Select Committee on Public Accounts Minutes of Evidence


Examination of Witnesses (Questions 80-99)

NORTHERN IRELAND DEPARTMENT OF HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY

2 NOVEMBER 2004

  Q80  Mr Allan: Do you publish those business cases?

  Mr Gowdy: No, we do not publish them.

  Q81  Mr Allan: You do not routinely publish them?

  Mr Hamilton: Not routinely. We have never been asked before.

  Q82  Mr Allan: Do you have anything like the Gateway Review process?

  Mr Hamilton: Yes.

  Q83  Mr Allan: How does that operate? Who does that for you?

  Mr Hamilton: As I understand it, it is done independently.

  Mr Gowdy: We have a Directorate of Information Systems within the Department which is responsible for taking forward all of the ICT needs for the whole HPSS. They work very closely with the trusts on the procurement process and so on. They review the development at each stage of the process.

  Q84  Mr Allan: You are not subject to the Office of Government and Commerce Gateway Review process?

  Mr Gowdy: We are subject to a similar system through our Department of Finance and Personnel which performs the Treasury function.

  Mr Thomson: Chairman, if I can comment on that. Yes, we do use the same approach as the OGC and, indeed, until we have sufficient staff trained here it is OGC who do the Gateway Reviews or lead the Gateway Reviews.

  Q85  Mr Allan: This business case we can expect to go to OGC and they will look at it and give a traffic light indication as they would for anything else?

  Mr Thomson: Exactly the same.

  Q86  Mr Allan: How does that fit in with the existing system? One of the recommendations of the Report was that the ATICS Directorate system of the Royal Victoria Hospital should be extended to other units, including some of the very important ones like cardiology. Is that kind of work on hold? Are you not advancing that recommendation until the outcome of this large scale procurement process?

  Mr Gowdy: They are proceeding with that work but obviously in the knowledge of the development of this other system. We do not want to hold them back. Their system will be compatible with the system that we will have for all the others. There are only a few suppliers who provide these sorts of systems so we know the specification is going to be almost identical.

  Q87  Mr Allan: Giving credit where it is due, I also notice in paragraph 220 on page 30, the Musgrave Park was praised independently by the Birmingham University unit for its system. Is that a different system again?

  Mr Gowdy: It has different features, yes. We will be expecting that they will take their system and compare it to the specification that comes out of the Belfast City Hospital model and we will see what additional needs we have to put in place. We want compatibility in these systems.

  Q88  Mr Allan: You would not necessarily be telling them to get rid of their working system and to replace it with a system that you are going to procure for everyone?

  Mr Gowdy: There will be a couple of decisions to be made. One is the functionality of their system compared to this new one. Another issue would be the cost. It may be that it would be more cost-effective for them to join in the overall system.

  Q89  Mr Allan: Who will actually buy and own this? Will you, as the Department, be buying it for them or will you be saying to each of the units, "You must buy this new system out of your budget"?

  Mr Gowdy: We will be saying to the trusts that it is a cost that they will bear, but because it is going to be done on a common procurement basis they will all be making a contribution essentially to the purchase of a system which they will all use.

  Q90  Mr Allan: So you will not be giving them additional funds for that?

  Mr Gowdy: There will be a need for us to secure some additional funds for this. Until the final business case is with us we do not know what the final cost will actually be. We have estimated it to be around £3 million and we will need to take that through the usual process with our Department of Finance and Personnel.

  Q91  Mr Allan: These are the kinds of projects we often end up looking at on this Committee.

  Mr Gowdy: I am very conscious of that.

  Q92  Mr Allan: It is nice to be able to learn a bit about it at this stage before the things are signed and start going wrong sometimes. Is there an overall Northern Irish IT strategy for the health service?

  Mr Gowdy: Yes, there is.

  Q93  Mr Allan: Was this in there or have you somehow had to bolt it on?

  Mr Gowdy: It is actually a priority within that strategy which we published about a year ago.

  Q94  Mr Allan: Was that in response to this Report or did it predate the Report?

  Mr Gowdy: We were conscious that we needed to computerise. The Report was very helpful in terms of defining some of the problems that were out there which gave us the momentum to say we need a common, consistent approach to this.

  Q95  Mr Allan: Is there a relationship between the Northern Irish strategy and the National Programme for IT in England and Wales, which we know is the biggest IT project in the world as I understand it from a government point of view and presumably it is going to be buying similar kinds of systems on a massive scale for England and Wales? How does that relationship work?

  Mr Gowdy: We work very closely with them, and our Director of Information Systems folk work very closely in terms of the specification of systems, the development of new ideas and also the benefits of procurement. Yes, we would want to make sure that we piggyback it where we can or that we get into a similar relationship with suppliers on the back of the developments that have taken place, or are taking place, in England.

  Q96  Mr Allan: A final word on the professional buying. It is fine buying systems but the big question is whether or not people end up using it and those are the kinds of questions always that are raised around health service systems. What are you doing to make sure that if you put in a new theatre management system the people who are important, and I am thinking particularly of consultants here, will want to use it rather than prefer to do what they are doing already?

  Mr Gowdy: We are saying that there is a need for monitoring by us as well as by trusts of what is happening in theatres. That is why we are saying a common specification is required, so that we all operate on the basis of the same information and then we can benchmark. We will be insisting that there is a monitoring return made to us on an identical basis from each trust.

  Q97  Mr Allan: I am thinking not of the monitoring side but the actual management side. The whole point of this investment, £3 million, is not to get the figures right, you can do that on the spreadsheet, it is to make sure that you get this throughput figure right and that changes working practices presumably.

  Mr Hamilton: The infrastructure is already in place, largely as a result of this Report, where we looked at our Theatre User Committees and what they have been doing and what information they get. Having been speaking to the people in the trusts, we know that there is a great deal more interest in the information that is being produced from the manual systems. There is almost a desire amongst the theatre user communities out there to have the computerised information available as soon as possible.

  Q98  Mr Allan: You have no sense of resistance in the sense of if you improve the management system then some of the issues that have been raised about timetabling and freedom, whether or not to come in for a particular session, that relationship will be changed if you have got a management system that is really effective people are tied in on a longer timescale than they have been to date. Is there any sense that there is any resistance to that? Do you have clinicians leading implementation in that area?

  Dr Carson: There would be many consultants who would have an interest in techie things and IT solutions to some of the difficulties that they have. In fact, many consultants, surgeons and anaesthetists would view the information that comes out of a theatre management system would help them demonstrate to the health service managers their particular needs in certain areas. Another important driver which will add to the acceptance of a computerised theatre information system is the introduction of consultant appraisal where consultants now have to demonstrate to their health service managers the areas of activity which they are taking part in. There are strong drivers there but they are drivers that by and large I think will be welcomed by the profession.

  Mr Gowdy: We do have in place now a Theatre Managers' Forum and all of the theatre managers across Northern Ireland, including those who operate in the private hospitals, join into this forum. That is the opportunity for us to give them some of these messages and to ensure that people fully understand the importance of managing and using the new systems effectively and we will be putting great emphasis on that.

  Chairman: Thank you for that. Mr Jenkins?

  Q99  Mr Jenkins: Thank you. Dr Carson, earlier on you replied to one Member and said that the Report was wrong insofar as it only took a 48 week working year for consultants, therefore four weeks holiday, and they have more holiday than that, is that correct?

  Dr Carson: What I was suggesting was the estimated availability of theatres was stacked around 48 working weeks a year for the theatre facility but, in fact, individual consultants are only available 42 weeks per year.


 
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