than any other country in the world, is that because you have the best healthcare in the world?

The United States life expectancy of 78.4 years at birth, up from 75.2 years in 1990, ranks it 50th among 221 nations, and 27th out of the 34 industrialized OECD countries, down from 20th in 1990.[2][3] Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and disability. Together, such issues place the U.S. at the bottom of the list for life expectancy. On average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country.[4] According to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.9%), than any other nation in 2011. The Commonwealth Fund ranked the United States last in the quality of health care among similar countries, and notes U.S. care costs the most. In a 2013 Bloomberg ranking of nations with the most efficient health care systems, the United States ranks 46th among the 48 countries included in the study.[5]

http://en.wikipedia.org/wiki/Health_care_in_the_United_States
And finally, you can get private healthcare in the UK too.

NHS software: open source it !!

[Anonymous Coward]

So, with all that money spent,
how can we, the taxpayer, get the
code open sourced ??

Re:Excellent!

[Anonymous Coward]

The funny thing is: this horribly wasteful government system is still about twice as efficient as the perfectly organised private system in the US!

Clinical records are hard

[benjfowler]

Clinical records are the last big domain that resists computerisation.

Why? Because it's really hard to get right. You have a massive quagmire of competing interests, egos, a very complicated domain model and legal/regulatory environment that changes constantly and is different in every country. And to top this off, you have privacy whingers.

Common sense suggests that if it was an easy problem, they've have cracked it by now. As it is, I walk into my local GP for a checkup, and behind the reception, there's a massive wall of paper patient records. In 2013.

You have government of course (let's face it, governments have few very good people, and hire literally millions of bozos), but I'm not sure if it's any worse than the privatized, Balkanized carpetbagger-fest that passes as a health system in the US...

Absolutely not excusing the disgraceful and self-serving behaviour of the big integrators here (CSC and BT, amongst others), but they've blown billions for a reason.