I'm pretty sure every member of the public with half a brain cringed when the government first launched this project. The woeful reputation earned over the years by (UK) government-led, data-driven IT initiatives speaks for itself.

It would seem that the two primary skills prized by the IT consultants is extremely short term memory and the ability to stick one's fingers in one's ears and go 'la la la - I can't hear you..oh, and here's my bill'.

Devolving the purchasing in itself would not necessarily be a good idea, but I'm all for a six-pronged approach:

1) Develop or adopt robust data handling standards and a certification strategy 2) Develop a common/compliant platform standard and a certification strategy 3) Issue RFQs and proposals to competitive tenderers with the clear understanding that there will be no sole supplier 4) Evaluate and certify the offerings from winning tenderers 5) Allow competitive purchasing decisions at a local level from the certified/approved hardware and software vendors. 6) Implement a rolling auditing, performance re-assessment and certification renewal scheme for all vendors

Time and time again the 'one shoe fits all', single vendor solutions from one of the big consulting organisations have proven to be a disaster, yet back they come when the next future-fiasco is in the planning stages. Cynical me smells something fishy about the whole cosy club.

Your points 1 through 6 sound pretty sensible to me - except that when it came to actually doing any of that it would all be handed across to the very same consulting companies and vendors that are, in my opinion, largely responsible for the mess in the first place.

Quite likely - although any vendor assessment programme would include reference to performance/deliverables in previous projects.

(Actually, if I had my way, certain vendors and consulting groups would be told to fuck off and not bother tendering!)

And that's presumably why you wouldn't be allowed anywhere near making such a decision. You would be trying to get the right thing done (a failing many of us have) whereas the goal of these consulting groups is to make as much money as possible and who cares about delivering anything!

I thought the whole idea was to allow sharing of patient data between units - how is that going to work if everyone buys their own system?

e.g. my son has an eye infection at the moment and we've been round 4 different places - GP clinic, optometrist, hospital, eye hospital over the last week. The process of getting the appointments was great (the time from asking for an appointment to the actual appointment time) has never been less than 2 hours - but this caused a problem in that the systems couldn't keep up.

> how is that going to work if everyone buys their own system?

Open standards?

In an ideal world, of course. But these are systems being purchased by the UK public sector....