I was interested to see that health secretary Jeremy Hunt appeared to be the Conservative Party’s designated Tweeter during the #leadersdebate on ITV.
Hunt’s done a good job of keeping the NHS quiet since he took over from Andrew Lansley, is relatively young, has a nice family, and ran a digital company – the online listings site, Hotcourses – before he entered Parliament.
So you can see why he might fancy that he looks like a future leader, and why he might be trusted to flag up David Cameron’s pithiest pledges and hardest hits (sic) during the debate.
Perhaps because of his background, Hunt is partial to a digital initiative. His big idea as health secretary was a “paperless NHS” by 2018 (see below), for which he managed to get two rounds of technology fund money out of the Treasury.
Or, in the event, one and a bit rounds of tech fund money. The first round was announced in the middle of last year, with the aim of encouraging paper-heavy trusts to start using IT and to accelerate the use of e-prescribing (enabling doctors to order drugs from the hospital pharmacy and nurses to dispense them electronically, with built-in safety checks to avoid problems with allergies or clashes with other drugs).
In the event, though, most of the money went to big trusts with big electronic patient record projects well in hand. In retrospect, this was more or less inevitable, because nobody else had time to get plans together, to go out to market, and to spend capital allocations – given that bidding closed just weeks before the end of the financial year.
The second round opened this May, allowed a lot more time for bidding, and also allowed councils to seek money for IT to support integrated care initatives. However, the outcome was held up by the Treasury, which eventually clawed back £200 million of the £240 million available, to bail out hospitals and avoid a winter crisis (see below).
Most of what was left then went to big trusts with big IT implementations. This had become inevitable, because only canny trusts, with large, running programmes, were in a positon to juggle money between their revenue and capital budgets by the time NHS England was in a position to make them an offer – which was just days before the end of the financial year.
The outcome means that the tech fund is unlikely to deliver what was hoped for it. The Tories are trying to get a ‘competence vs chaos’ theme going for the election, but it’s also not a great endorsement of the coalition’s ability to competently turn ideas into policy, never mind deliverables on the ground. In fact, asking public bodies to hang about for months and then spend millions of pounds in just a few days looks like a pretty chaotic way of doing business.
As such, I was particularly interested to see Hunt tweeting out Cameron’s bon mot about wanting “more doctors with stethoscopes and not bureaucrats with clipboards” in the NHS. That’s certainly one vision for a paperless health service. Just not the one Hunt or the NHS have been aiming at.