- NHS IT: I told you so
- UC will go the same way
- Passport Office IT costs
- ‘Flogging’ the dead horse
- Challenging the great and good
- Let’s make it all up
- Seddon on the radio
- Head stays stuck on wrong
- Procurement – the other fad
- Managing costs causes costs
- Health shows massive scope for improvement
- Managers conditioned on the front line
- Audit Commission lament
- Special event in Scotland
NHS IT: I told you so
I was reminded by journalists that back in 2004 I was the only commentator they could find who would argue that the NHS computer system was bound to fail. Now, £12bn later, it is finally declared dead. One journalist blogged the same:
And right now I, with others, am predicting the failure of the IT system for the Universal Credit. If you have missed the arguments, a summary is here:
The bad news is major IT suppliers have already been signed up: Two contracts have been awarded, set to run for seven years, and have been valued at £50m-£75m a year for one supplier; £5m-£10m a year for the other. So we can expect between £385m and £595m to be wasted. And this is from a government that promised to put a stop to large-scale IT projects. The news is here:
And I must repeat the offer I have made to the DWP: we could design this service locally with local authority partners who understand the Vanguard Method. It would be live in less than 7 months, not 7 years and it would require minimal investment in IT to get to the stage where the design is stable and delivering against the purpose. I’ll be saying the same again to Iain Duncan Smith.
Please help us make some noise about it. Charlotte has put a petition on the Number 10 web site calling for a re-think of the approach to the Universal Credit. Please take a moment to sign it and encourage others to do the same:
And in the news this month: The Passport Office IT contract, which was originally intended to cost between £80 and £100m has run up costs of £365m. The news here:
Meanwhile, the Department for Transport’s shared services debacle (newsletters passim) is to be sold off. Tenders are being invited to take it over and expand – yes expand – the shared service to include four other agencies. Currently it is thought that this new venture will cost £750m. See the news here:
The obsession with IT is just part of government’s obsession with scale. The obsession is so powerful that it is maintained despite overwhelming evidence to the contrary. I shall be amongst the eminent folk who are driving scale thinking in Scotland next month. They, like their Westminster counterparts, are oblivious to the evidence. You can rest assured I won’t hold back. Do come along! More info here: http://partnerships.holyrood.com/
And on November 3rd I shall be joining others who know that scale thinking is wrong-headed at the RSA in London. Let’s hope some Whitehall mandarins pop along. More here:
The Scottish government’s policy document driving shared services cites Western Australia’s shared services project as an example of what can be achieved. In fact it ‘blew out’, as the Aussies say, earlier this year, having wasted 0m. Having noticed this example, it is shocking how many policy documents include others’ projected savings as evidence of success. Is this an illustration of policy seeking evidence or does it show the lobbyists ability to hoodwink ministers?
During my visit to Australia I was interviewed by their National radio station (it is their ‘radio 4’). You can listen to it here:
I was invited to Budapest to speak to a collection of tax people from all over Europe. As I was already committed to go to Australia I asked Barry Wrighton, one of our most experienced consultants, to go instead. Apparently tax people across Europe have been following our work and are trying to use the principles to design better services.
Barry took them through the typical problems encountered with industrial service design and explained the principles we use to design services. Among other things this means the removal of all IVRs (‘press one for this, two for that’); and Barry remarked that when you remove an IVR you get about a 20% rise in capacity. It is easy to see why; if you remove a ‘sort step’ and its associated functional silos and instead create one group of people to take calls, you’ll pick up more calls.
At lunch the man representing the UK explained to the assembled company that he was sure he could improve the UK’s IVR, arguing it was an essential feature of service design. Others around the table sat politely while he went on and on. There are times when minds remain completely closed. Perhaps he ought to get a job with the Universal Credit team 😉
Next to shared services, procurement is the other fad of the moment among the cost-mongers.
Ben Goldacre, ‘bad science’ writer for the Guardian, exposed an evidence-less piece of drivel put out by a man-and-dog consulting firm on how councils could save money through procurement – the piece got headlines in the Daily Mail, claiming savings of billions.
What is completely shocking is that the Department for Communities and Local Government published a press release promoting it. It illustrates how narrative and ideology trump any sense of reason and judgement.
Ben Goldacre’s article here:
DCLG’s promotion here:
Central to scale thinking is cost. But, paradoxically, managing costs causes costs. Simon Caulkin wrote a powerful article explaining how last April. It is now in the public domain and I recommend it to everyone:
As regular readers will know, we are active in health. The obsession with cost manifests itself as commissioning, specialisation, bed management and so on. The scope for improvement is massive. We won’t be publishing the evidence for a while but if you want to hear from the people who are seeing what’s going on you can do so through the ‘Vanguard in health’ blog:
Meanwhile the boss of Unipart, John Neil, argues that the NHS should adopt his kind of lean management. I hope he is ignored; these are the people who industrialised HMRC. Neil claims it was a success. His claims for savings will, no doubt, be based on transaction costs and thus completely misleading. Maybe he should be dragged in front of the Treasury Select Committee. Read Neil here:
A reader writes:
‘I’ve been doing some work on Anti-social behaviour. One of the things we discovered when studying demand was the large amount of demand that we couldn’t do anything with. When we tried to stop doing this work – ensuring it didn’t get into the system – there was panic among managers. Part of the management thinking – creating the conditions for such waste to thrive – was that we had ‘to be seen to be doing something’ and a fear of being seen as negligent. So if someone rang in and complained that her neighbours children had been bouncing on a trampoline and being noisy in the afternoon this would be logged, an acknowledgement letter generated and an interview with ‘victim’ and ‘perpetrators’ (the language of ASB!) set up. All to get to the conclusion that this wasn’t really anti-social behaviour, but kids playing in their garden. Still – at least we did something! Other demands included theft of a bike (something the police would deal with – and after logging, acknowledging & visiting we gave the tenant some useful advice – ‘call the police’), unnamed people jumping over fences and a whole load of other stuff that was all logged, acknowledged etc. etc. All so we could be seen (if anyone was watching) to be doing something, and we had records to prove it!’
These poor managers are products of the last ten years of fear. It is sad to see what the regime has delivered.
Central to the rotten regime was the Audit Commission. The usual suspects were given airtime to lament its passing. They peddle the line that the Audit Commission contributed to improved performance and now it is going we should worry that things will no longer improve. I encourage you to read the article and comment:
On November 2nd, Jim Mather, ex minister for enterprise, will be opening a special event that features public- and private-sector leaders who have achieved astonishing results through studying and redesigning their services; not only an amazing line up but also amazing value for money. I recommend it. More here: http://www.systemsthinkingmethod.com/conference/