Friday, 21 August 2009

NHS Serious Staffing Problems

As mentioned many times by Cassandra, UK NHS is one of the biggest employers in the world. With that size comes a lot of bureaucracy which allows lots of hiding places for poor performance and bad people. This poor performance on the people front is evidenced by NHS UK's staff sickness rate (150% higher than the industrial sector), and an inability to develop its own people. Because it can't train enough of its own staff UK NHS is now the biggest importer of health care labour in the world. Thus the NHS imports more nurses than any other country, and more doctors and surgeons than any other country. In effect denuding poor countries of much needed skilled helath care staff. What a terrible accolade that is!
So, the United Kingdom, a country that considers itself to be in the leading ranks of civilised nations, with seats on the UN Security Council, and G8 along with many other other international bodies, preaches to others about probity and the rule of law, while it is using financial muscle to take away doctors and nurses from poorer countries like Nigeria, and India, leaving their populations with fewer health care staff for themselves. That is after these same countries have spent millions of dollars training them. In effect the UK NHS (and by implication the people of the UK) is subsidised by Nigeria and India and other poor nations.
However for the UK there is a down side of this arrangement in that the NHS because it does not vet people properly regularly hires under qualified people. Some if not caught early enough go on to cause real harm to patients. But that's not all. Due to the NHS's bad management of staff it is ironic that as a result the UK also holds the world record for the number of terrorists in any western organisation, ie the NHS. Please don't take this item as the mad ramblings of a right wing extremist. Read the news of who did the bombing across the UK and check out the bombers' employers. What a mess.

BT In Trouble - Still

This week's Economist magazine has a special article that picks at the flaws of BT in the usual Economist insightful manner. But it seems to miss what we consider to be some key points.
Firstly when BT devolved itself of its mobile business it tacitly accepted that it is a renter of fixed land line services, and not a communications company. Thus condemning the business in the long term to low value, low growth land line markets that are being surrounded and bypassed by mobile and radio telephony.
Secondly it started Global Services to move up the 'value chain' and become a services supplier to major corporations. If it had done so based on Telco services perhaps it would have made it. Sadly BT thought it could manage client data centres, desk tops, and write applications too. As history has shown, and we have previously blogged, it got this badly wrong.
Thirdy, it completely failed to create a management team, not just close to the board, but down through the organisation capable of facing a more commercial world.
This is why we continue to believe that BT must get back to basics and become a communications business again. One that can deal with the modern fast paced commercial less regulated world. We forecast that over the coming months Global Services will 'discover' more problems with major contracts, like NPfIT, and will be taking more write downs.
Unless radical steps are taken by Ian Livingston and his leadership team, on the current track it looks like BT will become rather like British Airways (a much Knighted, much Lorded flying pension fund) in that BT will become a copper cable pension fund with a value based on metal exchange prices, with more Knights and Lords of its own. Good for them. Bad for shareholders and staff.

Footnote: Speaking of capable IT Services management. Many Global Services managers now work for other IT services companies. They were probably hired when BT GS ruled the roost and their personal value was high. Now their new employers must be wondering if they have brought in the right sort of people given that they contributed to GS's downfall. But there again, perhaps the new employers like; Logica and HP/EDS, have not woken up to this one yet?

Thursday, 20 August 2009

CSC Results - again

Have any of the analysts who track IT Services companies worked out how much of the increase in CSC's reported increase in EPS is due to the stock buy back that cost the company billions of dollars?
I'll bet they haven't.
Put the EPS story to one side and you have a company going nowhere for three years that is bolstered by US Federal contracts, and of course the overblown, over priced, under delivered, yet very profitable for some, but not the English tax payer, UK NHS IT programme. I would venture to guess that without NHS IT CSC Europe would have to close down (so would iSoft), and without Obama's deep pockets CSC US would be in the toilet.
Come on analysts run the numbers and speak up.

Thursday, 13 August 2009

NHS Patient early deaths continue. Will no one stop them?

Read this little episode as an example of how well NHS is doing at meeting its targets and ignoring patients while doing so. Apparently the service worked wonderfully, according to the service provider, but the patient had the nerve to die.
I wonder what McBrown will put in his twitter about this........?


Thanks to Mark Steyn for this extract from his blog. http://www.steynonline.com/component/option,com_frontpage/Itemid,33/

Here's one of those anecdotal horror stories from Scotland's National Health Service that we are enjoined by American "reformers" to pay no heed to. From the Daily Record:

A mum suffering chest pains died in front of her young son hours after being sent home from hospital and told to take painkillers.
Debra Beavers, 39, phoned NHS 24 twice in two days before getting a hospital appointment. But a doctor gave what her family described as a cursory examination lasting 11 minutes, before advising her to buy over-the-counter medicine Ibuprofen...
Seven hours later, the mum-of-two collapsed and died from a heart attack in front of her 13-year-old boy.

It's one of those stories that has all the conventions of the genre: The perfunctory medical examination; the angry relatives; the government innovation intended to pass off an obstructive bureaucracy as a streamlined high-tech fast-track ("NHS 24" is some sort of 1-800 helpline). Indeed, in the end, it's all about the bureaucracy: The 1-800 guys don't think you're worth letting past the health-care rope line. So you call again, and ask again, and they say okay, we'll find you someone, but he can only spare eleven minutes of his busy time. And, while you're being carried out by the handles, the bureaucracy insists that all went swimmingly:

NHS 24 executive nurse director Eunice Muir said: "We can confirm Ms Beavers contacted NHS 24 and that her onward referral was managed safely and appropriately."

Phew! Thank goodness for that. In the Wall Street Journal, our old friend Theodore Dalrymple writes:

In the last few years, I have had the opportunity to compare the human and veterinary health services of Great Britain, and on the whole it is better to be a dog.
As a British dog, you get to choose (through an intermediary, I admit) your veterinarian. If you don’t like him, you can pick up your leash and go elsewhere, that very day if necessary. Any vet will see you straight away, there is no delay in such investigations as you may need, and treatment is immediate. There are no waiting lists for dogs, no operations postponed because something more important has come up, no appalling stories of dogs being made to wait for years because other dogs—or hamsters—come first.
The conditions in which you receive your treatment are much more pleasant than British humans have to endure. For one thing, there is no bureaucracy to be negotiated with the skill of a white-water canoeist; above all, the atmosphere is different. There is no tension, no feeling that one more patient will bring the whole system to the point of collapse, and all the staff go off with nervous breakdowns. In the waiting rooms, a perfect calm reigns; the patients’ relatives are not on the verge of hysteria, and do not suspect that the system is cheating their loved one, for economic reasons, of the treatment which he needs.

That's because, in their respective health systems, Fido is a valued client, and poor Debra Beavers wasn't.

....................................
Cassandra comment.
This and other episodes of failures by NHS bring to mind the old image of the British 'jobsworth' mentality that was so prevalent when Trades Unions ruled the land. I am now beginning to think it is a British cultural phenomina that has always existed. It allows people to say 'Well I did my job as per instructions', or 'It's more than me-jobs-worf to use discretion' while watching failures occur all around. In many cases the NHS failures lead to deaths. I guess as an Anglo-Saxon, quasi Germanic race this attitude is very similar to that of the WWII German soldier who just following orders when committing an attrocity.
What a legacy from McLabour!

Saturday, 8 August 2009

Guardian newspaper's PR for Labour's NHS IT Failure

The Guardian newspaper group continues to show it is the unpaid PR arm of the Labour government by starting to criticise those who have reported that NPfIT is a sham, a failure, and a waste of money. See Guardian article by Vic Lane on 4th August 2009.
This blog along with many others has surfaced sufficient information to support the above criticsms and there is nothing in the article; by a learned professor, for health infomatics, to support her case. What a shame she has not done sufficent analysis to support her thesis. She should read Tony Collins at Computer Weekly amongst others and not, like a tame Guardian reader, quote Barack Obama's so far failed health initiative if she wants real evidence.

Monday, 20 July 2009

NHS Continues to send patients to an early grave

This from the Daily Telegraph could happen to my 80+ year old mother as she recieves treament in this same hospital group.

I Hope the DT do not mind my repeating this story.....

Patient lived with cancer for 50 years before dying of bedsore
Cancer patient Pamela Goddard battled against cancer for 50 years before she died of an infected bedsore during a stay in hospital.

By Ian Johnston Published: 9:00AM BST 05 Jul 2009

Pamela Goddard had great faith in the NHS. It had, after all, kept her alive for more than half her 82 years.
The piano teacher first contracted breast cancer in the 1960s and had survived a series of recurrences of the disease over the years.

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So when it returned last year, this "completely vital" woman, who was still working up to 30 hours a week, was fully expected survive.
The cancer did not kill her, but a bedsore did.
What appeared to be the start of one was noted on her back as she was admitted for radiation treatment in September and it was allowed to gradually develop into a "raging sore" which left Mrs Goddard moaning in pain.
During four weeks of what her family describe as "torture" in a bed in East Surrey Hospital, the sore resulted in a fatal blood infection and she died on October 27.
Her son Adrian Goddard, who lives in the US, said: "She survived cancer for 40 years, then died from a bedsore.
"It is just beyond belief that they could let a bedsore develop to the point where it actually kills someone from septicaemia."
He said the nurses seemed largely unconcerned by the growing size of the sore and his mother's increasing pain.
"The bedsore was painful. There were various procedures that should have been done. You are supposed to debride the thing, clean it, treat it.
"She was supposed to be lifted and moved so there's not constant pressure on it," Mr Goddard said.
"There were explanations like 'there was only one nurse and it wasn't possible to do it or the equipment was broken'... just a series of excuses.
"Most of the time there were [enough nurses]. None of them struck me as being frantically busy to put it mildly.
"There were lots of conversations about last night's activities in the pub, a lot of strolling around, looking at charts without doing anything.
"The level of crisis that attracts their attention has to be very high for them to put down their biscuits. I guess they get inured to it, the moaning, the fact my mother was in great pain."
The first sign Mrs Goddard was unwell came early in 2008 when she suffered from back pain.
She went to Barts Hospital in London but the recurrence of cancer which was the cause of the pain was not diagnosed until she broke her leg in June.
The treatment for the cancer appeared to be working, but the bedsore continued to get worse despite attempts to treat it with "maggot therapy" in which maggots are used to clean out the wound.
On October 11, Mr Goddard said a doctor told him that "she was recovering well, except there was something in the blood work, which suggested an infection".
"If it didn't go away, he said he would give her penicillin or something," Mr Goddard said. "It never occurred to him this by now raging bedsore was the source of the infection."
Mr Goddard said he and other members of the family had tried to persuade nurses and doctors to take more action, but said the "inertia was extraordinary, the worst sort of institutional dysfunction".
Mr Goddard said anyone in a similar situation should "do what you need to do to find some sort of private care for them".
"She certainly wasn't ready to die. To the extent she realised it was happening, she must have been horrified," he said.
"The thing that makes me most angry was she had such faith in the system and it let her down so badly.
"She was basically in torture over a four-week period. Then she was drugged up and left to die.
"It's unconscionable, very sad."
Surrey and Sussex Healthcare NHS Trust Director of Nursing, Mary Sexton, said: "We offer our sincere condolences to the family of Pamela Goddard on the loss of their mother.
"We are committed to providing high quality patient care and are sorry that on this occasion the family feel that that standard has not been met.
"We have received a formal complaint, which we have responded to, but are carrying out further investigations at the request of the family.
"The presence of pressure sores is associated with a twofold to fourfold increased risk of death, but this is because pressure sores are a marker for underlying disease severity and other co-morbidities.
"Mrs Goddard was receiving complex treatment for a number of medical conditions from a number of health care organisations at the time of her death."


http://www.telegraph.co.uk/health/heal-our-hospitals/5740858/Patient-lived-with-cancer-for-50-years-before-dying-of-bedsore.html

Saturday, 11 July 2009

BT Sliding Away

So, BT has announced pay cuts, head count reductions, and more upheaval.
This is all brought about by what is almost certainly incompetence and perhaps fraud (because too many people got large bonuses that they did not earn) in the Global Services division, where massive contracts were signed up without any capability to deliver on the promises built into the contracts. BT-GS continues to bleed cash, and is on the hook to deliver on NPfIT, which it is failing to do. Unless BT cuts GS off and sells it, or closes down the loss making contracts, and takes the loss of the face that goes with it, BT will sink and the UK will lose one it's better technology companies. Time for Mandelson to step in I think.
These predictions were made last year and are sadly so far proving to be correct. Just read the rest of this blog for details.
Mr Livingston, the CEO has been given a hospital-pass.

Management Revolving Doors spin again at CSC

Whisper it quietly because no one is supposed to know but CSC's UK and Nordic leader has left the company after two years in post. He's gone to another IT services provider whose name is a set of intials too.
Shout it loudly, but only in French, Claude Czechowski, President CSC France and Italy, and elsewhere has announced in France, and no where else in CSC land, through his own publicity machine that he is now also Global Head of CSC's Consulting practises. Either he feels enboldened while the titular head of CSC Europe, who actually spends full time keeping NHS IT on the road, is in a weakened position or is CSC now a French company.
Doors spin again in Global Infrastructure Services - The head of CSC GIS EMEA has moved to Australia. His replacement will be the fourth person in this key leadership role in three years. In case readers are unclear; GIS runs all the datacentres and networks and delivers the outsourced operational services to all CSC clients in Europe, Middle East and Africa. The biggest client being UK's NHS.
It makes you wonder what the clients must think of this continuing turnover on key leadership positions!

Monday, 25 May 2009

NHS IT Does it again - ie fails

Some interesting and terrible developments this past week or so in the world of UK NHS IT.
The Interesting: The CEO of CSC Europe - a title which is more ceremonial than real as CSC is split into non-cooperating regions (or warring fiefdoms as insiders call it) in Europe - has stated that Lorenzo is only two years late. Which it might be now, but that is when compared with the last agreed delivery. Based on the original bids it is at least 4 years late. Not bad eh!
The Terrible: the reported loss of ten of thousands (or is it millions?) of personal health records is a big worry. It was reported here in this blog last year that NHS IT security is not fit for purpose. We have also written about this to journalists on the Daily Telegraph and Times, and Andrew Lansley - Shadow Heath Minister, and the Chair of Parliament's IT Select Committee - none of whom have replied. So I guess they are happy for the status quo to continue.
That notwithstanding anyone who says the security of NHS IT, let alone the system itself is fit for purpose, is either a fool or a liar. The suppliers of this solution and the government and its agents, inlcuding Percy Grainger, have all said it is secure and I will leave it to the reader to decide which of the above they are. Meanwhile GPs are down loading records they have no right to see, and then losing them. It has been reported that there are now over 140 security breaches across a system that has not even been implemented fully.
As mentioned before NHS itself is not fit for purpose. In the time it takes you to read this another victim will be killed in an NHS hospital. These deaths are the biggest unpublicised or championed scandal in the UK today. Where is the champion to fix NHS and save more lives?
Meanwhle the IT system has be stopped right now before more people are either killed or blackmailed or have their identities stolen.
On the subject of killing someone, Computer Weekly reports that in the US that a noted business IT guru Joseph Bugajski, was almost killed by a hospital relying on a system similar to NHS IT that was riddled with misuse and faults. Read about it here. http://www.computerweekly.com/blogs/tony_collins/2009/05/senior-analyst-nearly-killed-b.html
Note that Tony Collins of Computer Weekly, is a hero for standing up to the establishment and those who have tried to silence him because he is uncovering this unsavoury mess. Like the Daily Telegraph in its scoop with MP Expenses he is doing a public service.

CSC Results

It is good to read that CSC has reported 'strong results' for the last quarter, showing a growth year on year. However, what has been overlooked in any reports I have seen is;
1. All businesses except US Dept of Defence showed a revenue decline in Q4 Fy09 compared to Q4 Fy08.
2. There was a tax credit of $36m in Q4 Fy09 compared with a tax charge of $10m in Q4 FY08...making a $45m "swing" in EPS compared to pre-tax profits.
3. CSC has spent large sums on share buy back schemes that do not appear to have improved the share price. What was the motivation behind this expensive blunder?
Isn't it strange how these points have not been picked up by the market analysts?

On the subject of analysts; perhaps they ought to measure the value of IT Services companies on more than just current results. What really matters to the continuing success of any IT Ser is the ability to sign repeat contracts and grow business via pipeline of properly qualified and quantified opportunities. Rather like oil companies they have to have new supplies of business in several stages of development from discovery through to production. If I remember rightly several years ago Shell was lambasted for getting its oil reserves book wrong even though its current results were good.
IT Ser also have 'reserves' that need quantifying in order to measure the future value of the business. The smart analysts working for firms like Citigroup, Stifel Nicolaus, Jefferies & Co, Prudential, UBS, and Credit Suisse, who are all publishing comments and recommendations on IT servcies companies should perhaps look at how this might be accomplished.

Wednesday, 20 May 2009

BT and Global Services - Again, and again, and again

So BT have now reported a massive loss due to the complete shambles at Global Services. As in previous blogs I continue to maintain that BT will continue to be dragged down by GS. BT cannot and will never be able to manage the IT Services business as part of a telco for reasons previoulsy stated. Poor old Mr Livingston the new boss is lumbered. He's a decent enough type, but this is all outside his and his new team's experience. Watch for more losses in next quarter and more 'I didn't realise that....' type statements.
By the way, there's a thundering silence from NHS IT management who must be worried that one of the last two surviving contractors is in deep dooh dooh. Where do they go next for suppliers?

All Telcos that are trying IT Services are finding out their limits. Check out France and Orange Systems. It's the same story there. Contracts bid at rdiculous prices, delivery late, costs not managed, accounting systems inadequate, management systems inadequate, then more losses, bonuses paid out to the management and sales teams, tougher management brought in to fix it. But too late. Plus ca change..............

Tuesday, 14 April 2009

BT - and Global Services, again and again

So far in this blog we have shown that BT Global Services (GS) is a major problem that has been tolerated and allowed to cause massive problems for BT for too long. We reported last September, and have written to Mr Livingston, Chairman of BT, that the problems with GS are still buried and will continue to cause massive losses unless something radical is done. To their credit BT has put hard-nosed number crunchers in place to try and halt the slide. But this is only half the problem. GS also needs good professional IT services management in place to manage what’s left of GS, to recover from the bad technical decisions, and to ensure the number crunchers will work with them for a recovery. Paradoxically this insertion of financial may well not work. By this we mean IT Services is alien to BT Group as a whole. It is not understood, it is too different, it evaluates business on a different basis to BT Group, it requires different investment profiles to BT Group, it needs different staff to BT Group, it has different business processes to BT Group, it has signed up business and made promises it cannot keep re NHS IT, and it will bring the company down unless it is brought under control. We submit that while BT Group chases the Chimera of services growth, something that no other Telco has pulled off. It will be diverted from its core business which is to provide communications capability to consumers and business. The core is the one area that all the financial press say BT is world class at and the one area that does make and will continue to make BT’s fortune. Actually there is proof positive of this in that BT has two NHS IT contracts. One for the telcomms backbone, which is a success, and the other for IT systems, which is a costly failure. Need I say more?
In many ways Global Services is like the creature in Ridley Scott’s sci-fi film, Alien. The Alien was brought on board, with the best of intentions by decent people (shades of NHS) yet after chewing its way through a crew member’s chest (shades of GS Management recently fired) it wrought death destruction on the space ship. It was left to one person to deal with it. Therefore; for BT to be cured it needs a Ripley to hunt down and dump the Alien, Global Services. Is there a Ripley in BT and does the new management team have the guts (no pun intended) to do so?

PS. Are the major pension funds with large holdings of BT stock going to ask for the bonuses to be returned that were paid to Global Services Managers who knowingly oversold and under costed too many projects, including NHS IT?

‘Further Ideas For Improving NHS’ now looks at the cleanliness of hospitals.

Over the years there have been many incidents reported of filthy hospitals contributing to the deaths of patients. After 12 years of Labour rule and untold billions of pounds spent on supposedly improving services you would have thought that England would have the cleanest hospitals in the world. Yet several news articles have been reported just this last week of filthy un-cleaned hospitals, with blood on bed partitions, and excrement on the floor. As a result too many patients are being made miserable or worse dying from the infections. This is happening today in London, in Bart’s and The London Hospital Whitechapel. Both are hospitals within sight of the richest office space and bankers on the planet. What an accolade for London!
Why can’t something be done about it? I submit that the problem is not to do with the IT services. Although properly managed business like systems for monitoring cleaning and laundry schedules are sorely needed. What is needed is intense management focus on the basics of running hospitals, and an open culture which includes the staff in helloing make improvements. Many pundits, journalists, and bloggers have called for the return of ward sisters and matrons with the power to make things happen but these calls have all been ignored. Why is this? Try this theory for a possible answer. The Labour ministers of health have been in general decent folks, the current incumbent; Alan Johnson seems to be even more decent and less calculating than his predecessors. Yet even he cannot bring himself to make the changes. The fact is that Labour is held in thrall to old fashioned Socialist thinking which cannot tolerate dissent, argument or new ideas. As a result there are various entrenched leftist-givens which cannot change even to the point of causing ruin for many. Although the left in the UK are not violently Stalinist, Stalin’s way of thinking and intimidating holds at many levels. Stalin managed Russia’s empire for over 30 years with his wishes overshadowing everything by ruling by fear through his Party Apparatchiks, in our case NHS Managers (the ones who get bigger pay rises than nurses), who allowed him to out a reign of terror in which millions died. In addition there were many instances of senior soviet figures disappearing into Stalin’s jails to be tortured for some minor infringement, while some of the family were murdered. When the senior people emerged from jail they went back to work and said not a word to the survivors of their family. The parallel experience in NHS is where senior labour politicians’ family members, generally elderly relatives, go into hospital for some minor treatment only to die from MRSA, and the Labourites say not a word. Of course there is no one as evil as Stalin in the Labour Party but there is a mind-set which says if something is not working then more of the same is needed to make it work. This was the thinking which led to Pol Pot and his faceless minions to push for ever more excessive socialism and eradication of the old order in Cambodia resulting in The Killing Fields. Closer to home; The CJD scare of several years ago led to the complete wasting of the British beef industry. It ruined farmers, led to some suicides, and cost the tax payers billions of pounds. Yet so far just six deaths have been attributed to it. Sad though these deaths were how do they compare with the thousands caused each year by the English NHS’s incompetence and blind management? This is a bigger scandal which Labour should be thoroughly ashamed of.
Come on Mr Johnson, be more than decent. Be a change maker; call in matron and sister, and fire the overpaid managers. Or will you be like one of Stalin's generals who has just been released from the Lubyanka and say nothing?

How Many More Mid Staffs in NHS? The Answer

The answer to last month's question is 10.
What a disgrace. I thought perhaps 4 or 5. But 10. That's awful, and what is more the NHS Central Management do not intend to do anything about it? The excuse is something about 'already under scrutiny' and I don't think!, or 'they are not really that bad'.

If these ten are about the same size as Mid Staffs then the NHS are killing, or causing the early deaths of, 4,400 people each year in these 11 trusts alone, and what is more they are getting away with it.

Friday, 27 March 2009

How Many More Mid Staffs around the UK?


It is now emerging that many whistle blowers went to various authorities over the years to report the disaster that is Mid Staffs NHS Trust. None of them were listened to. Nothing was done, and patients continued to die or suffer great pain. It was only when Central NHS saw the relative health care statistics produced over a period of years that somebody actually took notice and decided to investigate, and then take action. Thank goodness this was done – BETTER LATE THAN NEVER.
But why did it take so long to spot something so glaringly bad? I submit it is because there is not a proper scientific and business like management of health metrics service that regularly monitors what is going on in the NHS monolith. As a matter of urgency the NHS management together with its new IT management team must prepare systems of data gathering and metrics reporting at all levels of the service. There are health service benchmark software companies or Total Quality Management companies out there who can almost certainly provide a basis to build what is now being shown to a very crucial need for NHS and indeed the citizens of the UK. See blog posting on 11th Feb
The metrics should be more than just for finding out failures, their proper use has to be to learn about best practices and solutions, and to spread them across the NHS thereby driving out the need to look for failures as there won’t be any. If done correctly, in the right spirt with the right tools, there would in future be only places in the service where a business-as-usual tuning, or upgrades and improvements would be made to make health better for all. Now that’s something to look forward to.

Are NHS Hospital Group Managers and Governors Brown's Lemmings?

The news this week continues to report many failures in NHS and flaws in NPfIT that should worry us all. The latest includes The Joseph Rowntree Reform Trust report on government data bases. This claims that many NHS databases among which are; Detailed Care Records, and CRS Secondary User Services, should be scrapped or redesigned. As mentioned in previous postings to this blog, insiders were reporting a long time ago that the design of the technology and the management procedures are fatally flawed leaving many openings for non-authorised users, usage, and corrupt records.

There is also the news that three NHS Trusts are not using all of NPfIT. In fact Rotherham has actually signed up for Meditech’s solution, while many others are sounding out McKesson’s, another IT solution which many of them already have, to see if they can extend the contracts. So there you have it. A solution where security is not good enough, data management is not good enough, and delays continual while some users are backing away from it and actively looking at extending the life of what they already have. Not bad for a £13bn spend is it?

What is astonishing; is that with so many problems with NPfIT across all Health Trusts,that so few trusts have chosen to exit the programme. The governors of these bodies should ask themselves why they are continuing with this disaster. Are they Brown Lemmings?

Sunday, 22 March 2009

How NHS Can Do Better - More Thoughts 2

Sorry for the length of this post - there's a lot to cover.
Following this week’s report of the early deaths caused by neglect at a major hospital group in Staffordshire anything any the IT critics and bloggers can say on this subject would be inadequate. We can comment, criticise, warn, and offer ideas for improvement; but can’t do much to stop a sickening catalogue of shameful events like those in Staffordshire from happening. They were not caused by lack of training, or by lack of funds, or lack of IT, or by force majeure. These deaths and the suffering of many patients were caused by bad leadership and that alone. On TV News the other night a Labour Party Health Minister, Ben Bradshaw, showed little if any remorse for their leadership and its role in the deaths. He blamed the local health authority and other quangoes. What a creep. Now read his Wikipedia comments NHS IT: “On the subject of the National Programme for IT, a scheme dogged by cost overruns, failing public confidence, delays, and doubts over its benefit to patients,[6][7] he commented: "Our use of computer technology in the NHS is becoming the envy of the world. It is saving lives, saving time and saving money. If you talk to health and IT experts anywhere in the world they point to Britain as example of computer technology being used successfully to improve health services to the public.” This shows his lack of consideration, and an ability to live in a parallel world to rest of us who have to be treated within his NHS or have to pay for his NHS IT system. Just like Gordon Brown he is denial of the obvious.
So; what can NHS IT do better? This piece will look at non-urgent ambulance services – my term for ambulance services that are used to take out patients from home to hospital for booked treatment. As touched on previous postings; this service, at least in London is dreadful. Let me explain from personal experience.
A semi-invalid old man who needs to help to get down to street level from a 2nd floor flat to be driven various appointments, gets up at 6am to prepare for an 8:30 pick-up. The ambulance arrives at 11:00 with one driver who refuses to help him down the stairs with the words “No one told me I was to help you, it’s not my problem”. Or, the ambulance arrives late at the hospital, which means the appointment is missed and has to be rebooked for some months in the future. Or, the patient arrives on time at the front of biggest hospital in London and is 80 year old wife is left to find a wheel chair to wheel him herself to the clinic as no staff can or want to help. Or the ambulance arrives at the wrong entrance and goes away with even trying to telephone for instructions. Or should two ambulance staff turn up they drive round London spending two hours plus with old and frail patients being jostled about while they do a’ bus tour’ to various hospitals. The same occurs on the way home. So a 30 minutes consultation at mid-day can require that a patient start the day at 6am ending it at 6pm after spending upwards of 4 hours sitting in an ambulance and 8 hours in waiting rooms. Even the youngest of us would find it hard to survive this sort of treatment.
What does all this poor service do? It requires ambulances to drive on long wasteful journeys which cost extra money on wasted fuel and staff costs. For the Greenies it also adds to UK’s carbon footprint. It means appointments are missed and therefore NHS capacity is wasted adding to costs. It means that a shortage of ambulances occurs; requiring emergency crews to drive from East Coast or South Coast towns to fill the gaps. All this leads to yet more wasted time and money and bigger carbon footprints. Above all it means that patients who are in a frail condition are stressed to breaking point, probably making their conditions worse.
What’s needed to sort this mess out? Apart from some motivated management and staff, i.e. The Culture Thing mentioned before.
It needs IT systems in which ambulance bookings can be entered to ensure the full needs of each patient are logged. Currently each hospital, each ambulance station uses pen and paper to record and transcribe appointments.
It needs ambulances equipped with GPS devices for routing and location tracking.
It needs ambulance crews equipped with hand-held type pc’s for managing their service just like modern home service companies who service washing machines, or carry parcels.
It needs links for hospital doctor pa’s to have access to ambulance bookings to enter their patient’s needs.
It needs, above all, leadership willing to put their political rhetoric to one side and consult with and listen to staff and patients (not trades unions or quangoes) to ensure solutions are developed from which all can benefit.
Sadly I cannot see Gordon Brown, Alan Johnson, or Ben Bradshaw having the courage to admit their past is wrong and that a new future, not one based on NpfIT, is needed.

Wednesday, 18 March 2009

IBA Health Rights Issue

I must be a bit thick when it comes to understanding how rights issues work as this particular one seems to be a circular process. Let me explain. IBA Health which is 35% owned Allco Equity Partners (AEP) also owes them A$60mln, and in the middle of AEP collapsing (don't take my word for it read the Oz business press or this bloomberg posting http://www.bloomberg.com/apps/news?pid=20601081&sid=auY_Y0jUi7F4&refer=australia) IBA asks current share holders, which presumably includes AEP, to fess up with cash to pay for the rights issue.
On top of this there are bad stories emerging from the UK where it looks the new NHS IT management are about to reconsinder the decision to use Lorenzo, IBA Health's flag ship new product which several years behind schedule and massively over budget.
Question 1. If IBA Health's biggest customer, UK NHS, pulls the plug on Lorenzo what happens to IBA Health earnings and this rights issue?
Question 2. If AEP does not buy into the rights issue who will?
Question 3. Who gets the A$60 mln or part thereof that IBA are going to pay back after the rights issue.? Is it AEP or the administrator?
Question 4. If AEP is collapsing it ought not be able to buy into the rights issue. But you never know with banking and finance laws or rulings, these days they seem to defy common sense. Perhaps they can buy into the issue in which case AEP has a new asset to help defray losses.
Question 5. It looks to me like the collapse of AEP and this rights issue will cause a major change in IBA Health's ownership with perhaps one or two companies holding majority stakes. What does this do for the customers, partners, and minority shareholders?

As all this looks decidely odd. But you never know it might all be business as usual. Can anyone out there in financial analyst land enlighten me?
Am I worrying about nothing?

Sunday, 8 March 2009

Perhaps a basis for better services management for NHS is in sight.

Capita’s announcement on 19th February that it is acquiring CHKS Ltd. is interesting and fascinating as well being in my opinion an astute move as it bolsters Capita’s capabilities for the measurement and hence management of health services. As discussed in previous posts the management of metrics and their analysis to define problem areas, and potential improvements is sadly lacking in many areas of the NHS, particularly the non-clinical ones like cleaning services, procurement, materials supply, theatre scheduling, appointments, and non-critical ambulance services. One hopes that the NHS trusts can make greater use of services management analysis for the benefit of all.

Note: I have to register an interest in that I own shares in Capita.

The Curse of NHS Again

IBA Health
Let’s have a look at recognition of revenue which is always a ‘sensitive’ issue for IT Services or Software companies. IBA Health’s results statement says; “The National Programme for IT contract in the UK is a product delivery arrangement with a phased release of functionality enhancements over the period of the arrangement. Any licence revenue is recognised as the elements of the product are delivered. Implementation and service revenues are recognised upon the provision of those services.” It seems that the ‘product delivery arrangement’ is one in which licence revenue is recognised as elements of the product are delivered? This indicates that IBA Health’s revenue growth as claimed in the results is in part based on revenue for which no invoice has been raised, or the product is actually paid for, i.e. IBA Health has the money in the bank. Just how much of the claimed revenue is actually in this category is difficult to see. One can also see from: Notes to the FinStats no 8 (p58) and no 9 (p59) there is $35.4m of Past due receivables, and $58.7m of Accrued Revenue (ie not yet invoiced).
All this lack of clarity always worries and as clarity of results should benefit all parties surely it should be more clearly reported in the results? Until they are more searching questions are necessary.

CSC
Here is more detail on CSC’s restated results for FY97 to FY07 which caused announcements of results throughout 2008 to be continually late - as referred to in a previous post. Apparently the restatements are in the light of the FASB Interpretation 48 re Uncertainty in Income Taxes. The restatement coincided with an IRS investigation of CSC's US tax returns. The investigation concluded: “Under the settlement, which is evidenced by a Form 906 representing final resolution, CSC and the IRS have agreed to certain adjustments, the collective effect of which include a net operating loss carryover, research and foreign tax credits and charitable contribution carryovers, and other adjustments relating to amortization and depreciation deductions. The company will not be subject to penalties from matters covered by the settlement.” See the full text of the announcement on CSC’s web site here: http://www.csc.com/newsroom/press_releases/3374-csc_settles_irs_examination . Perhaps it is this complex tax and statement situation which has led CSC to make some significant assignments within its Investor Relations department.
It is strange though that few if any other major US corporations seem to have had to restate earnings to this degree.

Thursday, 5 March 2009

IBA Health half year results - what do they tell us about the health of this business?

IBA Health results – Are They Good or Are They Bad?
On 17th February IBA Health published half year results to 31st December 2008. A cursory look indicates that things are looking good. Revenue is up, profit is up, new business signings are up. But note; cash flow is negative at -$ 12.9m while Debt is up by S66.6m. Together these show that money is flowing out of the business.
As mentioned; new and renewed business signings look good. However if the average contract duration is 2.2 years and 36% are for 3+ years then the other 64% of new contracts are for an average 1.5 yrs each, which to me looks pretty short. Imagine trying to sign up deals fast enough to keep the business fed with contracts? It’s a task which would require Super Salesman to step forward and deal with.
The results presentation has suppositions about the world health market for IT, quoting healthy growth in gross terms with no mention of the fit with IBA’s products. This is rather like stating that China has a growing population who will all ride bikes and we intend to sell them all cycle shorts. The market volume to be based on the number of bikes per head when no one knows how many people would wear the shorts. A recipe for failure I think.
There is no mention of the many issues with NPfIT in UK. i.e. ‘It’s Late’, ‘It is not fit for purpose’, Health Trusts are backing out and doing their own solutions. The press and pundits are all over this programme. As indeed is UK’s Parliament. See the following from the proceedings of The Public Accounts Committee:
"Trusts in the largest of the regions covered by the national programme, the North, Midlands and East, are using an interim system because of major delays to the Lorenzo system which should have been deployed there. At the end of last year Lorenzo was being used in only one primary care trust, and in no acute trusts.
It recommends that before the new arrangements for the South are finalised, the Department of Health should assess whether it would be wise for trusts in the South to adopt these systems. In particular if either of the local service providers takes on additional work in the South, the department should assess the implications for the quality of services to trusts their existing areas of responsibility. "
Edward Leigh, chair of the committee, said: "The original aim was for the systems to be fully implemented by 2010. The truth is that, while some are complete or well advanced the major ones, such as the care records systems, are way off the pace."
Yet IBA Health does not acknowledge the problems in anything I have seen from them. IBA Health talks up the product set even though many deadlines appear to have been missed. Are they being entirely honest with the audience and investors?
Read this interview with Gary Cohen CEO of IBA Health in which he manages to not mention any of the problems seen by the UK Public Accounts Committee who represent his single largest customer.
http://abnnewswire.net/press/en/60157/IBA_Health_Group_Limited_ASX:IBA_Interview_With_CEO_Gary_Cohen_on_Earnings_Visibility.html

All the above notwithstanding if Obama does a Blair/Brown toss-money-at-health-IT-programmes-to-see-if-it-sticks then IBA Health could be getting some handsome revenues from the US, assuming the US Government can bring itself to buy products from non-US companies. Its track record here though is very poor.

Chairman Brown and NHS IT - NPfIT

Ignore McBrown’s refusal to apologise about missing the debt ridden mistakes of the banks under his purview (he’d rather die than admit to a mistake) – instead ask why even a self evident failure like NPfIT does not receive an acknowledgement from him it is failing right now when there are many experts telling him so. Perhaps as it is an English only solution and the Scots are staying out of it (smart move that) he feels it will do for anyone without a Mc/Mac prefix to their name.

Sunday, 15 February 2009

Why The UK is short of Superbandwidth

Brown's Leadership self-delusions - Again
In 2003 Chancellor McBrown auctioned wireless bandwidth to the major Telco's who wanted to set up 3G mobile phone services. At the time McBrown thought he had got a good deal because the Telco's mortgaged their futures to the tune of £23bln. Unfortunately for them 3G has never really taken off and they have wasted most of the £23bln. Meanwhile McBrown has spent the £23bln. Now we hear that the UK is behind on installing megabandth width broadband and Wi Fi points in public places. This has to be due in part to the Telco's having mugged for £23bln and now being short of sufficient readies to invest in new services. Now guess what? McBrown has decided that through his visionary leadership new wi-fi and broadband capacity is needed and that he intend to make it happen. Is it too much to assume that if McBrown had not led the Telco's up the Primrose Path to 3G Auctions we might have had a decent broadband and wi-fi service for the UK already?

There's something odd about the NPfIT suppliers

Isn’t it odd that so many of the suppliers to NPfIT have troublesome financial records?
Firstly there is CSC which a year or so ago had trouble getting approval from the US financial authorities when closing its books, or it couldn’t actually close the books in time. Then there is iSoft which had an investigation into accounting irregularities in the UK two years ago. Note: iSoft is now owned by IBA Health of Australia and their shares have underperformed vs peers. IBA Health has also suspended dividend payments. Finally there is Allco in Australia, which owns 35% of IBA Health Group and they cannot get approval from the Australian financial authorities to divest a subsidiary. Also Allco’s shares have underperformed from some strange reason. Then there is BT that is losing its shirt, and mine, on Global Services.
Check these sites for more details:- http://www.capital-chronicle.com/2008/03/aussie-regulators-on-ball-as-always.html and http://www.healthtechwire.com/Projour-Singleview.206+M5d7e8fe4389.0.html
What’s going on with these companies? Is it the curse of NHS?

Something else to consider about NPfIT; With the exception of BT the entire programme appears to be being developed, and operated by foreign companies using mainly foreign labour and foreign software. This means the bulk of the £18bln will find its way into the profits of CSC and EDS – both based in the US. Accenture who cannily pulled out before their losses got too high – based in the US. Fujitsu – based in Japan. HP and IBM based in the US. Cap Gemini – based in France. IBA Health based in Australia. Microsoft/VMWare and the majority of the other operating system suppliers – based in the US. Indian sub-contract staff, 10’s of 1,000’s of them – based in India. No Buy British here then!
One assumes Prime Minister Brown and his Cabinet are satisfied with this result. Perhaps it is part of the master plan to help ‘Save The Global Economy’?

Thursday, 12 February 2009

BT Reports Fall in Profits - Again

Judging by the number of times BT has issued a profits warning it is more and more obvious that they did not and still do not know what's been going in their Global Services Division which is now declared to lose over £500mln. What a shocker! But perhaps not. It was widely known last Summer that BTGS was in trouble and that too many under priced contracts had been signed. In essence BT management acted just like the bankers who have been heavily criticised of late for dodgy deals and not being sufficiently contrite.
Questions to Mr Livingston, the boss at BT;
Why has it taken so long to understand the depth of the problem?
How long will the earnings hits continue?
What is being done to recover bonus payments made to those who over egged the earnings forecasts and signed up for the bad contracts?

Questions for The Secretary of State for Health, Alan Johnson;
If BT GS have over sold to their management the costs of IT for NHS what are the true costs going to be to the UK tax payer?
Will NHS IT have to renegotiate the contracts to ensure the losses sustained by suppliers like BT GS are not passed on?
In the light of continuing failure of suppliers to NPfIT will NHS IT be reviewing the capability of its chosen suppliers to continue to deliver before they fail or pull out?
As all public service contracts are subject to specific rules about offering accurate prices and not under bidding (which BT-GS seems to have done) have these rules been broken by BT?

Questions for the boss of Ofcom;
If BT GS obtained these contracts by under pricing their bids do their opponents in the bids have a case for malpractice?
As BT is legally obliged to bid for contracts within certain price parameters and seem to have ignored them to win business has BT broken Ofcom's own rules?

Question for the Prime Minister;
Is Mr Livingston still on the short list of knighthoods yet to be awarded?

Wednesday, 11 February 2009

NHS IT Strategy - Some Recommendations and Possible Solutions

Following my previous blogs in which I criticise NHS IT I guess it is only right that I should offer up some ideas and solutions to the problems. So here goes.

Organisational Reform Is Needed: Firstly assuming that NHS continues with its current structures and remit one has to make do with what’s in place and perhaps make some changes in the various established groups that are part of the UK Health sector. I refer to The British Medical Association, The Colleges of Dentistry, Nursing, Mid-Wives, Surgeons and other similar groups. These should be asked to take on the skills and quality management side of each of the professions, and if there are not similar organisations for para-medics, ambulance drivers, and hospital management, they should be sponsored and set up. These groups, which I would call Guilds, should not do anything that intrudes into the area of Trade Unions as the support and championing of the workers (cleaners to surgeons) should be via Unions whereas Guilds would champion quality and skills. Currently the BMA, for example, gets too involved in trade union type work while trying to ensure clinical excellence. This creates a conflict of interest which is never properly resolved and hence service, and the patients, suffer.

Understand That Our Health Is Part Of The State Of Our Being: It is not something managed for us by the government. Neither is it apart from how we live. It should be seen as part of the whole of life. Which means that our health systems must be integratable with our other life systems like; email, calendars, iPod, mobile phones, Facebooks and the like. Thus health systems have to be as user friendly and based on open standards and architectures which allow integration and assimilation. This would enable easier usage, and thus greater usage and uptake, leading hopefully to better health.

Empower The Health Sector Staff; by ensuring they are consulted and included in decisions and solutions design. Give them a part of the £18bln to spend within their team. In the previous blog I facetiously said it would be possible to give each person in the NHS £10,000 to spend on their personal IT and still have £3bln change left over for central solutions. If this £10,000 were pooled by team, or task force and all the members of the team voted on the best way to spend it, it is almost certain that this will give better solutions and value for money than the current Big-Brother-knows-best approach. After all – it has been shown that Big Brother most certainly does not know best as he has over spent by a factor of three and is late by 5 or 6 years in providing a solution. Can you imagine a team of ward sisters over spending their budget by such a factor, or waiting six years for their new IT to work for their wards?

Create More Openness and Support Empowerment; by publishing every statistic available on the components and participants in health. The Guilds could play a role of ensuring that stats are accurate and meaningful and auditable. But first publish everything that is to hand and deal with the inevitable entrenched power groups who prefer to keep information to themselves. Too often we hear that the public can’t be trusted to understand the information given to them. This is patently wrong. In every instance where the public are given the correct information they enhance their lives by making the right decisions appropriate for them and thier families. The statistics could be easily available via something like Swivel.Com which is now the universal repository for statistics and graphs. This would make it cheap and easy to do. The benefit would be that anyone from anywhere could look at the NHS performance, and query the results, offer suggestions for improvement and use the best ideas which deliver best performance. It would thus demystify NHS reporting and create support for it.

Address Only Specific High Priority and High Profile Items: rather than trying to be all things to all people and creating a universal messaging and record tracking system, beloved of apparatchiks and bureaucrats – which is where most the IT spend is currently focused, the NHS IT strategy should be enabling strategy which allows multiple solutions and applications to communicate across a common open back bone, ie the Internet. As many people die from infections picked up in hospitals why not focus an entire set of solutions on this problem, which seems to start from infected patients bring in the infections to staff and visitors spreading them? For instance simple monitors could be attached to disinfectant hand sprays located at entrance doors to see how they are used and to ensure they do not run out of disinfectant by flagging up empty bottles. For patients when first entering hospital there should be a monitoring system used to ensure they are checked and what the results are. Once outbreaks occur graphic map over lays of the hospitals could be used to show the extent and depth of infections. This information could be made available to all hospital staff to keep them informed and alert. Another area that consumes a lot of time and money is the movement of non-mobile, normally old, patients to and from hospitals. From personal experience I know of examples where; 80 year old people spend an entire afternoon in an ambulance moving around London in order to get home from a morning appointment, or where ambulances have turned up to pick up a patient with insufficient staff to help move them, or the right equipment or the driver does not have the right directions. Thus many patients miss or are late for appointments or are traumatised by the experience. In addition too many ambulances travel too far from base to pick people up. Instances of 200+ mile round journeys happen all too often. Most of the scheduling is done via telephone and recorded on pencilled log books, leading to many mistakes of recording, transcription, and interpretation. A fleet management system would pay huge dividends. The list of issues goes on. An empowered work force would be able to come up with the most important ones to act on, assuming someone listens to them. Start with the people – not their quasi unions.

Sunday, 8 February 2009

Why NHS IT Won't Work

Let's look at some basic facts about NHS to see there is anything there that explains why the IT Strategy has gone very wrong.
1. It is the largest single IT project anywhere in the world.
2. It is charting new waters and just like Starship Enterprise, goes where no one has gone before.
3. The NHS with its more than 1.5 million employees is the single largest employer in Europe. Only the Chinese Peoples Liberation Army, Indian Railways, and Wal-Mart employ more people.
4. With one exception there is not a single country in the world that uses the UK's NHS model of providing health services. This exception is not Russia (even Stalin wouldn't inflict the NHS in his people) he had the gulags to help deal with them. Mind you given the death rates in some of our hospitals, passe Maidstone General, we might want to reclassify them. It is not Japan, where centralised management and pulling together is a strong ethos. Neither is it any of the socialist Scandinavian countries. It is in fact that country well known for creative management and a people centred view of life; North Korea, which is hardly a role model that anyone would want to boast about. But there you go.
All the above tells us that this is going to be high risk, high spend, slow and very difficult. Yet as the single biggest project in the UK government the NHS IT is not reviewed regularly at any depth by the Cabinet.
So, without a wholesale restructuring of NHS it looks like a recipe for failure to me. Do the English and Welsh have stomach for restructuring? Is there a politician out there capable of articulating what needs to change? Without such a person I am afraid NHS will continue to fail, the IT project will never succeed, and all the investment will be wasted.
As we all know neither the Labour Party not the Liberal Democrats can bring themselves to ever have a frank debate about NHS's issues. Anyone who says anything mildly critical is given pariah status. It is probably left to the Conservatives to come up with something. But as a 'contaminated brand' and 'health pariah' anything they do will always be suspect, no matter how sensible it may be. They also have the problem that Andrew Lansley MP, Shadow Health Secretary, has had a charisma bypass and is almost invisible to the public. What does he stand for? What will he do to improve matters when in power? Is he just waiting for Labour to fail and is keeping quiet because he has so little to add, confining himself to unambitious tinkering at the edges of NHS. It's not a very inspiring picture is it?
I have now drifted away from IT to the much bigger and more complex problem of what to do about the delivery of health services in England and Wales. See further blogs over the next days for some thoughts.
Meanwhile back to NHS IT:-
Let's now discuss the chosen solutions. The one based on iSoft is the place to start. This package was originally designed work within the precincts of a health practise and by all accounts worked quite well. The problem is that it was decided by the solutions providers, CSC and others, to base their solution on this product. Smart move you might say. But unfortunately as anyone with experience in IT will tell you, taking a small scale system and stretching it to a wider geography, across multiple locations, with hundreds, if not thousands, more users, is doomed to failure.
Accenture who should know better had this very experience when they rebuilt a small scale shop application more suited to a local corner shop than to the core of a solution for a stores chain, British Home Stores. That failed and Accenture bailed out once they saw it wouldn't work and would not make money for them. Just like they have done in NHS, and who can blame them! In essence scaling iSoft up to mega health region size is rather like taking a tug boat design and turning it into an aircraft carrier. It might float but will it be fit for war?
In addition, there has been the problem that many of the iSoft founding management left as fast as they could once they cashed in the share options based on an inflated share price due to iSoft being part of NHS IT. Thus we have a complex, overly political customer taking on a much amended and stretched solution. Which is where we are today.
The technical solution to all this is supposed to be Lorenzo. The next version of iSoft's solution. Now what odds am I offered that this will work on time too? How about 100-1?
Those are long odds you say, and given that iSoft has built up all this experience they can surely get the version right. Ok then, let's build on the tug boat analogy. SS iSoft was built in a local boat yard on the Isle of Wight, and now the builders have to move operations to Clydeside to design and build a Nuclear Submarine, something they have never done before, just as the boat yard owners and managers have taken their cash and emigrated to new villas in the South of France. Does 100-1 sound too long now? I don't think so.
But surely the systems integrators with the NHS contracts can make it work? Unfortunately they have found out they have bitten off more than they can chew. As mentioned before Accenture a world class systems integrator has cut and run. Others will almost certainly follow soon. Those left struggling to make this work (which interestingly includes CSC who picked up the failing BHS stores solution from Accenture several years ago) have probably found they have invested several times more than they bid and are suffering cash flow problems as a result. They have also put a huge amount of management focus on getting iSoft up and working (much of it with subcontractors in India) and thus have not spent sufficient energy, cash, and management time to turn their cobbled together HMS iSoft aircraft carrier into a Lorenzo nuclear submarine. They have also got a dysfunctional client to deal with and are not totally to blaim. But they are culpable.
Where does this all leave us? It leaves us with £18bln spent on IT that won't work or won't be used because the client has decided to buy elsewhere, and with NHS trusts who are going to commision their own solutions. Which is where this should have begun. What an expensive lesson?
You know it would be cheaper to give each NHS's 1,500,000 employees £10,000 to buy their own IT to help do their job better, and it would leave £3bln spare.
See later blogs for ideas on NHS IT.

Saturday, 31 January 2009

IT Services Tittle Tattle

BT is not the only IT services company where contracts are too complex to manage. There's also a colourful services company, a subsidiary of a Telco, operating mainly in France, Germany, and Switzerland that can't do a P&L for each contract. It just takes the revenue it collects, assumes a 10% net operating margin and calls the rest 'costs'. How quaint! I wonder how long this lot will stay in business?

Which leading IT services provider in the UK involved in government contracts, where security is a must, has a boss who has lost several Blackberries full of sensitive information?

Is business too complex for some?

Baring Bros, Northern Rock, AIG, Fannie Mae, Freddie Mac, Soc Gen, Lehmanns, and BT. What do they all have in common? All had people in positions of influence to make big decisions impacting the whole company yet many of their bosses didn't know just how complex and how much out of control they were.
For Barings you could say that was because the dear old buffers in London were caught napping by a smart operator, Nick Leeson, at work 7,000 miles away in Singapore.
For Northern Rock you could say an aggressive and persuasive CEO led the board by the nose.
For Soc Gen yet another smart operator got away with bad complex trading, a' la Leeson.
But why are BT in this lot I hear to ask? It's because like the others BT got involved in business BT did not understand and let aggressive and persuasive people have their own way. BT's Mr Livinston has even said they were in big contracts that were too complex and they did't understand them. If that's the case why did the over sight committees and non-execs not step in and call time? As a result of this BT's share holders have a seen a slump in the value of their holdings, with even the dividend under threat. Therefore change is needed.
As it was BT Global Services that caused the problems while the other business units are still doing well, and as BT GS is an entity not well understood by and alien too the BT way of businsess would it not be wiser to hive off GS and for the BT to stick to becoming a world class carrier and provider of internet access.? After all the UK, and much of the world, is short of high quality, large scale internet and wi-fi carrier. There's more than enough work here for a focused business team to build up substantial profits from.