Good news at last for IT salesmen: an order worth at least £2.3bn is in the offing. The snag is that the customer is the computer shopper from hell.
The department of health team in charge of dragging the NHS into the computer age last week formally launched the process of picking suppliers for a national IT programme in England. Its vision, set out in Tony Blair's e-summit speech in November, is an NHS in which doctors will book appointments from their computers, prescriptions will flow electronically from GP to pharmacy, and health records will be available on screen.
But realising this vision is a lot more difficult than simply loading new software and upgrading some desktop kit. Hence the procurement launched last week. Three kinds of contracts are on offer. Separate consortia will supply:
· National systems for appointment booking, electronic prescribing and basic electronic records; and
· Electronic plumbing to underpin these systems and to allow multimedia information to be zapped securely around the country. The first big job is upgrading the existing NHSnet intranet, conceived in the early 1990s.
Alongside these national projects is a major overhaul of frontline IT in use in hospitals, GP surgeries and community health organisations. It is badly needed. After decades of stop-start funding and policy U-turns, the quality of IT across the NHS varies from world-class to appalling.
Many hospitals deal with dozens of suppliers, ranging in size from Microsoft to doctors who write programs as a hobby. Hence the third type of contract announced last week. Each geographical NHS region will pick a single contractor to take over all IT used by its member organisations.
These "local service providers" will be responsible for integrating or replacing dozens, sometimes hundreds, of systems to prepare for the national applications. They will also create a "standard desktop front end", so that staff can sit down and log in wherever they are.
Nearly everyone agrees that this revolution is long overdue. With the prime minister's personal backing, and £2.3bn guaranteed funding on top of existing IT budgets, what can possibly go wrong? Plenty.
The national programme has all the makings of a classic public sector IT disaster. It is big, its success depends on changing the work practices of powerful professional groups such as doctors and nurses, and it involves experimental technology.
Most of all, it is being done in a rush: No1 on a list of 12 procurement principles published last week is "rapidity". Because the risk of disaster is so obvious, the contracts will come with interesting small print.
For a start, only major companies will be invited to bid. Smaller firms, responsible for most of the better systems in use today, will have to operate under their wing. The procurement principles spell out that if projects fail, suppliers will suffer.
They will be paid only when projects start delivering value. Companies that fail will be stripped of contracts. In an even bigger break with tradition, the seventh principle says that the NHS will "ensure applications and systems perform before we buy them". All components will be tested in a "simulation of a live NHS environment", especially for compatability. "Providers of systems which lead to information silos as a result of poor or non-existent data interfaces will have no future within the NHS."
The final principle concerns probity. It requires "explicit disclosure" from individuals with commercial interests who may be involved in projects (and requests the same from external commentators). Prospective suppliers have a month to express interest in bidding.
In the current state of the IT services market, these contracts look like a godsend. Companies such as Fujitsu and IBM, which in the 1990s largely pulled out of the NHS, are likely to bid, as are EDS, Schlumberger SEMA and consultancies such as KPMG. Despite the risk and the tough conditions, the NHS is in a buyer's market.
