PAC warns against CSC monopoly

The Commons’ public accounts committee has warned the government not to let the Department of Health award a new contract to CSC that would give it “an effective monopoly” in the North Midlands and East of England.

The PAC’s report on the National Audit Office’s investigation of the delivery of detailed care records by the National Programme for IT in the NHS says that both BT and CSC have failed to meet commitments, and damns weak programme management by the DH.

Margaret Hodge MP, chair of the PAC, said: "[The Department] should now urgently review whether it is worth continuing with the remaining elements of the care records system.

“The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

Parliament’s spending watchdog says the Cabinet Office’s Major Projects Authority should be asked to “exercise very close scrutiny over the DH’s continuing negotiations with CSC”, which has missed a series of deadlines to supply iSoft’s Lorenzo electronic patient record system to trusts in the NME. It urges the government to review whether CSC “has proved itself fit” to tender for future government work.

“One supplier, CSC, has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap,” says the report.

“There have been major delays in the North, Midlands and East, where just 10 of 166 trusts have received only the most basic Lorenzo system, and no system has yet been successfully delivered in a mental health trust.”

The PAC report says that instead of providing contracted systems CSC has instead provided lesser ‘interim’ alternatives that had been rejected when contracts were originally awarded.

It warns that rather than holding CSC to its contract commitments the DH is planning to award a deal that would enable it to offer older software to a much smaller number of NHS trusts.

It states that the DH must not now reward CSC’s failure with a new contract on favourable terms. “It is important that CSC, particularly given its proposed purchase of iSoft, does not acquire an effective monopoly in the provision of care records in the North, Eastern and Midlands clusters.”

CSC’s purchase of iSoft, its main software subcontractor and the developer of Lorenzo, was completed last Friday.

The report warns such a move could have dire consequences for NHS trusts: “This could result in the Lorenzo system being dropped as the system of choice and many trusts left with little choice but to continue with out-dated interim systems that could be very expensive to maintain, or accept a system of CSC’s choice.”

It warns against a repeat of the kind of new deal awarded to BT, which had also been unable to deliver against its original contract, which slashed the number of new systems while increasing the price for each system.

As part of any new contract the PAC say that CSC “should not be given minimum guarantees or a license to sell a product other than that procured and selected by the programme within the LSP contract.”

MP Richard Bacon, a close follower of the national programme who triggered the latest NAO investigation, said: “The DH is unable to show what has been achieved for the £2.7 billion spent so far on care records systems.

"The only good news from this fiasco is that every move of the DH in this area will now be subject to the closest scrutiny from the Cabinet Office”.

A DH spokesperson said: “The government recognises the weaknesses of a top-down, centrally-imposed IT system.

"We have reduced spending on the NHS IT programme by £1.3 billion. We are engaging with the NHS to ensure it delivers even greater benefits for patients.

“We are determined to deliver even more value for money from the programme. The findings of the Public Accounts Committee, alongside the outcome of the Major Project Review Authority, will contribute to the planning currently underway for future informatics support to the modernised NHS.”