Ian Cheong wrote: > At 2:23 pm +1000 17/6/07, David More wrote: >> <http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=3529>http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=3529 >> >> NHS IT chief Granger quits >> Head of £12.4bn programme will go before roll-out of crucial care >> record system >> >> ================================================= >> The lessons to be learnt from this are legion and need to be carefully >> learned. >> Cheers >> David >> ---- > > ...but the lessons were known prior to the project/programme starting. > Probability of failure being proportional to project size.
I suspect that Grainger is going because Blair is stepping down this month, and without Blair's backing of the massive expenditure needed to support Grainger's maximal cost strategy, it is all going to go even more pear-shaped than it is now. A prime lesson is that core health care information systems need to be sustainable, and this includes financially sustainable, through periods of recession and through political changes - both being very likely to happen in the lifecycle of most national-level health IT deployments. Personally I think that a lot of health IT software which is bought from overseas could have been developed here in Oz, had there been sufficient belief in local ability and some national leadership. But if systems do need to be purchased from overseas, the key thing is to ensure is that there has been sufficient technology transfer and sufficient rights obtained so that, if a recession comes or the terms of trade turn against imports (that is, our dollar weakens), then we are not left to pay a ransom in US dollars or Euros for software upgrades and services in order to keep out health system running. I suppose it is a similar question to whether our telecommunications companies or national airline or other core infrastructure providers should be foreign-owned or not. Apart from some GP systems, Grainger has linked the fate of health IT in the UK to CERNER, iSoft, Microsoft, CSC, IBM, Accenture, PWC and Fujitsu. Of those, only iSoft is a British company, and Grainger's programme has driven it to the wall and it is reputed to be in danger of tanking or being bought out. However, Grainger has always espoused the line that the UK NHS was a partner with these firms, with IP and copyrights jointly held with the companies concerned, and with complete or very good access to their underlying technologies. In Australia, we are more just clients of those companies, I think, which puts us in a riskier position, at least with respect to the public hospital sector. The GP software sector is much more indigenous. But talking of risk management, how many GP software vendors provide source code escrow agreements, or even better, access to source code (short of a license to re-distribute or modify that source code, which is of course the open-source approach and is even better again)? Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
