Delays with the £6.2bn NHS IT programme have been blamed on a lack of proper clinical consultation during the procurement of the systems.
NHS CEO Sir Ian Carruthers and NHS director general of IT Richard Granger were grilled on the Connecting for Health programme by MPs during a heated Public Accounts Committee (PAC) meeting at the House of Commons this week.
The National Audit Office (NAO) also came under attack for the "gushing" and "universally positive tone" of its long-delayed report into the NHS IT programme, despite the fact the cost of the scheme has risen to £12.4bn and the rollout of key systems is running years behind schedule, and was accused of being "ground down" by officials at the Department of Health.
At the PAC hearing professor Peter Hutton, who resigned from the NHS' National Clinical Advisory Board in 2004, told MPs he was asked to step down by the then-chief executive officer of the NHS, Sir Nigel Crisp, after airing concerns about the procurement of the NHS IT contract and the "sham" of a consultation with clinicians.
He said: "My feeling is that the contracting process did not purchase what we wanted. Those early days it was like being in a juggernaut lorry going up the M1 and it didn't really matter where you went as long as you arrived somewhere on time. And then when you'd arrived somewhere you'd go out and buy a product but you weren't quite sure what you wanted to buy."
That view was echoed by Dr Anthony Nowlan, former director of the NHS Information Authority, who told MPs at the hearing: "The urgency to procure really trumped all other aspects of consideration."
But Granger hit back, saying it was not his recollection of events and quoted from an email he had sent to Hutton in 2003 asking him to get back to him with a plan for clinical engagement. "I am still waiting," Granger said.Despite this, the core national electronic care record system is now running two and a half years late, with clinicians and GPs unable to agree on which patient information should be stored on the centralised system.
Granger said some of the problems with the NHS IT programme were due to a shortage of capacity in the healthcare IT industry.
He told MPs: "We have had to bring in a lot of resources from abroad - India and the US in particular - and some things have gone wrong as a result of that with some of those suppliers. It will continue to be something that requires close attention."
Asked if some suppliers, such as iSoft and Accenture, were "showing the strain" of the financial burden of the NHS IT contracts, Granger said: "They are, and better they are than taxpayers."
Granger also apologised for a nine- to 12-month delay in the rollout of a digital picture archiving system in the northwest, saying that the supplier, ComMedica, had failed to provide a satisfactory reference solution.
PAC chairman Edward Leigh, Conservative MP for Gainsborough, concluded that the NHS IT programme is "not yet working fully on the ground" and said the committee will ask the NAO for another report on its progress at a later date.