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Abandoned UK National Health Service IT System Has Cost $16bn... So Far 220

Posted by Unknown Lamer
from the waterfall-is-back-in-style dept.
dryriver writes with news of yet another major software project gone awry. From the article: "An abandoned National Health Service (NHS) patient record system has so far cost the taxpayer nearly £10bn, with the final bill for what would have been the world's largest civilian computer system likely to be several hundreds of millions of pounds higher, according a highly critical report from parliament's public spending watchdog. MPs on the public accounts committee said final costs are expected to increase beyond the existing £9.8bn because new regional IT systems for the NHS, introduced to replace the National Programme for IT, are also being poorly managed and are riven with their own contractual wrangles. When the original plan was abandoned the total bill was expected to be £6.4bn."
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Abandoned UK National Health Service IT System Has Cost $16bn... So Far

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  • great deal (Score:4, Interesting)

    by beefoot (2250164) on Wednesday September 18, 2013 @11:42AM (#44884367)
    That makes the $1B Ontario (Canada) government spent in E-health for nothing a great deal to me.
  • "Dayum!" (Score:5, Funny)

    by wcrowe (94389) on Wednesday September 18, 2013 @11:43AM (#44884383)

    I cannot fathom any software system costing that much. I imagine even the people over at SAP are going, "Dayum!"

    • Re:"Dayum!" (Score:5, Insightful)

      by CastrTroy (595695) on Wednesday September 18, 2013 @11:52AM (#44884469) Homepage
      Yeah, It certainly is absurd. I can't even imagine it if you factor in the hardware to run it on. Assuming you spent half of it on hardware, you'd have $8 billion worth of hardware (which is just plain ridiculous). You now have $8 billion left over to pay people, assuming each person working on the project makes $100,000 a year, for $8b, you can get 80,000 person years. The project was launched in 2002, so even counting 12 years, that means they could have hired 6666.667 (nice how that works out) people to work on the project.
      • Re:"Dayum!" (Score:4, Interesting)

        by AmiMoJo (196126) * <mojo@NOspaM.world3.net> on Wednesday September 18, 2013 @12:58PM (#44885107) Homepage

        That amount is not for the software and hardware alone. There has been a big reorganization of systems and computerization of records. Staff have been trained to use what has been delivered so far, and patients are being asked for permission to make their records available on the system. It's not a total write-off.

        • and patients are being asked for permission to make their records available on the system

          Maybe they had more people (like me) say no than they expected making it non viable? Given the govt's record on protecting data, there's no way they were putting my medical records on it.

          • Re:"Dayum!" (Score:5, Interesting)

            by malkavian (9512) on Wednesday September 18, 2013 @06:35PM (#44888749) Homepage

            No, they had lots of people that said the system was unusable.. There were priorities of error, and a priority 1 was a showstopper.
            The places that consistently tested showed that the system for the first several years (already way past expected implementation date) for the Care Records part was seriously broken, and not fit for live use (bear in mind, this system isn't just supposed to be able to hold your office files, and it's fine if it's down for half an hour now and then, and perhaps lose a few things along the way with only a grumble; it holds your medical records.. The things that make the difference between life and death in some cases).

            With things not working out on either side (again, for the Care Records parts; some parts, like PACS [Picture Archival and Communication System;the digitisation of your X-Rays instead of using film] work fine and are in almost universal use now, vastly changing the nature of care in the NHS.
            The big problems with it were:

            A) Tony Blair not having a clue what was wanted, but saying it should be done in a year.

            B) Setting a guy in charge of it that failed his computing degree.. One Richard Granger [wikipedia.org]. It was pretty much his ideas that doomed the Care Records part of it, and allowed out a spec that was more a back of a cigarette packet sketch than a real spec.

            C) Failing to have a real spec. Now the companies all bid for a very nebulous thing that said "You give us a lovely system that does what we want, and we'll give you billions.". Of course, they produced what they thought the NHS wanted, but the NHS discovered that it wasn't what they wanted. You know, basic Spec documentation you cover on computing. Which Granger failed.

            D) There was also fault with the companies who leaped at the cash without a real spec.. They should have known that the contract was WAY too wooly and actually tied it down to real deliverables.

            At renegotiation time, some of the vendors (like Fujitsu) worked out the cost of really doing what the NHS asked for (which was all the project management of the first round, plus a semi accurate spec). Which was a truly staggering figure. More than the NHS could stomach. The two are still in a legal scrap.
            Some vendors still kept the lights on in the data centres, and hosted what was there, but those installations are likely going to have to move out of those data centres by about 2015, as they're too expensive to maintain for the few installs.. And none of the vendors want to renew the system contract.

            So, the price tag covers all the allocation (it was scaled to host EVERY NHS hospital in the UK, which is most of them), training, consultancy, migration of data (a high precision activity that needs zero data loss on a vast amount of very complex information, coming out of a vast quantity of different databases, and being shoehorned into one uniform schema. Doing this while still providing clinical care (you don't get to shut a hospital down for ripping out the heart of its data systems and replacing them with a new; it's all done while still treating patients and making sure nothing gets mis-recorded).. Training of a huge number of clinical staff (doctors, nurses, and anyone else who needs to use the system inside the NHS), the feeds.. Interfaces between that system and the various disparate ones that it needs to communicate with inside a hospital..

            When you look at it, it's a breathtaking proposal, just nobody on high seemed to recognise that, and expected fast results because they said so and waved a fat wallet around. Unsurprisingly it went awry. The current UK government looked at the figures, the legal position and the chances of getting it sorted from a more businesslike side, and canned the bits that wouldn't work (the care records area).

            As for the data protection side, that was one of the most heavily guarded I've seen anywhere.. It was pretty robust. The few 'leaks' that happened (people looking at records they shouldn't) were spotted by access audit, and people lost the jobs.. That simple, that strict.

      • Re: (Score:2, Funny)

        by Anonymous Coward

        You forgot to factor in health insurance costs. From what I hear, they're quite high due to some boondoggle computerized records project.

      • Re: (Score:3, Insightful)

        by Joce640k (829181)

        Yeah, It certainly is absurd. I can't even imagine it if you factor in the hardware to run it on. Assuming you spent half of it on hardware, you'd have $8 billion worth of hardware (which is just plain ridiculous).

        You don't get it at all.

        Before you even start buying hardware or writing code you have to build some modern new offices and fill them with nice desks, leather chairs, etc. to attract the right sort of people for the management positions. Then you need hot young secretaries around the place and plenty of thousand-pound lunches to discuss their six figure salaries, annual bonuses and exactly what model of luxury car they'd like to drive to work.

        Only then can you start the actual "IT" part of the project.

      • Yeah, It certainly is absurd. I can't even imagine it if you factor in the hardware to run it on. Assuming you spent half of it on hardware, you'd have $8 billion worth of hardware (which is just plain ridiculous). You now have $8 billion left over to pay people, assuming each person working on the project makes $100,000 a year, for $8b, you can get 80,000 person years. The project was launched in 2002, so even counting 12 years, that means they could have hired 6666.667 (nice how that works out) people to work on the project.

        I can imagine it. FIrst off, you are counting salaries, but not benefits, offices, personal computers, and other things it actually take to run a business. That'll cut your estimated number of employees in half right there. They're also not dealing with one location working on one program. They are developing a system that has to integrate and be deployed at every hospital in the nation. Each of those hospitals (and other health care locations) will have to treated individually with most running unique comb

    • Re:"Dayum!" (Score:4, Insightful)

      by fustakrakich (1673220) on Wednesday September 18, 2013 @12:06PM (#44884577) Journal

      I cannot fathom any software system costing that much.

      Padding... The money was/is being stolen, looting the treasury.

    • Re:"Dayum!" (Score:5, Interesting)

      by deusmetallum (1607059) on Wednesday September 18, 2013 @12:16PM (#44884693)
      There's a lot to this kind of thing. I worked in a help desk once where a system was promised to be rolled out by X date. The contractor brought on all the staff based on that promised, kitted out the building with all the required hardware to provide the support and... nothing. The guys couldn't be fired, and there was no other contracts to move them on to, so they sat around waiting for the software to finally be rolled out.

      In other words, it's not just the software that cost all the money, all the fuck-ups along the way compounded and inflated the price tag way beyond what it should have been.
    • Re:"Dayum!" (Score:5, Insightful)

      by petes_PoV (912422) on Wednesday September 18, 2013 @12:58PM (#44885105)

      I cannot fathom any software system costing that much

      It cost that much because that was the amount of money available to pay for it. If there had only been £5Bn in the budget, the project proposals would (magically!) have cost that much - and would STILL offered the same results. And exactly the same final outcome would have been proposed if the budget had been doubled. Success or failure was not a function of the budget, nor of the requirements. Even back in the 2000's when this was still a comparatively young project, I was asked to work on it. I spent a day with some of the project people and knew even than that it didn't stand a chance of ever going live. Mainly due to the intransigence of the NHS workers, especially the doctors and consultants (who all believe the only function of the NHS is to keep them employed - any resulting healthcare is merely a bonus).

      The sorts of companies who bid for this work, just like defence contractors, are masters at configuring their projects to consume all available resources for a constant output. The problem is that they are much better at negotiating than government employees (who have no personal investment in the project) and more highly motivated, what with their contuned salaries, bonuses and commissions.

    • Re:"Dayum!" (Score:5, Insightful)

      by ShanghaiBill (739463) on Wednesday September 18, 2013 @01:05PM (#44885173)

      I cannot fathom any software system costing that much.

      It is easy to fathom if you look at how the program was structured. All the incentives were inverted: nearly everyone involved actually benefited from cost overruns (the contractors got more money, the bureaucrats had the prestige of managing more resources, and the politicians had more patronage to dispense). There was no accountability (no one is being disciplined or fined). There is not even any political fallout because the blame is smeared out over multiple administrations (Conservatives can blame Labour for starting the project, while Labour can blame the Tories for mismanaging the implementation). It is like it was designed to fail. A decade from now you will be reading about some other project that failed in the exact same way, for the exact same reasons.

      • by Darinbob (1142669)

        This is the one area where I think government should do the job but at the same time is incapable of doing it well. Government is no necessarily more corrupt that the private sector and no more greedy. However when government is greedy they tend to just spend more money, whereas when private sector is greedy they spend less money and pocket the savings.

        The best outcome I think is a mix. Leave the implementation and management to the private sector but at the same time have a strong and robust regulatory

    • Re:"Dayum!" (Score:4, Insightful)

      by bobbied (2522392) on Wednesday September 18, 2013 @01:23PM (#44885383)

      I cannot fathom any software system costing that much.

      Haven't worked on any government programs I see.

      Start with lots of money, fuzzy requirements and add general stupidity in the contracts office and you can get a LOT of money wasted. Who's got more money to waste than the government?

      I've worked on government programs that I firmly believe where managed to get as much money out of the customer as possible (not to actually *deliver* something they wanted). One such program had taken more than 3x the initial cost estimate, taken 3 times as long and was nowhere near half done (by my estimate) before it got cancelled. Mission accomplished... (I made the mistake of actually voicing this theory in the midst of the program too.. I don't work there anymore...)

      And here in the US we are rushing head long into government run health care... Yikes.. It's going to be way more expensive than you can imagine.

      • I can imagine the cost of your current for-insurance-co.-profit system.

        Will it be more expensive than that?

        • by bobbied (2522392)

          Oh yea, it's going to be LOTS more expensive.. Insurance companies are in business to make money, government is about spending money.

          The beauty of capitalism and the profit motive is that if somebody starts making loads of cash in some specific business line, others will see that and rush in to "make their share too". So competition reigns, supply increases and prices go down. The business of health insurance was no different. Government has no such "profit" motive to keep it efficient.

          At one time, long

  • Lost cause (Score:5, Informative)

    by Anonymous Coward on Wednesday September 18, 2013 @11:44AM (#44884387)

    My father was contracted a few years ago as a consultant to help update the NHS's infrastructure. After a year working there for a year he ended his contract. He said that it was impossible to get anything done because the higher ups didn't listen to the engineers and project managers on the teams. There was also a lot of unmotivated and lazy people working on the teams that slowed everything down. Politics also played a big part and people cared more about keeping their comfy job that never really had an end date than finishing the project.

    • by TexNex (513254)

      Thats fairly common with IT install projects. Between mission creep and idle time (usually caused by mission creep and work outage disputes) its surprising anything gets done on these contracts. Install projects take a special kind of insanity to manage.

    • Re:Lost cause (Score:4, Informative)

      by Anonymous Coward on Wednesday September 18, 2013 @12:57PM (#44885065)

      On the NHS projects I was working on, most things were working nicely on Sun systems. Then came this big idea that they should change everything and use Microsoft windows. Chaos ensued. I did what I could for about 2 years, but could just see the change going nowhere. In the meantime, the old systems just kept running.

  • by TWiTfan (2887093) on Wednesday September 18, 2013 @11:46AM (#44884413)

    Thank God that here in the U.S. we're protected from this kind of system. Sure, getting sick here without insurance can bankrupt you, drive you into lifelong debt, etc. But at least we don't have to put up with any red tape in our health care system!

    America, America, God shed his grace on theeeeee!

    • by intermodal (534361) on Wednesday September 18, 2013 @11:47AM (#44884427) Homepage Journal

      Unfortunately, what we're seeing is a preview of what I expect with Obamacare.

      • Naw, the primary burden of all those computer upgrades was stuffed upon insurers and hospitals/clinics instead, who quietly did the required systems upgrades with a minimal amount of fuss over the last couple of years. (Except the ones in denial who are now panicking.) They rolled it into their planned systems upgrades, and while the software was a large investment, it also replaced outdated systems with much smoother modern records systems.

        About the only major issue with the electronic medical records
      • by SuricouRaven (1897204) on Wednesday September 18, 2013 @12:08PM (#44884597)

        The silly thing is that 'obamacare' doesn't actually change anything. Same doctors, same hospitals, same procedures. No grandiose new projects. For most people, same insurance company. All it does is subsidize health insurance to make it affordable to those on low income - that's it.

        • Re: (Score:3, Informative)

          by intermodal (534361)

          2009 just called. They want their blatant lies back.

        • by sycodon (149926)

          Just more expensive...as I just saw during open Enrollment. Why? Because although I am single and have a vasectomy, my new and improved, Obamacare approved plan is required to cover Obstetrics.

      • by plopez (54068)

        As if insurance companies do not have red tape. Or death panels, they kill people all the time by denying care. Or computer systems that are running on bubble gum and bailing wire. God Bless the Insurance Companies!

        • As if insurance companies do not have red tape. Or death panels, they kill people all the time by denying care.

          And that is the basis of why you guys can't figure out the real problem.

          Insurance companies don't deny care.

          They just don't agree to pay for some of it.

          The doctors decide not to offer that specific care since you can't pay for it yourself.

          And for that, you blame the insurance company.

      • by hedwards (940851) on Wednesday September 18, 2013 @12:54PM (#44885023)

        That's because you're crazy. But, thankfully you'll be able to get affordable coverage starting in a few months.

        Honestly, when you look at the cost of health care in America compared with even the most expensive systems in the developed world, the costs are higher here and the outcomes are inferior.

        In other words, it may cost more in the near term as preventative care becomes more accessible. But, fewer people using the ER for primary care and fewer bankruptcies caused by medical bills should start to bring the costs down fairly quickly. Then in a few decades the savings from preventative care should be apparent.

        It's mostly people who watch Fox Noise and have no idea what it is that they're paying for when they go to the doctor's office that are afraid. All that charity care isn't being paid for by the government, it's being tacked on to the cost of insurance.

    • by mi (197448)

      Sure, getting sick here without insurance can bankrupt you

      Getting sick without insurance may bankrupt you everywhere, where insurance companies are the dominant payers for healthcare.

      The problem outlined by this news is that, when the insurer has no competition, they can continue raising their premiums to no end and survive any sort of idiotic inefficiencies and waste. The joys of the "single-payer" system, that Obamacare is the harbinger for...

  • by Anonymous Coward on Wednesday September 18, 2013 @11:46AM (#44884415)

    So, with all that money spent,
    how can we, the taxpayer, get the
    code open sourced ??

    • That much money spent on a failed software product? I think releasing it in the public domain would violate a dozen geneva convention regulations. It could be legitimately argued that the code base would constitute a weapon of mass destruction.

      No, the only way to effectively handle that steaming pile of...code...is to destroy all copies but one, which you then entomb in a sealed vault miles under the surface of the earth with warnings in every language imaginable.

      • by RoboJ1M (992925)

        I say we dust off and nuke it from space.
        It's the only way to be sure.

        But yeah, source code please or it never happened and we want a refund.

  • by advid.net (595837) <slashdot@adv[ ]net ['id.' in gap]> on Wednesday September 18, 2013 @11:48AM (#44884433) Journal

    Usually when I hear about a doomed IT project, I share my optimism with other colleagues:
    this means that we still have plenty of IT job offers guaranteed by these failing managements.

  • I'll Save Them (Score:4, Insightful)

    by khr (708262) <kevinrubin@gmail.com> on Wednesday September 18, 2013 @12:00PM (#44884535) Homepage

    I'd be more than happy to save them a lot of money by abandoning a similar system for a mere tenth of that amount!

  • by sandytaru (1158959) on Wednesday September 18, 2013 @12:05PM (#44884567) Journal
    Isn't the British government supposed to have created the friggin' world standard for proper service management of IT projects? Do they not read their own material?!
    • Re: (Score:3, Informative)

      by Dann25 (210278)

      Dont forget PRINCE (http://en.wikipedia.org/wiki/PRINCE2)

    • by RoboJ1M (992925)

      Yep, sadly I think at some point everybody decided private companies would do it better and cheaper.
      When all it really turns out is they did precisely *nothing* for 10 billion pounds.
      If they are interested, I'll write the entire thing myself for just one billion.
      I am literally one tenth the cost, it's a deal, it's a steal, it's the sale of the f*****g century.

      • I'll be your PM and we split the money. You do the code, I'll write all your documents. Deal?
  • Surely for a few tens of thousands of pounds, it would have been better to publish and API for storing and modifying the info on (secured) web servers locally in a way that could be indexed and catalogued separately. Then, incentivize private firms to make and sell software to surgeries and hospitals that provide the API. Why do people always go for monolithic top down solutions for these things?

    • by durrr (1316311)

      Because the moron with the cash listens to the psychopath that wants an early retirement.

      The moron with the cash doesn't even have to spend his own cash, it's tax money after all, so he just signs whatever sounds good and goes home.

    • Yea verily, every large software system that works was made from small software systems that worked. Since they have to trash this one, why not have a look at http://freecode.com/projects/openemr [freecode.com]
  • Contractor Failure (Score:4, Informative)

    by thoth (7907) on Wednesday September 18, 2013 @12:25PM (#44884761) Journal

    Before all the anti-government bozos show up to point and laugh:

    However, 10 years on CSC has still not delivered the software and "not a single trust has a fully functioning Lorenzo care records system". This failure, the report said, was "extraordinary", while CSC was accused of a "failure to deliver" and "poor performance".

    Yeah, that's a private corporation failing to perform/deliver. They're too busy focusing on cashing their checks, locking in their revenue stream, and paying their executives to actually deliver the product they agreed to.

    What the government is bad at is managing contracts:

    "systemic failure" in the government's ability to draw up and manage large IT contracts.

    "there is still a long way to go before government departments can honestly say that they have learned and properly applied the lessons from previous contracting failures."

    CSC should be sued for breach of contract, sued for fraud, sued for damages.

    • by RoboJ1M (992925)

      Too slow and expensive.
      Seize all assets and nationalize them, fire every manager and conscript them into the army.
      Good lesson for all the others, play the game and the rewards ($16bn) are tremendous but the risks come with catastrophic consequences.
      >-)

      • Too slow and expensive.
        Seize all assets and nationalize them, fire every manager and conscript them into the army.

        3. Invade Great Britain.
        4. Profit !

    • by Kjella (173770)

      What the government is bad at is managing contracts

      Well, if you broaden contracting to the whole concept of being a professional customer with requirements, deliverables, change orders and decision making. It's not the lawyers to set up a proper contract that is missing, it's that the "the product they agreed to" is some vague concept that is all but impossible to spec, estimate or deliver. No contract can give you cost control when the essentials of the contract are so bad, it's just trying to polish a turd.

  • by benjfowler (239527) on Wednesday September 18, 2013 @12:37PM (#44884873)

    Clinical records are the last big domain that resists computerisation.

    Why? Because it's really hard to get right. You have a massive quagmire of competing interests, egos, a very complicated domain model and legal/regulatory environment that changes constantly and is different in every country. And to top this off, you have privacy whingers.

    Common sense suggests that if it was an easy problem, they've have cracked it by now. As it is, I walk into my local GP for a checkup, and behind the reception, there's a massive wall of paper patient records. In 2013.

    You have government of course (let's face it, governments have few very good people, and hire literally millions of bozos), but I'm not sure if it's any worse than the privatized, Balkanized carpetbagger-fest that passes as a health system in the US...

    Absolutely not excusing the disgraceful and self-serving behaviour of the big integrators here (CSC and BT, amongst others), but they've blown billions for a reason.

    • by slimdave (710334)

      Speaking as a dyed-in-the-wool data modeller and corporate database guy, I wonder what the problem would be with throwing all of that data modeling and medical coding stuff away and just letting people write into the system what actually happened, exactly as they do with paper records. Some tagging for "this was a procedure" or "this was a test", but free text the rest of the way.

      At least the information would then be accessible through a computer to far-flung locations (Norwich) in case it was needed there

      • by Virtucon (127420)

        You can't really. Medicare for example has mandated that specific codes be used for billing and with that the rest of the industry has followed suit. These are called CPT codes and you'll see them on every medical bill you get here in the US. You now have multiple generations of doctors, nurses and medical coders who know what the codes mean and how to enter them for reimbursement but the doctors usually keep their own notes because the billing codes don't form a diagnosis or a treatment regimen, they ju

    • by xaxa (988988)

      The two GPs I've used (both in London) have had electronic records. The first, which was the GP attached to my university, had what looked like quite and old system -- full-screen CLI based interface.

      The second has a Windows desktop application. I've only seen it twice. It told the doctor I was missing a vaccination, and she set a thing to automatically remind my in 1 year to get the second part of the vaccination (for better immunity).

      However, I don't know what would happen if I was taken to hospital an

  • After all, the olympic games cost that much - and they only lasted 2 weeks.
  • as a bit of a strawman, I'm suggesting that we IT people have a moral obligation to get involved in projects like this. sort of the way doctors are obliged to help any patient that presents, regardless of who they are or what they've done.

    these sort of megaprojects seem to be self-justifying in some weird way: managers who don't know what they're doing adopt an incredibly conservative attitude toward risk management when any large project is proposed. once that phase-space is entered, it's an upward spira

  • by LostMyBeaver (1226054) on Wednesday September 18, 2013 @04:31PM (#44887553)
    Throughout my life, I have never heard of a government contractor completing a project anywhere near on budget or on time. I assume it must happen sometimes, but what their incentive to do so?

    The bidders come in, underbid each other to an unrealistic level, pump out a bunch of documents claiming they can accomplish a project without any proof of actually understanding the project.

    The government pays a certain amount up front and some along the way and that money isn't used to develop the project but instead is invested in preparing for second round funding and lobbying for it.

    The people who bid the initial deal are fired with gigantic golden parachutes for gross negligence.

    Papers and stuff are assembled to make it look like they project is far enough along that the government can't possibly justify dumping the contractor and feeds the contractor the "Real financing" which they should have asked for when they initially bid.

    The project is then overstaffed through an employment/consulting agency which charges 400% of what they're paying the employees which happens to be run by one of the guys fired for gross negligence.

    Management is constantly promoted and the developers who actually can do the work are promoted to management several times ensuring that at no point in time does anyone actually have a good overview of the project.

    A product goes into testing only to find out that instead of a medical billing system they wrote a medical pilling system for pharmaceutical management.

    A new budget is approved to adapt the pill pusher records to hold medical data for patients.

    Rinse and repeat.

    This is not even something we need to be surprised about. These people are thieves and they play their hands the same way every time. Wouldn't it be better to feed all the bidders the startup money for the project. Then as milestones are met, the companies not managing to keep up lose their budgets until there's only one? It's a massive amount of wasted energy and work, but the project will probably come in at much less money then if they're managed in the classic sense.

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