With the election season officially in full swing, the political parties have published their manifestos, starting an intense campaign process. Whichever party winds up in power following May’s election, the NHS will be subject to a number of changes that will affect the way we receive care. Below is a run-down of the parties’ proposals for the NHS IT programme.
Labour has promised in its manifesto to “release savings by cutting red tape and directing resources to where they matter most.” This translates to scaling down the NHS IT programme, a move which Labour claims will save hundreds of millions of pounds.
The Tories want to devolve control over the health budget to the “lowest possible level,” giving patients a role in managing their own health budget, and with that, management over their own health records. They would cancel the government databases, and break up larger Information and Communication Technology (ICT) projects so that smaller suppliers could create ICT solutions in their local areas.
The Lib Dems are aiming to cut the size of the Department of Health in half. To do that, they would, among other things, cut budgets to quangos, and even abolish Connecting for Health, the NHS organisation created in 2005 to deliver the NHS programme for IT. Interestingly, although they want to eliminate Connecting for Health, they state that GPs should be accessible to patients by email.
All three parties have focused on the theme of patient control. They’re responding to the perception that the NHS is too bureaucratic, and that power should be in the people’s hands instead. And while all of their proposals are merit-worthy, they each come with their own problems.
For example, scaling down the NHS IT programme will not necessarily bring great savings. The NHS is involved in a number of contracts that will be difficult to renegotiate, and many of them are based on results, so we do not yet know just how expensive they will be.
Smaller, more local suppliers may be able to provide more bespoke solutions to local trusts, but they are not a perfect answer either. Smaller firms may not be able to offer the best deals that come with orders on a national scale. Moreover, unless clear rules are set out regarding how data should be stored and shared, individualized IT systems may be incompatible with each other, thus losing one of the original benefits of a national system. And by cancelling the government databases, Conservatives imply that they are considering a deal with Google or Microsoft to provide record acess on behalf of the NHS, which raises a whole new set of questions about how far we trust private companies with our personal data.
Nor is abolishing Connecting for Health necessarily the best solution to address budget concerns. Gayna Hart, managing director of Quicksilva, argues that one of Connecting for Health’s aims is to join up medical care with social care, providing better information to both sectors to improve the overall level of care. She claims that eliminating this connection could mean that vulnerable people would slip through the cracks of the system, or that the elderly wouldn’t receive the most comprehensive care.
It’s certain that the healthcare debate will continue throughout the election campaign, and that the substantial pot of money allocated to NHS IT will present a tempting target for parties who are under perssure to spell out where they would make cuts. What’s less certain is whether the new government will actually be able deliver its promised savings and benefits once in office.