Healthy competition

A more innovative approach to IT could have prevented the NHS records fiasco

The recent announcement that the Financial Services Authority is investigating iSoft, the troubled computer software company charged with delivering a large part of the new, centralised patient records system for the National Health Service, is just another sorry episode in the government's Connecting for Health initiative.

In June 2005, Fujitsu, winner of the contract for southern England, changed horses midstream and dumped its software supplier. BT, the national telecoms provider, which owns the London contract, followed suit last month. And in July the Computer Sciences Corporation suffered an outage at its Maidstone data centre that left clinicians in the north-west and West Midlands stranded without computerised patient records for three days. As if this were not bad enough, a recent National Audit Office report was accused of censoring criticism of the scheme.

The Department of Health's disastrous project aims to centralise our most personal information - our confidential medical records - but even so, I wouldn't expect protests outside Richmond House any time soon. Just as we sigh and hit reboot every time our laptops freeze, we expect large-scale government computer projects to fail. They have failed many times before, from the EDS's botched job on the Child Support Agency to recent leaks that the ID card scheme may be scrapped due to technical concerns.

There could be another way. Partly why we feel so powerless when our computers crash is that most of us are locked in to services provided by a monopoly supplier. Remarkably, it's the same at state level: familiar company names appear regularly in the news, because governments are flogging the same dead horses.

Government IT contracts are often so tight that only huge companies will touch them. In the case of the NHS, the decision to pay on delivery for a highly complex system meant smaller, potentially more innovative producers could not take on the risk of tendering. Rather than nurturing a competitive ecosystem, such practices entrench the position of monopoly suppliers, regardless of actual past performance.

The demand for centrally controlled systems is another hurdle. The most successful information pool is the internet - essentially a decentralised network run on open standards - yet governments persist in demanding control from the centre, and allow contractors to keep their standards hidden.

If the government used its leverage as the largest spender on IT in the UK to demand that suppliers forfeit their intellectual property rights, they could open their code to smaller innovators. Managed correctly, such a move could change public IT for ever: rivals could salvage botched projects, and smaller producers could develop additional, specialised tools that plug in to the system.