back to article MPs slam mandarins over failed GP IT system

MPs have today slammed "the severe failures" of an IT system designed to allow the extraction of data from all GP practice computer systems in England. The General Practice Extraction Service started five years too late, is over-budget and still does not provide the full service required, said a report by the Committee of …

  1. BebopWeBop
    Facepalm

    Lessons will be learnt.

    1. Stumpy

      ... and then roundly ignored.

      1. Anonymous Coward
        Anonymous Coward

        and then roundly ignored.

        Calling Dame Lin Homer! Calling Dame Lin Homer! Toxic spillage on aisle four.

    2. Mark 85

      and everything properly improved such that the next project will be even a bigger boondoggle to the system and better enrichment for the company. Haven't you Brits learned anything from us in the US and our assorted projects? A good start is the F-35.

  2. nematoad
    FAIL

    Facepalm.

    "Atos...appears to have acted solely with its own short term best interests in mind".

    I nominate this as a candidate for the award of the "Statement of the Bleedin' Obvious" for the year just ending.

    What do they expect?

    If you go swimming with sharks you must realise that you might get bitten.

    1. Anonymous Coward
      Anonymous Coward

      Re: Facepalm.

      I liked

      "Atos, supplier for a key part of the system, may have met the letter of its contractual obligations but took advantage of a weak client by taking the client’s money while knowing full well that the whole system had not been properly tested."

      So, they have them what they asked for and not what they later decided they wanted...... Have you tried working with the government? The local managers are told to get something, then part way through they're told to do something else then staff are swapped out and they ask for something different again....

      I've got know idea if Atos are much cop but in those circumstances what were they supposed to do?

      Hello, I'm the government, go and make me a swimming pool.

      Ohh, sorry, make that a dock. What, it'll cost more and take longer? Well, come on you should have known what I wanted! You were happy enough to take my money!

      1. This post has been deleted by its author

      2. Skoorb

        Re: Facepalm.

        Bingo. The first spec was to extract READ codes, for example "C10" means diabetes, and “C10E012” means Insulin-dependent diabetes mellitus with renal complications. So a simple find all the patients with C10 means tell me who all the diabetics are.

        Then it turned into queries being written as "business rules" which somehow the extraction system had to turn into something that could actually search against these read codes.

        Then another part of the NHS decided to migrate from READ codes to SMOMED CT codes in GP land. This is ongoing and should finish by 2016 or 2020 depending on which document you read.

        So, from a simple "extract the READ codes" system that would run queries a bit like SQL against 4 different supplier "databases" we have moved to a system that is supposed to interpret "business rules", convert them into READ and SNOMED CT codes (at the same time) and run that against four different underlying "databases" then convert the results back into "business rules".

        Whilst ATOS are not entirely to blame here, I don't think the HSCIC (and their forerunners Connecting for Health) can really say it's all ATOS' fault.

        1. Anonymous Coward
          Anonymous Coward

          Re: Facepalm.

          Of course c10e012 could mean something completely different as those wonderful codes are case sensitive.

      3. Alan Brown Silver badge

        Re: Facepalm.

        "Hello, I'm the government, go and make me a swimming pool.

        Ohh, sorry, make that a dock. What, it'll cost more and take longer? Well, come on you should have known what I wanted!"

        What actually happens is that companies like Atos know full well at the outset that the spec they're given won't work for the stated purpose and do the job anyway - on time, under budget and to the letter of the spec - by putting in the lowest bid even if it means an on-paper loss doing so. Other bidders will say "this won't work" - and be fired from conetention, or price to the actual needs and be eliminated.

        Atos then rely on the goalposts having been changed to make a handsome profit. Every single change is out-of-contract and charged through the nose. Meantime the people who wrote the spec in the first place are rewarded handsomely for having the project completed on time, etc despite it not working and when it's shown to be inadequate, they're the ones who are relied upon to adjust things - despite having already demonstrated they weren't competent to do the job properly in the first place. They usually call the project a resounding success in their brag sheets unless things blow up publicly.

        These incompetent people (usually upper management) are not the ones hauled over the coals in parliamentary inquiries. They're usually good at insulating themselves from consequences and underlings are the ones thrown under the bus, often having their careers wrecked in the process (and frequently this is retaliation for having flagged that there were problems in the first place)

        Atos don't care. They did the work to the letter of the spec and to the letter of the changes - they don't lose business through this model. No-one will ban government departments from considering Atos as a contractor because Atos would tie that decision up in courts for decades (or simply extrude a new pseudopod with a different name so that the Atos connection isn't obvious) - and so the cycle keeps continuing.

        Even if govt departments hire decent project managers they're often hamstrung by not having the full set of information available to start with.

        Some digging into the financial and social connections of the management of both groups is usually also enlightening. There is still a lot of business settled by means of a handshake on a golf course, or with corruption in the wings - not usually kickbacks, but often you'll find there's a financial interest held by management making selections in the contractors selected - this is most frequently detectable at local council levels due to the small sizes of companies involved. At higher levels there may be a couple of levels of isolation of shareholding to dig through and there's always the god old standby of "companies paying for 'business trips' for execs and their spouses to 'seminars' at exotic locations which just coincidentally happen to be resorts"

        This latter set of problems is almost never looked into as a matter of misconduct or fraud unless the connections are blatently obvious or someone finds them out who can't be silenced.

        Even when orders are made, govt departments often thumb their noses at them - a classic example being the one of kickbacks over 0845 and 0870 numbers - 2+ years on from being ordered to cease this practice the Home Office is still using them - plus actively blocking attempts to dial on non 08[47]* numbers - with attempts to being this back to the inquiry's attention are going nowhere. (which indicates they're only really interested in soundbites, not actually enforcing them)

    2. DocJames
      Holmes

      @nematoad Re: Facepalm.

      ""Atos...appears to have acted solely with its own short term best interests in mind".

      I nominate this as a candidate for the award of the "Statement of the Bleedin' Obvious" for the year just ending."

      I thought self interest was supposed to invoke the magical invisible hand, which would promptly solve all problems, create jobs, drive the economy, hide the poor, prevent floods, make Europe go away, etc etc. Have I got this wrong?

      Yours,

      Gideon Osborne

  3. Smudged

    So can we look forward to these companies never being awarded another government contract, or will we get the ridiculous logic applied that having messed up this baddly this time, they must be best placed to know what not to do next time? Bizarely that seems to be how these things work.

    1. Anonymous Coward
      Anonymous Coward

      I don't think they did mess up. They admitted that the letter of the contract was met.

  4. Doctor Syntax Silver badge

    Could have been worse...

    ...it could have succeeded.

    1. Mary Hawking

      Re: Could have been worse...

      GPES actually *is* working and being used routinely for a large number of extracts including QOF, "Indicators no longer included in QOF", immunisations, various "enhanced services", monthly figures for increased numbers of patients with a diagnosis of dementia etc - and will be used for care.data - and the proposed "single National GP dataset".

      If anyone has managed to find out what effective control or scrutiny has been put in place to replace the functions of the GPES IAG (abolished on 30th June 2015 - before the consultation on IGARD - for release of identifiable data from the HSCIC - or any consideration of how to scrutinise data requests for public interest, risk* - or even whether the data requested would fulfill the stated objectives - could they let us all know?

      "Transparency" seems to be somewhat lacking: but make no mistake: GPES can and does extract data from GP practices: the quality, of course, does depend on GPs recording that data in a form amenable to extraction by GPES....

      *the risks attached to any set of data include restrictions on the uses to which the recipient - whether within or outside the HSCIC (the only statutory "safe haven") is subjected - and the willingness and ability of the HSCIC - or other Data Controllers - to audit and enforce such restrictions...

  5. Tony S

    "The Government needs to get its house in order"

    Most definitely. I'd say that statement should also include the civil service, as it does seem that they are more involved in the actual management of the projects than the MPs.

    But I suspect that whilst they continue to use the same old crowd of suppliers, the situation will never improve. Maybe some of the smaller businesses might not do any better, but it seems likely that they wouldn't do much worse.

    1. Wommit
      FAIL

      @ Tony S - "The Government needs to get its house in order"

      The small companies will never get a chance. If they are allowed to bid for a contract, then their bid will be under cut. Under cut to such an extent that the larger company doing the under cutting will lose money on the contract. But these large companies can afford to do that. The small companies can't.

      And don't ask how the larger companies will know what their opposition are bidding, after all alls fair in love, war and "business."

      1. Warm Braw

        Re: @ Tony S - "The Government needs to get its house in order"

        >The small companies will never get a chance

        To be fair, I worked for a time on a system that was similar in principle (getting data in standardised form for national use from a loose network of local government-sponsored organisations) in an industry sector where all the IT suppliers were small companies. We did try very hard to get them to work together (which didn't work as they weren't prepared to make any concessions that might advantage a rival) and if one of them had been awarded a sole contract for the job, none of the others would have cooperated at all. The project, inevitably, didn't make much progress.

        You need strong leadership for projects of this kind, regardless of the contractor and separate from the contractor - and with some clout over the other parties involved to get them to play ball too. Writing a specification and then putting it out to tender and hoping all the external dependencies will work out for the best is simply the wrong model for delivering IT projects of any kind.

    2. Anonymous Coward
      Anonymous Coward

      To be fair to the civil servants, I think the problem is that they're passed the government's latest half thought out scheme and told to get on with it.

      The government doesn't take well to being told how stupid their ideas are so there's no point telling them it won't work or even suggesting alternatives.

      The government has made being a civil servant less and less attractive so good staff tend to go into the private sector.

      Then the government changes its mind, tries to hide what it's done and then find someone to blame.

      1. Anonymous Coward
        Anonymous Coward

        The government has made being a civil servant less and less attractive

        What, apart from the ones paid six figure salaries and then rewarded in the now-permanently soiled New Year's Honours List? Or what about Sir Philip Dickhead, paid a six figure salary for three days a week to run the Environment Agency, who flew off to the family property Barbados to sun himself whilst his own plonkers deliberately flooded the centre of York, and whilst most of Cumbria took a pasting?

        Oi! Cameron, you knob end! Can you slow the gravy train momentarily so that I can climb aboard, please? I promise I won't bring any baggage with me, you know, stuff like competence, moral rectitude, talent, or common sense.

        1. John Brown (no body) Silver badge

          "Oi! Cameron, you knob end! Can you slow the gravy train momentarily so that I can climb aboard, please? I promise I won't bring any baggage with me, you know, stuff like competence, moral rectitude, talent, or common sense."

          Have you ever had any sort of relationship with a pig? Answer yes or no.

          I'm not sure which answer will get you on board though. Your answer may decide which train you get on. Gravy or Apple Sauce.

  6. Halfmad

    Yeah well nothing changes

    I worked in GP IT for 5 years, left a couple of years ago. ATOS here have done what they always do - exactly as requested and not an ounce more, yet the blame is being landed on them for "taking advantage", well no they haven't. In every dealing I had with them the problem was the local NHS staff who had contracted them not having either experience of delivering IT infrastructure or system development projects or local senior management expecting it done to a cost rather than to an objective.

    If you then offer to pay ATOS they'll accept the money, the staff who signed off the payment should be held accountable for not having ensured the system was fully tested beforehand, I don't really see how ATOS is in anyway to blame for that especially as the chances are the system wasn't fit for purpose from day one.

    1. Anonymous Coward
      Anonymous Coward

      Re: Yeah well nothing changes

      In other words ATOS failed to accurately analyse the problem the specification was trying to solve and performed in a highly unprofessional manner in implementing the letter of the specification rather than working with the client to achieve the actual solution. Even worse maybe they analysed the problem/specification and knew that it would not solve the problem yet did not speak out so the problems could be fixed earlier in the process, and so be cheaper to resolve. The other option is they are so grossly incompetent they were not aware the specification wasn't right. Given the mess I've seen some of these companies make of simple systems it could very easily be the latter.

      1. Joe 35

        Re: Yeah well nothing changes

        "Even worse maybe they analysed the problem/specification and knew that it would not solve the problem"

        Anyone that did that, would not win the contract, because the idjuts who run these tenders dont want to hear the truth. To coin a phrase, they can't handle the truth.

        So all you are left with, is people running teh same game as said early on, bid at a loss, make it up on changes.

        This is why no SMEs will win these contracts either, they can't bid at a loss, nor can they accept the onerous Ts&Cs anyway.

  7. Anonymous Coward
    Anonymous Coward

    Sounds like any other public-private partnership.

    One of the main attractions of PPP is that everyone gets paid and if^W when things go wrong they can all blame each other.

  8. Prst. V.Jeltz Silver badge

    as usual the numbers are staggering 14 million , rising to 40m , for a few SQL queries. The beauty of computing and code is that its scalable when done right. that dosent might the price should go up proportionately

  9. x 7

    daft thing is, any of the four clinical systems suppliers could have done this without problems.........the data from Emis/Vision/SystmOne is already cross-compatible, Microtest is convertible, while Adastra can access all of them

    1. Anonymous Coward
      Anonymous Coward

      Something tells me you haven't actually dealt with this data. The data is theoretically cross-compatible. In practice it isn't always quite so simple.

      1. Richard 12 Silver badge

        So call them on it

        Your product claims to read the data format of %other%, please now demonstrate.

        If it won't do so usefully, then give them some time to fix it and eventually can take them to court over it (failure to meet published spec).

        If it gets most of the way there, then you can pay them to do the last bit.

  10. Commswonk

    Let's be honest...

    ...this is not really news.

    "Government IT procurement a success" says Public Accounts Committee really would be news.

  11. jrchips

    Same old, same old.

    These kind of IT project definition and management issues have been around for 40 years.

    Until government departments terminate incompetency it will always be 'same old, same old'.

    1. oldsteel

      jrchips you are spot on. Whilst everyone bangs the same old accusations back and forth regarding the outcome, the problem lies in the tender process. Lowest price wins after weeks of handling huge bundles of paperwork written to tender requirements. During implementation, flexibility should be the key (er .. Agile?), if the contractor finds something isn't working or is unexpected, they should be able go back and re-negotiate the contract to handle it. But the terms of the tender don't allow for that, if they did then the public would be crying 'blank cheque for the supplier'. Dilemma.

      Shame of all this is that our money is wasted, and projects that need to be implemented don't get done - especially in the healthcare sector. Of course there is corruption, nepotism and incompetence as well, but that will always be there.

      Has anyone in the world got a successful public service IT tendering system? If so we should swallow our pride and go and look at it. Today's process isn't working.

  12. Tubz Silver badge

    The mandarin's have learnt well, how to keep their heads down, pass the blame and secure ongoing employment, payments and golden handshakes. So business as usual in Government !

  13. tin 2

    Interesting....

    "may have met the letter of its contractual obligations"

    and

    "while knowing full well that the whole system had not been properly tested"

    ?

    Properly testing the system is not in the contractual obligation? If I attempted to write such a contract tomorrow, I'd expect to remember to put that one in.

    However this does prove once again that a proper, well managed in-house team is needed for this kind of work. Always.

    1. Anonymous Coward
      Anonymous Coward

      Re: Interesting....

      "Properly testing the system is not in the contractual obligation? If I attempted to write such a contract tomorrow, I'd expect to remember to put that one in"

      Testing of any system is the Customers responsibility, the clue is usually in the name 'user acceptance testing'

      Having worked in the NHS for many years, I see the time and time again at a local level, systems procured with weak specifications developed, things like "95% of users able to access data within the module within 2 seconds" I asked how we would measure this and just got a shrugging of shoulders.

      I have yet to work with any third party who doesn't charge for changes, this is how they make their money,

      Unfortunately the whole tender process is hindering innovation within the NHS as the same old crowd end up winning contracts because they all come in at a lower cost than the smaller players, I have seen many good products overlooked because the suppliers financial status isn't as sound as the big boys, however the small supplier wanting to get a foot in the NHS door may have been more likely to be flexible when the specification was found to be wanting.

      1. Adam 52 Silver badge

        Re: Interesting....

        "Testing of any system is the Customers responsibility"

        Really it's not. Testing is the supplier's responsibility. UAT is just the customer satisfying themselves that the supplier has done as asked. It should be possible to go live with a system without UAT and for the supplier to have confidence that it'll work.

  14. Philip Virgo

    Tomorrow came yesterday

    Back in 1984 the NCC Microsystems Centre has a contract to test six GP systems. Each contained routines for recording, collating and exporting adverse reaction data (still not standard across) and not just record export (albeit on floppy discs) for transfer to other practices. Most also contained field level security (including "named doctor only" envelopes for "sensitive" information such as "says he caught it off the senior partner's daughter").

  15. PaulAb

    I remember posting a comment in one of the major IT newspapers back in the day. It was the NHS IT Fiasco which ballooned from around 5bn to 13bn and still couldn't hold up an ante-natal clinic for a morning after 5 or so years of development. I remember at the time that Novell had products that could do off the shelf what the NHS wanted, but no, some muppet decided that they really needed to recode the whole system to be able to use it. I also mentioned the inevitable golden goodbyes that each successive failed contractor would recieve, I recall being harranged by NHS IT execs who said I had no idea what i was on about. I suspect that if you look closely enough you will fine those same people with the purse strings. Career morons who move stealithly from one failed project to another but do so with the backing of senior civil servants and politicians because they know nothing.

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