NHS computer chief reprimanded for speaking out

Britain's highest-paid civil servant, the director of the National Health Service's (NHS) £6.2bn IT programme, has been reprimanded for exposing serious tensions among managers implementing the new system.

Richard Granger, the £250,000-a-year director general of the Department of Health's (DoH) `Connecting for Health' project, gave interviews last week revealing that the government had damaged the huge programme by changing the specifications of the design well after contracts had been signed with suppliers.

Any anger aroused was compounded by a leak of e-mails exchanged between Mr Granger and Margaret Edwards, the DoH's director for access and patient choice. He claimed that her ìconsistently late requestsî for changes in the electronic booking system for hospital appointments were ìin grave danger of derailing (not just destabilising) a £6.2bn programme.î

There was no evidence connecting Mr Granger to the leak, but Sir Nigel Crisp, the NHS chief executive, is said to have been understandably annoyed at developments. According to the DoH, John Bacon, the senior civil servant in charge of the programme `had a word' with Granger about recent events, reprimanding him for making his comments in public.

The story is a familiar one for many in the computer industry, and arguably in the NHS - an employee being reprimanded for telling their boss that their expectations and demands are unreasonable or unhelpful.

Despite the outburst, Granger retains plenty of support within the DoH and NHS. The chief executive of one strategic health authority told the Financial Times: ìGranger is entirely right. There has been a management failure on this in the department.î

Granger has attracted widespread admiration in the industry for good management of suppliers, with binding contracts and adherence to deadlines. For example, the first wave of equipment to the NHS was delivered and set up on time, with payment to contractors being withheld until everything worked correctly; it may be commonsense but can be surprisingly rare within the industry.

However, questions have now been raised about the whole NHS IT system. The 'choose-and-book' part of the system is a year behind schedule. It should allow 10m patients to choose where they will be treated, but only 20,000 currently have access to it. 32 Foundation Trust hospitals are not yet logged on.

With haunting stories of failed government IT schemes in the not too distant past, questions about the wisdom of taking on such a huge challenge may arise once more.