Published: 15/01/2004, Volume II4, No. 5888 Page 1

Despite the doubters, Richard Granger has kept his promises, for which he deserves praise, says Lyn Whitfield

Richard Granger has achieved something that almost nobody thought he would when he was appointed director general of NHS IT in 2002.He has got the contracts to put almost all the key elements of the national programme in place, within weeks of the deadlines set for doing so.

It is worth pausing to reflect on just how big an achievement this is.NHS chief executive information forum head Carol Clarke says the fact Mr Granger has done what he said he would do - and got a good deal into the bargain - is forcing senior managers to take the programme seriously.

But there is little time for congratulations because the real work is only just beginning.BT must build an NHS care records service for 50 million patients.Local service providers, and the implementation organisations that will work with them, face a bigger job sorting out local IT.

At the same time, disbelief has just shifted ground.Mr Granger may have got the contracts signed, critics argue, but there is no guarantee he will stay the course, that the Treasury will continue its commitment, that NHS organisations will find the money for local implementation or that staff will use the new systems.

None of these are bad points to make.Everything about Mr Granger's career suggests he will move on pretty soon, there will be a squeeze on public spending, NHS organisations will certainly find it hard to get IT investment up to the 4 per cent of total expenditure demanded by the Wanless report and managerial and clinical engagement remain critical issues.

But for the moment, let's just hope it works.The NHS has known for a long time that modernisation cannot happen without IT - yet coherent investment has not happened.

Two years ago, ministers felt they had to do something, and the national programme looked like a reasonable thing to do given the circumstances the NHS found itself in.

Now, modernisation - and with it patient and public support for the NHS - depend on it delivering.So well done, Mr Granger.

And everybody else - good luck. l