[Mr. Mike Weir in the Chair] — Electronic Patient Record

Part of the debate – in Westminster Hall at 4:32 pm on 21st February 2008.

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons) 4:32 pm, 21st February 2008

I begin on a note of complete consensus; I shall not pick up on that last point, which is definitely one that I shall leave to the Minister. We totally support the use of information technology to improve patient care. Although I accept entirely, as my hon. Friend Mr. Bacon said, that the process began long before 2002, there is complete agreement among contributors to the debate that it is a good thing in principle. I shall make two general observations about the report, and then I shall deal with matters in more detail.

First, the NHS IT programme covers a good deal more ground than the report. Mr. Weir, you would not wish me to go into detail about the stuff that the report does not include, so I shall restrict myself to that which it does. It does not, for example, include choose and book, which has been mentioned, or the electronic prescription service. That is worth noting.

Secondly, the report was not unanimous, as Mr. Barron said. It is true that part of the reason why was the perception—I am sure that it was inaccurate—that the right hon. Gentleman had, to some extent, made up his mind at an early stage about some of the issues that the report covers. He spoke on 6 June 2007 in an Opposition-day debate about the more general subject of NHS information technology, and he made two points of note for today's debate. First, he appeared to indicate that an independent review of the electronic patient record project would not be in the interests of the NHS, which is entirely consistent with what he said today. Secondly, in his view, confidentiality and security of electronic patient records was not a significant concern, which is not entirely similar to what he has said today. Be that as it may, we should concentrate on those two issues: first, whether a wide-ranging review of the system is appropriate; and secondly, whether issues of confidentiality and security have been adequately dealt with.

On the question of a review, we have already heard that the National Audit Office makes multi-billion pound estimates of the system's cost to the taxpayer, but it seems that a full zero-based independent review of the project, which can be conducted while the work on the system continues, would allow us to know whether the investment will deliver the improvements that it should. I take entirely the point that Dr. Taylor made. It must be an option for any such review to say that we should go back to square one. If the review, properly conducted, came to that conclusion, we would be well advised to listen, but the process of reviewing need not stop the process of developing the programme.

There is clearly room for doubt about whether the programme will deliver what it is expected to. Although the Committee was right to reject the option of a full review, in the areas that the report covers, it seems to me that the Committee made a pretty good case for one. Several extracts from the report have already been quoted. I will not read them all, but it is worth noting several fairly trenchant criticisms that were made about the general direction of, and grip on, the project, which is clearly not there. Paragraph 115 states:

"The Committee was dismayed, however, by the lack of clarity about what information will be included in the SCR and what the record will be used for", which has already been quoted. Paragraph 131 states:

"There was a stark contrast between the specific and detailed vision set out for the 'Integrated Care Records Service' in 2003, and the vague and shifting vision set out for the DCR in 2007."

Further, at paragraph 192, the Committee states

"that other parts of the project are beset by significant problems. The most serious of these are: the lack of clarity about the ultimate vision for the shared DCR record, particularly the area which will be covered and the level of information which will be shared; the absence of a clear timetable for implementing shared DCR records".

Finally, paragraph 229, which the right hon. Member for Rother Valley quoted, indicates the

"perplexing lack of clarity about exactly what NPfIT will now deliver."

Indeed, the report later states:

"There is an explanatory vacuum surrounding DCR systems and this must be addressed".

If those issues are not properly understood and dealt with, the system cannot be effective, and that is why a full review is necessary.