

NHS £13bn IT programme to be overhauled - good luck with that - strawberryshake
http://www.computerworlduk.com/management/government-law/public-sector/news/index.cfm?newsid=21093&utm_source=ycombinator&utm_medium=sb&utm_content=anguyen&utm_campaign=sb

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jgrahamc
I wish these large IT projects would be done in an agile manner. Start in one
hospital and one doctor's surgery and work up from there. Of course, that's
politically not acceptable because what ministers need is a massive project to
announce.

I bet a small group of motivated people could get the work done faster,
cheaper and with greater user satisfaction if they built out from a small
project to the wider NHS.

I happen to be in the weird position of knowing some of the people who are
currently running the UK. I was at Oxford at the same time as Cameron etc. and
actually know Michael Gove. I wrote time him just before the election about
this very issue. Who knows if they'll listen.

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pmjordan
More to the point, unlike bottom-up the top-down approach tends to be a
solution in search of a problem.

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Gormo
And centralized financing and management of large segments of the economy
tends to encourage top-down decision making.

I think one of the biggest problems with modern society is that due to the
scale of institutions, there are way too many layers of abstraction and
aggregation between decision-makers and the decisions they make. This breaks
the feedback loop, since decision-makers can only operate against generalities
and not actual knowledge, and it encourages a great deal of risk aversion that
prevents the exploration and variation necessary to create real solutions.

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singular
The impression I've got is that the problems with the project come down to a
combination of firstly, as @jgrahamc rightly points out, the fact the project
has been unleashed all at once across the country rather than one surgery at a
time as would be sensible, and secondly (ok, I am risking downvotes here
bigtime), I think, poor programmer and management quality - I'm sure there are
good programmers on the project, but overall it seems to me the quality must
be pretty low. The damage one bad apple can do in software is immense and
entirely out of proportion to their position, magnified if that person is
higher up in the hierarchy. Additionally it seems obvious that the project has
been somewhat mismanaged.

I do understand the project is huge and really very complicated, and naturally
a difficult problem probably more so than is immediately obvious, but it is
that very fact that makes it easy for poor engineering decisions to have a big
impact.

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jgrahamc
I agree with your on the programmer quality. I know people working on these
type of projects: not the sharpest knives in the drawer.

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arethuza
I bet they are charged out at over £1000 a day though.

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junklight
ranges between £400 to over a grand in my experience depending on what kind of
skill sets.

Remember that scaling this kind of business is hard because you are selling
peoples time - so for each salary you pay you can only sell it one time over.
Compare and contrast with being a product company - I might spend a few weeks
working on a product and then those few weeks of my salary can be sold over
and over again.

The scaling of so many employees also brings massive overheads.

So yes - the day rates seem high but the margins can be pretty rubbish.

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nudge
Can someone with knowledge or experience of extremely large projects such as
this please explain what exactly are the costs? I cannot even begin to
understand how you could ever arrive at £13bn, even if you had an army of
systems engineers and buildings full of new equipment. What exactly is being
paid for, and what is it billing at?

(I'm not looking for an answer like "They're gouging them because they can" -
although I'm sure there is some of that going on - I'm actually interested in
what are the purported costs, i.e. how could it even be seen to be the correct
order of magnitude of expenditure)

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SandB0x
It's a huge mess of contractors, sub-contractors and consultancies. Enormous
companies or consortia bid for these projects, government ministers have no
freaking idea about software or technology so hire consultants to consult
about hiring these consultancies and get thoroughly shafted in the process.

For example, check out the UK e-Borders system [1]. The spec, according to the
article is

 _"Under the e-Borders scheme, immigration and government security systems
will be linked with transportation hubs to check and log every passenger
travelling in and out of the country."_

On the face of it, it doesn't sound much more complicated than say the
Diaspora project, and I'd fully expect a small group of YC-calibre hackers to
put together a functioning prototype in a couple of months. It's obviously not
_that_ simple, but what do you expect when you hire a consortium consisting of
Raytheon, Serco, Accenture, Detica, QinetiQ, Steria and Capgemeni [2]? Christ.

And how do you think the existing security systems that need linking to have
been developed? Do you think there's an api?

[1] [http://www.computing.co.uk/computing/news/2202536/borders-
wi...](http://www.computing.co.uk/computing/news/2202536/borders-winner-set-
sign-3607674)

[2] <http://trustedborders.com/about-us.shtml>

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arethuza
There will be no push back on requirements - nobody is going to say "do you
really need that" as they will be reducing the scope of the project and
therefore the amount of money made.

Implementations of complex systems in the commercial world (e.g. global ERP
systems) often work best when the chance is taken to align the processes of
the organization at the same time. I can't see that happening in the context
of outsourced government projects - nobody has any incentive to reduce the
amount of money spent.

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junklight
The current cuts are providing some incentive but I think you are right but
there is another part of the picture:

the lack of incentive to cut is one thing.

The ability to see things that _can_ be cut is the other piece of the jigsaw -
and I guess this stems from exactly what you are talking about - its not been
a necessary skill or a part of the process before.

In order to constrain costs both motive and ability to do so are essential.

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dreemteem
£13bn? Are these people nuts? That's more than 10% of the total NHS budget.

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user24
yeah, the benefits afforded by IT aren't worth 10%.

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c1sc0
Actually, in many use cases & for many organisations 10-20% of budget on IT is
a very reasonable ratio. As hackers we may not like it, but that's how the
real world functions.

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user24
I was being sarcastic. Evidently I wasn't clear enough.

