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What price the NHS computer upgrade from hell?

This article is more than 17 years old

What are the lessons to be learned from the unfolding fiasco engulfing the £12bn NHS computer upgrade?

It is a large and complex programme designed to hold the records of 30 million patients, one of the biggest projects of its kind, so it needed to be thought through properly. And the users - the consultants and clinicians - should have been widely consulted.

Neither seems to have happened, demonstrating the propensity of government to throw taxpayers' money down the tubes. If everything was going smoothly, why would Accenture, one of the key suppliers, have written off $450m because of delays and glitches that have left its executives seething?

Within the NHS, there are stirrings of discontent as fears grow that hospitals may be signing up to something they don't want. The Sheffield Teaching Hospitals NHS Foundation Trust, for example, recently announced it was abandoning one leg of the programme.

The troubles at financially stretched iSoft, which is providing some of the software, illustrate what can happen when one firm's fortunes are so closely tied to a single client. They also highlight the need for careful project management, sadly lacking in this instance.

It is difficult to escape the feeling that this project is being rushed with unrealistic deadlines (no one seriously believes that it can be completed by 2008) and that targets set for suppliers are too tough to meet.

Perhaps the writing was on the wall at the start when IBM pulled out of the bidding - wary, no doubt, about the ability of government to execute such an ambitious task.

If IBM, or 'big blue' as it is known in the US, was alarmed about the intricacies of the programme, perhaps others should have drawn their own conclusions. If Accenture decides to quit, as is widely expected, we should be concerned: this is a company which generates tens of millions of pounds from government contracts - and would bend over backwards not to upset one of its most important customers.

The NHS computer programme, championed by the Prime Minister, is a wonderful idea in theory. It allows electronic access to patient histories around Britain, making it simpler for people to choose where they have treatment and easier to treat those who fall sick miles from where they live.

But with forecasters now saying that the true cost of the upgrade could top £30bn, the question has to be asked: at what price?

Barclays at a loose end as bank mergers take off

Finally, after many a false dawn, banking consolidation in Europe is under way. On Thursday, two large Italian banks announced plans to merge. Over the past 12 months, Holland's ABN Amro has bought another Italian institution, Antonveneta,while UniCredit, Italy's largest bank, paid nearly $20bn for Germany's HVB. There have been others. But where are the British?

It is ironic that just as the EU has made it clear that it is not prepared to sit and watch member states bar foreign takeovers of their banks, most of our own players are otherwise engaged.

Investors still haven't forgiven RBS for overpaying for Charter One in the US and are reluctant to let chief executive Fred Goodwin write a big cheque for a European bank. Instead, they have made him promise to keep them in the money - hence, the chunkier dividends and a £1bn share buy-back.

Lloyds TSB doesn't have a big war chest to go hunting on the continent; most fund managers would prefer that the bank made a better fist of its operations in Britain.

HSBC is already a global bank with its next move expected to be Latin America, not Europe. Then there is HBOS, but it has made a virtue out of shunning 'risky' overseas expansion, and says there is plenty to play for in its own backyard, where it is taking a bigger market share of corporate banking and mortgages.

That leaves Barclays, the one UK major that could conceivably make a large European acquisition. It already has a presence in Spain, following its purchase of Zaragozano in 2003. A second Spanish purchase, one that would offer scope for cost-cutting and synergies, is almost a slam dunk. Bankinter, a snip at €5bn would be my hunch.

America's economic woes: enter the dragon

Economists are worrying about China again. With GDP running at 11 per cent and an investment boom that is leaving buildings empty and airports with no planes on the runways, it is small wonder that China is viewed by many as a disaster waiting to happen.

But what could go wrong? The answer is simple: America. It is ironic that the fortunes of the world's biggest capitalist power and an economy which is run by a one-party communist state are so inter-linked. China's economic success has been powered by an export boom with US consumers spending billions on cheap goods manufactured in a country where labour costs are a fraction of what they are in the West.

But with US interest rates rising and consumers battening down the hatches, the danger is that China's growth could come to a juddering halt if Americans stop sucking in cheap Chinese imports.

Beijing is clearly frightened: it has raised interest rates several times since last autumn and is attempting to reduce the construction of new factories by removing incentives for (often corrupt) local officials.

The doomsday scenario is that the Chinese and US bubbles burst simultaneously. If that happens, Beijing will no longer be able to bankroll America's massive budget deficit by buying US treasury bonds; the dollar will go into freefall and the global economy would spin into a nasty recession.

We are nowhere near that point yet. But the situation calls for some fancy financial footwork and, above all, stable Sino/US relations.

That won't be achieved if certain hotheads on Capitol Hill manage to push through measures designed to impose hefty tariffs on Chinese goods. No doubt they are pandering to popular sentiment as the mid-term elections loom, but they are playing with fire.

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