Computer scientists call for audit of NHS IT programme
http://bmj.bmjjournals.com/cgi/content/full/332/7547/930-c
London Michael Cross
Leading British computer scientists have called for an independent audit
of the NHS’s information technology programme to verify that the network
of systems being installed in England is technically feasible and secure.
In an open letter to the parliamentary select committee on health,
academic experts in computer science, engineering, and security last
week urged the committee to ask for an independent technical assessment
of the £6bn (€8.7bn; $10.5) programme “with all possible speed.”
Signatories include former advisers to the government and to the BMA,
who question the wisdom of continuing the programme without an
“independent assessment of its basic technical viability.”
The letter reflects concern among computer scientists that commercial IT
products are inherently unsuitable for the development of very large and
complex systems of the kind being created by the NHS national programme
for IT. It claims that objective information about the programme’s
progress “is not available to external observers,” and it suggests that
the audit should ask “challenging questions” about the technical
architecture and detailed design of systems being created under the
programme.
The group, led by Martyn Thomas, an Oxford University professor of
software engineering and former member of the government’s Foresight
technology panel, asks whether the programme has a comprehensive and
robust technical architecture, project plan, and detailed design. “Have
these documents been reviewed by experts of calibre?” it asks.
Another signatory, Brian Randell, a professor of computer science at the
University of Newcastle upon Tyne, advises the government on complex
“pervasive” systems.
The NHS IT programme’s main architect, Richard Granger, chief executive
of the Connecting for Health agency, has resisted publishing technical
details on the grounds that these are a matter for commercial
contractors, who are engaged to provide “output based” functions rather
than to follow exact specifications.
But he invited the academics to a private meeting this week in London,
to give them an opportunity to raise their concerns and provide them
with an overview of the programme, its progress to date and its
technical architecture.
Another area of scrutiny in the academics’ letter is the programme’s
consequences for patient confidentiality. The letter says that the audit
should ask whether the systems being developed “conform to guidance from
the Information Commissioner in respect to patient confidentiality and
the Data Protection Act.” This reflects the long standing concerns of
one of the signatories, Ross Anderson, professor of security engineering
at Cambridge University. Professor Anderson, a prominent and outspoken
critic of the NHS’s central IT policy, advised the BMA in the mid-1990s.
The academics’ letter, published in Computer Weekly (April 11, p 14),
and picked up by the national media, emerged at a difficult time for the
four year old programme. At the beginning of this month Accenture, a
major contractor, announced that it had set aside $450m in its accounts
to compensate for a shortfall in earnings caused by delays in the programme.
Because the open letter was published during the Easter parliamentary
recess there was no immediate indication whether the select committee,
chaired by the Labour MP Kevin Barron, would act on the recommendation.
Connecting for Health refused to comment. In its latest update on
implementation the agency reported a leap in usage in the programme’s
first main national system, Choose and Book. At the end of March the
average number of daily bookings being made through the system was 4000,
double the figure at the end of January.
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