Friday, February 11, 2005

Sir Peter and NHS Direct

I’m possibly the only person in the world that watched the repeat of Sir Peter Gershon’s appearance before the HoC Public Administration Committee (see previous post on Gershon Review). I don’t know what kind of audience BBC Parliament normally gets- the fingers of one hand presumably- but I’ll wager Sir Peter would have been even lower.

Anyway, he turns out to be the spitting image of a middle age Rimmer from Red Dwarf- strangled and nerdy, but with a strong sense of his own superiority. And as he burbled away- fielding questions by repeating them while waving his hands around a lot- I started to drift off.

Until that is, he was asked why we should believe all those savings that he reckoned would come from successful public sector IT projects. After all, there had never been any successful projects in the public sector.

Not true, he said, there’d been lots- it was just that the media didn’t report them ‘because that doesn’t sell newspapers’. He then listed a few. Obviously most of them were obscure computer programmes for counting paper clips etc, but my ears pricked when he mentioned NHS Direct. Because I have first hand experience of that.

That was the 3am episode where I somehow managed to swig a couple of mouthfuls of something that turned out not to be Gaviscon, but menthol and eucalyptus vaporiser fluid (embarrassing details here).

After a blood pressure raising conversation with NHS Direct, during which it was obvious they had no information, and at their suggestion, I went to A&E. The receptionist checked me in:

‘Ah… I phoned NHS Direct and they...’

‘…they told you to come here.’ This was not the first time she'd heard this. In fact, they get more visits from people referred on and generally scared stiff by NHS Direct than they get from people who are making their own decisions whether to come or not.

I was seen very quickly by a nurse who contacted the Toxicology Unit at Guy's Hospital. They immediately told us I’d need to ingest a swimming pool full of menthol and eucalyptus before it would do me any harm.

What a relief. I make to leave, but I can’t because I now have to see a doctor, because…well, those are just the rules.

A couple of hours later the doc pitches up, glances at the nurse’s notes, and confirms there’s no danger.

‘Yes well... ha ha... that's what I thought really. I'm sorry to have wasted your time but NHS Direct...’

‘... told you to come. Yes I'm sure they did.’ He smiles a thin I’ve-just-worked-ten-back-to-back-twenty-hour-shifts-and-now-I-not-only-have-to-deal-with-stupid-bastards-like-you-but-I’ve-got-to-deal-with-NHS-Direct-as-well kind of smile.

Now the aim of NHS Direct was to save money by screening out people who otherwise might call an ambulance for a minor cold. But my experience shows just as many people phone them with a headache only to be told they'd better pop along to casualty to get a brain scan just in case it’s a tumor.

And it turns out that’s exactly what the National Audit Office found when they looked at it. It costs more than £100 million a year to run- over and above the original £70 million cost of the IT system- and less than half of that is saved elsewhere by screening out minor complaints. The rest is a net addition to overall NHS costs.

Thus in the public sector even a successful IT project ends up costing us more. It’s an iron law (not quite sure which law- either Parkinson’s or LUC- Law of Unintended Consequences).

If Sir Peter really does think we’re going to save money by undertaking even more public sector IT projects, then my advice is to phone NHS Direct. They’ll probably refer him to A&E.

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