LYN WHITFIELD ON THE CHALLENGES AHEAD

The big day has come and gone. And NHS IT didn't swing the election one way or the other - although the national programme went into purdah for the duration of the campaign, just in case.

The Labour manifesto promised to give patients more information through NHS Direct and the new NHS Direct website. The Conservative and Liberal Democrat manifestos had nothing to say on the subject at all.

This prompts several thoughts: first, things used to be different; second, It is low profile is strange, given some of the other themes of the campaign; third, things may change now the election has passed There was a time when Labour found new technology exciting. Its 1997 manifesto, for example, promised to 'promote new developments in telemedicine - bringing expert advice from regional centres of excellence to neighbourhood level'.

And the NHS plan was full of technology promises. 'Modern IT systems for every hospital and GP practice': bedside telephones and televisions for every patient, direct booking for hospital appointments (a 2001 manifesto pledge) and patient smartcards holding medical records (another manifesto pledge).

Looking at that list, perhaps it is not surprising that Labour was less prescriptive in its promises this time around.

Telemedicine never seems to get beyond pilot projects, and smartcards are yesterday's hot technology.

Bedside telephones and televisions have been rolled out, but how many patients resent the cost and the involvement of private companies?

And then There is the big stuff: electronic booking and modern IT systems. Which brings us to the national IT programme, renamed NHS Connecting for Health on 1 April.

Even NHS CfH director Richard Granger admitted at this year's Healthcare Computing conference that the programme has been in a 'dip' for the past few months. Of course, he is also adamant that it will climb out again, and his list of successes makes it possible to construct a case in support (HSJ, news, page 9, 31 March).

However, with the N3 broadband network running into problems, suppliers (un-named) being warned they could be booted out if they do not start delivering, money tight and choose and book still making appointments in the low dozens, ministers must have been glad they didn't have to state the case in April.

This low profile is strange. After all, the government's competence in spending taxpayers' money was a theme in the election campaign. So was the need to find efficiency savings and to deliver a more personalised health service.

Of course, election campaigns are about big themes, not details, and this one was less enlightening and more alienating than most. But It is hard to believe that things will stay quiet on the NHS IT front once memories of the election have faded.

For a start, poor John Hutton has been allowed to escape the Department of Health in the reshuffle, and Lord Warner put in charge of delivering the programme.

And the programme needs to get out of its 'dip'. This may mean some action on the supplier front, but it may also require action on funding.

IT spending across the NHS seems to be rising, but only slowly, and unevenly across the country (see pages 8-9). Mr Granger hinted in Harrogate that this is because managers fail to understand the benefits of IT.

However, chief executives are - generally - canny people. It is possible they're also waiting for IT to become an actual, rather than a stated, priority, and/or for more incentives to get with the programme.

I am sure Mr Granger, an arch negotiator, knows this. It will be interesting to see who has to give what to start the whole show moving forward again.

Finally, the programme needs to come out of purdah and use its relaunch to both open up and try to charm a few people, not least doctors and the public, who continue to worry about security and confidentiality. .