[5] The cost of the programme, together with its ongoing problems of management and the withdrawal or sacking of two of the four IT providers, placed it at the centre of controversy, and the Commons Public Accounts Committee repeatedly expressed serious concerns over its scope, planning, budgeting, and practical value to patients.
[citation needed] In August 2018, NHS launched a healthcare finance innovation initiative to identify solutions which could streamline financial operations.
By 2009, it was still managed nationally by CfH, with responsibility for delivery shared with the chief executives of the ten strategic health authorities.
[14] The Conservatives pledge £730 million to expand NHS mental health services in England, aiming to reduce welfare costs by helping more people return to work.
Critics, including Labour and the Institute for Fiscal Studies, question the feasibility of the projected savings and effectiveness of the proposed reforms.
[17][18] On 6 October 2006 the same signatories wrote a second open letter[19] A report by the King's Fund in 2007 also criticised the government's "apparent reluctance to audit and evaluate the programme", questioning their failure to develop an ICT strategy whose benefits are likely to outweigh costs and the poor evidence base for key technologies.
[24] Similarly, the British Computer Society (2006) concluded that "...the central costs incurred by NHS are such that, so far, the value for money from services deployed is poor".
The report concluded that, despite a probable expenditure of 20 billion pounds "at the present rate of progress it is unlikely that significant clinical benefits will be delivered by the end of the contract period.
These security measures were queried during the early stages of Spine development, with leaked internal memos seen by the Sunday Times mentioning "fundamental" design flaws.
[4] However, in July 2007 Accenture withdrew from their 2 clusters, and in May 2008 Fujitsu had their contract terminated, meaning that half the original contractors had dropped out of the project.
[39] IDX Systems Corporation was removed from the Southern Cluster Fujitsu Alliance in August 2005 following repeated failure to meet deadlines.
[8] In 2000, the NHS Executive won the "Most Heinous Government Organisation" Big Brother Award from Privacy International for its plans to implement what would become the NPfIT.
[43] In 2004 the NPfIT won the "Most Appalling Project" Big Brother Award because of its plans to computerise patient records without putting in place adequate privacy safeguards.
Concerns over confidentiality, and the security of medical data uploaded to the Spine have also led to opposition from civil liberties campaigners such as NO2ID the anti-database state pressure group and The Big Opt Out who provide patients with a letter to send to their doctor so that their records are withheld from the database.
[citation needed] As of 5 August 2005, research carried out across the NHS in England suggested that clinical staff felt that the programme was failing to engage the clinicians fully, and was at risk of becoming a white elephant.
The Public Accounts Committee observed in 2009 that "the current levels of support reflect the fact that for many staff the benefits of the Programme are still theoretical".
[citation needed] According to the Daily Telegraph, the head of NPfIT, Richard Granger, 'shifted a vast amount of the risk associated with the project to service providers, which have to demonstrate that their systems work before being paid.'
[28] The programme's largest software provider iSOFT has been seriously affected by this process and is under investigation by the UK Financial Services Authority for irregular accounting.
Difficulties with the system meant that:[49] The NHS appointed a management team, responsible for the delivery of the system:[50] In October 2002, Richard Granger the former Director General of IT for the NHS, took up his post before which he was a partner at Deloitte Consulting, responsible for procurement and delivery of a number of large scale IT programmes, including the Congestion Charging Scheme for London.
[53] His credentials were questioned by his own mother, a campaigner for the preservation of local health services in her area, who expressed her amazement at his appointment, criticising the whole scheme as "a gross waste of money".