ntouk.com - Jerry Fishenden's technology policy blog

I see there's been a lot of coverage about Conservative Party leader David Cameron's views on how to improve the role of information technology (IT) in the public sector (eg. politicians question major IT projects and Tory Leader wants to give our medical records to Google).

Both David Cameron and Lib Dem spokesman Vince Cable have made clear they would cancel some of the current public sector IT programmes.

All of which raises the question of what alternative IT proposals might be made in their place (if any).

I think this is a long overdue debate and it's good that it's provoking a reaction. I'd rather we had a good discussion about the role of technology and associated technology policy well before decisions are taken and budgets committed or cut. The status quo was unsustainable before the economic situation deteriorated and is even more so now.

Many of the failing or misguided and expensive IT projects that we currently see around us exist only because policy decisions were made in the past without an adequate understanding of technology and technology policy forming an integral part of that process. If politicians are increasingly aware of this reality (and only recently we've seen David Blunkett calling for the scrapping of the ID Cards scheme) and want to make changes in the way future policy decisions are informed by a better understanding of technology, that is something to be welcomed.

Analysts Ovum have released their perspective on David Cameron's ideas, entitled "Could change in government threaten NHS IT?" You can find some coverage of it here, including:

"Tola Sargeant, a principal analyst at consulting firm Ovum, has spoken out against these moves claiming the EPR [electronic patient records] system will still be needed, regardless of the current economic climate"

Which is revealing in itself. The EPR system? Doesn't that tell us something about an assumption of a single monolithic and centrally imposed system versus systems designed at the most appropriate local level to fit an organisation?

Part of the problem of late to my mind has been the simplistic assumption that to solve every business issue what we need is an uber-database that brings everything together with a design imposed from upon high. The NHS however has never been a single centrally run system. In many ways it's a confederation of independent organisations that sometimes need to work with each other. And the IT should have been designed to reflect that.

I thought we had learned long ago that imposing IT designs onto organisations that do not fit the business or processes of that organisation are doomed to failure and over-running budgets?

In terms of seeking alternative models for organisations such as the NHS, it seems to me perfectly valid to explore the potential role of systems centred on the citizen (patient) such as Google Health, Microsoft Healthvault and others. Well, you might expect me to say that I suppose. But there is a bigger underlying transition in IT happening at the moment. Vendor Relationship Management (VRM), the idea of us controlling our personal information rather than the service provider, is an idea that seems to be growing and has some interesting potential to both save the taxpayer money and enable us, as citizens, to retain greater control over our own personal information.

In terms of specifics for organisations such as the NHS, in the US systems such as Amalga are already demonstrating a smarter, more efficient and productive way of achieving results inside complex operational environments such as healthcare. Such systems work with existing information systems and equipment already in place in the health service. They help to improve operational efficiency, the quality of care, and the patient's own experiences by providing a single view of healthcare information brought together from the underlying range of existing systems. They don't impose and alienate, they complement and support.

I think that what some analysts and press seem to have missed in their hurry to comment upon possible changes to models of public service IT is that elsewhere some of these approaches have already proved successful. And yes, of course there will be a need to adapt products and services to the specifics of somewhere such as the UK. But it seems to me a mistake to attack the idea of a model built around making smart re-use of what already exists, and placing users (both professionals and us, as end users) at the centre of design.

When I look around at what is happening elsewhere on the Internet and the Web, it seems to me that this model of user-centric services is an idea whose time has come. And that politicians are right to ask questions about how public sector IT could be improved to reflect this.

There is too a wider underlying issue here, of how we tackle what my colleague Jonathan Murray has described as the GAP principles. Governance, Architecture and Procurement. All three of these need to be reviewed in conjunction to successfully transition IT away from the old, centrally imposed, designed-at-a-moment-in-time models, to ones that are citizen-centred, agile and cost-effective.

This is precisely the sort of debate I would like to see our politicians having, without some vested reactionary interests instantly claiming the status quo is better than alternative models. Closing down debate as soon as it starts is not healthy and helps contribute to the type of ill-informed group-think that has caused some of the existing problems with IT in the public sector in the first place.

If nothing else, we should be grateful to David Cameron and Vince Cable for asking hard questions about public sector IT. They are right to highlight that there are better ways of doing things, that there are real savings to be made, and that there are better and more efficient ways of providing high quality public services centred on our needs as citizens, not on the needs of the state as provider.

If all this ruffles a few vested interests and analyst feathers, so be it. But we should not close down this debate before it has barely started. It is a debate I welcome and so should the wider IT industry.

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