Published:25/04/2002, Volume II2, No. 5802, Page 6 7

NHS IT faces an uncertain future despite the Wanless report's recommendation that spending on IT should more than double.

The NHS in England currently spends about£1.1bn a year on IT.

The Wanless report recommends this should rise to£2.2bn in 200304 and£2.7bn in 2007-08.

Analyst Murray Bywater of Silicon Bridge Research said there were serious doubts about the NHS's capacity to make best use of the money.

This month, the NHS missed the first targets for implementing electronic patient records set out in the 1998 Information for Health information strategy. There now seems to be a new emphasis on electronic health records - nationwide systems rather than hospital ones. At the Healthcare Computing 2002 conference, Department of Health director of research, analysis and information Sir John Pattison also indicated a new direction for IT procurement, using a smaller number of 'preferred' suppliers.

Mr Bywater said the result was that NHS IT managers were 'like rabbits caught in the headlights... too confused and too frightened' to do anything. He said trying to bring in huge, centralised systems would not work and the NHS needed instead to set standards that would allow different systems to communicate with each other.

His view was echoed by Markus Bolton of System C Healthcare, who said it would 'take ten years' to design a huge procurement process 'and in the meantime everyone will stop doing anything'.

There is also considerable concern about the future of smaller NHS IT suppliers, who have tailored their products towards meeting Information for Health targets.

Peter Dyke, head of marketing at BT Health, pointed out that the increase in funding called for by Wanless would still mean the NHS was investing just 3 per cent of its total spending in IT - far less than large firms spend.

'It is no surprise that Derek Wanless, who was chief executive of a bank, sees the benefits of IT, ' he said. 'But this will still not take the NHS up to commercial usage of IT. It will bring it into line with the rest of government, which is a welcome first step on the evolutionary ladder.'However, Mr Dyke said the large sums of money going into NHS IT should attract larger firms and the market should consolidate around them. 'The really good thing is that the spending is going to be big enough for people to worry about where the money is going, and - frankly - at the moment, it is not, ' he said.

Kingsley Manning, joint chief executive of consultants Newchurch, was also cautiously optimistic. NHS suppliers have been deeply scarred by earlier IT disasters, but Mr Manning said the IT programme should be compared to the private finance initiative - something that got off to a slow start but is now working well.