Comment Ring-fenced funds may be only hope of dragging NHS into 21st century

Published: 13/12/2001, Volume III, No. 5785 Page 19

Hot on the heels of chancellor Gordon Brown's pre-Budget report, with its£1bn extra for the NHS next year, comes health secretary Alan Milburn's explanation of how that money - and the extra which had been previously planned - is to be distributed. It represents an overall 9.9 per cent increase across the service.

Though we have shared managers' despair at the mania for ring-fencing dollops of cash for which they have to mount elaborate cases to gain access, in some instances it can be justified - and never more so than for IT. The NHS is desperately in need of massive IT investment if even a fraction of the NHS plan's aims are to stand a chance of fulfilment.

Patients used to surfing the Internet from their home computers now feel only frustration and impatience at the woefully archaic, often still paper-based systems on which the NHS has relied little-changed for more than 50 years. And where the mouse and keyboard have superseded ledgers and brown envelopes, they are frequently manifestations of legacy systems dating from 10 years ago or more. IT needs to permeate every aspect of NHS activity, and become ingrained in its very culture. Too many senior managers, even now, feel instinctively hesitant about computer technology; planning for it, deploying it and using it personally ought to be second nature to them.

So Mr Milburn is right to earmark£85m of Mr Brown's largesse for IT. But that alone is not enough: he must make doubly sure that this time the money is not salted away for other uses: three-quarters of the cash identified for implementing Information for Health has been used for other purposes. If the same happens again, the entire NHS modernisation programme will be in danger.

Elsewhere in Mr Milburn's allocation statement, the news was less good. In particular, it is a colossal mistake to continue to starve social services of resources - to the tune of£700m a year, according to the King's Fund. As no NHS manager needs reminding, pressure on social care impacts directly on healthcare, and risks undermining NHS reform, especially if its careful preparations for winter are jeopardised by bed-blocking arising from paralysed social services. l