Hospital PFI project went ahead despite warnings

A hospital now losing £44 million a year was allowed to go ahead with a private finance deal to build new premises despite the Government being warned that the project was unsustainable.Hospital PFI project went ahead despite warningsA report, commissioned by the hospital regulator, Monitor, reveals that strong concerns were raised that Peterborough Hospital would not have the money for the new buildings.

Despite the warning – to both the Treasury and the Department of Health – the go-ahead was given for the project, which is now costing the hospital trust £22 million a year to service.

Last year, Monitor found Peterborough to be in “significant breach” of the terms of its authorisation and warned that work on a turnaround plan for the hospital had “not progressed at the necessary pace”. In February, the Government was forced to establish a £1.5 billion bailout fund to help pay the debts created by prohibitively expensive PFI schemes, of which Peterborough was one.

Peterborough is judged at high risk of financial failure by Monitor and is likely to have to cut or reconfigure the services it provides and make staff redundant to balance its books.

In the report, from the accountants KPMG, into what went wrong at Peterborough, auditors conclude that while Monitor was aware of the risks of the project it was powerless to stop the Government from giving it approval.

It is embarrassing for Labour because, at the time of the approval, Andy Burnham was a Minister of State in the Department of Health. He is now shadow Health Secretary.

The report reproduces a letter sent by the then head of Monitor, Bill Boyes, to the hospital trust in 2007 and copied to officials in both the Treasury and the Department of Health, warning of the dangers of the project.

But because Monitor had no power to intervene, it went ahead and it was only in 2010, after the hospital had been built, that the true financial picture emerged.

It has now emerged that up to 30 NHS trusts could be forced to merge, devolve services into the community and make jobs cuts as part of a radical restructuring of hospital care – partly as a result of the cost of PFI.

The Department of Health said it considered 21 hospitals to be “clinically and financially unsustainable”.

Commenting on the report, a Department of Health source said: “This was a disastrous Labour PFI blunder. Labour was warned repeatedly by their own regulator that this PFI deal could bankrupt Peterborough Hospital but they pressed on regardless.”

A spokesman for Mr Burnham said he would not comment until he had seen the full published report.


NHS is paying for Labour’s dodgy deals

The NHS faces huge costs because of flaws in Private Finance Initiative (PFI) contracts agreed by the previous administration.NHS is paying for Labour’s dodgy dealsYesterday afternoon, the Queen opened the South West Acute Hospital in Enniskillen. She will doubtless have been impressed: the facility, the first to be built in Northern Ireland for more than a decade, is a gleaming shrine to 21st century healthcare.

What may not have been mentioned, however, was that the £276 million hospital was constructed not with public funds, but by a consortium under the Private Finance Initiative – and that the deal to build it included a 30 year “facilities management” contract for one of the firms involved.

The Enniskillen deal may be a shining example of value for money.

But many PFI contracts are not.

Ministers are on the verge of taking over the South London Healthcare Trust, after it proved unable to cope with a bill of more than £60 million a year in interest alone.

One of the trust’s three hospitals, the Princess Royal in Bromley, took £118 million to build, yet will cost roughly £1.2 billion. All told, Labour signed 103 PFI deals for the NHS, at a value of £11.4 billion and an eventual price of more than £65 billion.

The diversion of that money away from patient care will put inexorable pressure on budgets, to the point where some hospitals will crack under the strain.

PFI, in short, is not merely about £22 light bulbs and £875 Christmas trees – it is about budgetary incompetence on a monumental scale.

And it comes as little surprise that it can be traced back to Gordon Brown, who turbo-charged the Tories’ fledgling public-private partnerships in order to buy schools, hospitals and more on the never never.

This allowed him first to evade spending restrictions, and later to splurge on public-sector salaries; in the mean time, the credit card bills got higher and higher.

Many PFI deals delivered what was promised – but where things have gone wrong, as in Bromley, the contracts were often drawn up so poorly that there is little the Coalition can do. Ministers have renegotiated some deals to claw back costs, and should make every effort, and twist every arm, to do more.

They should also remind voters of the ignominious parts played in this debacle by Ed Miliband, Andy Burnham and Ed Balls.

But, above all, they need urgently to produce a way of funding infrastructure that draws on the private sector’s strengths rather than exploiting the public sector’s weaknesses.

Jesse Norman, the Tory MP who has led the way in exposing PFI’s flaws, points out that the state must spend more than £200 billion on new infrastructure over the coming decade, and cannot do so without private help.

The Treasury is beavering away on a new model of funding. If it repeats the errors made by Labour, the cost to the nation will be heavy indeed.


A scandalous waste of money in the National Health Service

The public want taxes to be spent on patient care, not paper-shuffling- Telegraph Editorial.A scandalous waste of money in the National Health ServiceThe astonishing levels of pay for agency doctors employed by the NHS, revealed in our investigation, provide further evidence of how dysfunctional the health service bureaucracy has become.

Nor do these findings suggest that the EU Working Time Directive, limiting doctors’ working hours, is operating to good effect.

Although there were strong objections from the medical profession when this directive was imposed, there was also a recognition that doctors’ hours needed to be regulated to some degree: there is an obvious risk to patients being seen by an exhausted doctor, panda-eyed from lack of sleep.

The revelation, however, that in the two years since the directive came into force, NHS hospitals have spent more than £2 billion on temporary clinical staff makes it clear that something is very wrong.

One problem has been highlighted by Professor Norman Williams, President of the Royal College of Surgeons, who has expressed concern about hospitals attempting to economise by leaving vacant the posts of retired consultants, only to spend large sums employing locum staff.

That is sheer incompetence and evidence of the urgent need to rationalise NHS bureaucracy.

Doctors perform a vital service; but it is neither reasonable nor necessary to pay rates of £20,000 a week (equivalent to £1 million a year), especially when many of the payments to on-call doctors include hours when they are asleep.

This scandalous situation has all the classic ingredients: European diktat, bureaucratic incoherence and abuse of taxpayers’ money.

The public agency on which taxpayers least begrudge their involuntary contributions being spent is the NHS; but that generosity is predicated on the money being spent at the “sharp end” of patient care, not dissipated in the black hole of public sector paper-shuffling.

Doctors must not work excessive hours, but both the directive and NHS administration should be searchingly reappraised.


Scandal of NHS production line as readmissions soared under labour’s red tape

The number of NHS patients who have to undergo emergency readmission to hospital within a month of being discharged has increased by more than three quarters over the last decade, the Daily Telegraph has disclosed.Scandal of NHS production line as readmissions soared under labour's red tapeHospitals have been accused by ministers of treating patients “like parts on a production line” after official figures suggested that hundreds of thousands of people every year are being sent home before they are well enough.

More than 660,000 people were brought back to hospital last year within 28 days of leaving, statistics show, sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets.

The official figures show that some NHS trusts have seen their emergency readmission rate rise more than threefold over the past decade – while some hospitals have seen only a modest increase.

Last night, Andrew Lansley, the Health Secretary, said that the “hugely distressing” trend must stop.

“Patients have a right to expect that when they go in for treatment that they are looked after properly and that the treatment they are given helps them to recover,” he said.

“Having to be readmitted and treated all over again is hugely distressing. These figures show how Labour’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for.”

The Department of Health has released detailed information on the number of emergency readmissions in every area across Britain.

The figures show that 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78 per cent increase. Over the past five years, there has been a 31 per cent rise and a five per cent increase on the previous 12 months.

The data also highlights the widespread regional variations. The rate of readmission in the Kensington & Chelsea PCT area has risen by 287 per cent over the past decade to 1,582 people.

However, North Lincolnshire PCT has only experienced a 3.37 per cent rise over the same period.

Hospitals within the Hampshire PCT area readmitted 13,239 people last year. The nearby area covered by the Isle of Wight PCT only had to readmit 1,098 people.

The figures, do not include patients suffering from cancer or mental health problems or maternity patients.

Most of the areas with the highest increases in readmission numbers are in London and the south east, where pressure is greatest on the NHS. The Department of Health has analysed the social make-up of each area and concludes that the so-called “thriving London periphery” – the relatively wealthy commuter hinterland around the capital has suffered the biggest recent deterioration.

About 10 million people are admitted to hospital wards each year. Critics claim that government targets, such as the demand that patients be admitted to hospital for treatment within 18 weeks of seeing their GP, mean hospital managers are pressured into releasing patients early to make beds available.

Earlier this month, The Daily Telegraph disclosed that the Government is moving from a system of targets for hospitals based on waiting and treatment times – to a system of so-called “outcomes” which measures the success of treatment.

In a criticism of previous targets which he blames for the increase in emergency readmissions, Mr Lansley said: “Instead of focusing on the results which actually matter for patients, they focused on narrow processes to the detriment of patient care. That is why we have taken action to address these increases in emergency readmissions.

“One of the new goals we are setting the NHS is reducing emergency readmissions. In order to help achieve this we have created a re-ablement fund of £300 million and we have taken action to stop hospitals being paid when they readmit a patient after discharging them too early. These steps will turn Labour’s poor performance around.”

Under the Government scheme, hospitals will effectively be responsible for people’s care in the weeks after they return home and will be financially penalised for discharging patients too soon.


New 60 step plan for the NHS by Andrew Lansley

Andrew Lansley has called on the NHS to focus on “what really matters” as he prepares to announce plans to judge hospitals and doctors against 60 new goals that are designed to save more than 20,000 lives a year.New 60 step plan for the NHS by Andrew LansleyThe Health Secretary has unveiled a new system to assess success in the health service based on the quality of care patients receive – not merely the speed at which they are treated.

Comprehensive data on hospital death rates, the individual performance of GPs and surgeons and patients’ experiences under their care are to be published in an attempt to improve standards.

Mr Lansley has set out 60 benchmarks that will replace Labour’s system of targets and will be used to define success in the NHS.

These include a commitment to preventing unnecessary early deaths, a pledge to enhance the quality of life for people with long-term conditions and a drive to ensure that people have a positive experience when using the health service.

If the new standards are achieved, 24,000 early deaths a year could be prevented from cancer and other long-term conditions, Mr Lansley believes.

In addition, fewer people with long-term conditions including asthma and diabetes will be treated in hospitals, he will claim, while patients undergoing routine hip and knee operations will no longer be left in pain or unable to walk.

Access to NHS dentists will also be improved, he will say.

The Cabinet minister said the record on unnecessary early deaths varied across specialties as he urged the health service to focus on “what really matters” – the results achieved for patients and their experiences while being treated.

“If you look at the question of how many patients in this country die who could live if they got the best health care, it is literally over 10,000 patients a year if we were simply to get to a place which is better than the average across the OECD (Organisation for Economic Co-operation and Development) countries.”

In an interview with The Daily Telegraph, Mr Lansley says his tenure as Health Secretary will have been a “failure” if the 60 new “outcome” targets do not improve by the next election. He pledges that the benchmarks will now “define what the NHS is setting out to achieve”.

“We have to clear the decks and be clear this is what we are focusing on,” he says. “People say in three and a half years’ time, in 2015, at the next election, how will we know whether you’ve succeeded or not? The answer is ‘have the outcomes improved?’

“It will be my failure if we haven’t improved them and the NHS should feel that it has not succeeded, that is what we are setting out to do.”

Next week, the Government will set out current performance for each of the 60 indicators. It will then set out national targets for improvement “by the time of the next election and beyond”.

The new NHS Commissioning Board and the Care Quality Commission will also intervene directly to address problems that are highlighted by the data.

In today’s interview, Mr Lansley says that the long-running row over NHS reform must end and the health service must concentrate on improving patient care.

“We’ve really got to get into the big picture, which is delivering improvements in the results we achieve for patients right across the board,” he said. “We know that we can do it.”

The benchmarks will be monitored partly through studying clinical data – for example, to ascertain whether mortality rates for cancer, liver and heart disease are improving — and partly through surveying patients to gauge whether they were satisfied by the standard of care they received and the speed of their recovery.

The Health Secretary says: “This is literally saying to patients ‘if you were in hospital, if you were being looked after by your general practitioner was the service and experience you had good or not?’ It’s not like some other kinds of medical model where you kind of treat people and they get better. This is different.

“This is really where you begin to kind of focus on the experience of care.”

For the first time, the views of bereaved relations and even children will be surveyed so that the quality of NHS care from early years until death can be assessed.

“We’ll be undertaking a consistent national survey of the bereaved relatives of people who received end of life care,” Mr Lansley said. “Asking them, after a suitable passage of time, what was their loved one’s experience of care and how well were they looked after towards the end of life.”


NHS PFI debts rising by 5pc a year

Taxpayers are paying five per cent more per year for hospitals built under Labour’s Private Finance Initiative (PFI) because the debts are linked to inflation.NHS PFI debts rising by 5pc a yearCurrently the combined debt for some 800 PFI projects, including 103 PFI hospitals in England, stands at about £300 billion, according to makers of the programme.

When a BBC Panorama programme contacted 85 hospital trusts with PFI deals, it found 80 of them said they were having to make increased payments due to inflation.

When most of the deals were set up, inflation was low and the outlook was for that to continue well into the future.

Most trusts decided not to protect their debts from rising inflation, against the advice of the Treasury.

By contrast, the companies building the hospitals insured themselves against losses due to inflation.

The PFI deals, under which companies build hospitals to be leased back by the NHS, typically run for 30 years.

Margaret Hodge, the Labour MP who now chairs the Public Accounts Committee, admitted to the programme: “We should have been much more transparent about the costs. I think we got the balance wrong.”

Richard Bacon, a Conservative member of the committee, said he thought taxpayers were being “ripped off”.

A spokesman for the Treasury said that protecting PFI debts against inflation was “not mandatory … because it is subject to individual authorities undertaking their own project assessments”.

He added said: “The Government has consistently expressed concerns about the misuse and costliness of PFI. That is why, less than two weeks ago, the Government launched a fundamental review of the PFI model, which will see the end of PFI as we know it.”

Dismantling NHS IT computer scheme could cost more money

Dismantling Labour’s disastrous £12 billion NHS IT programme may cost taxpayers more than keeping it going.Dismantling NHSfIT computer scheme could cost more moneyMinisters announced on Thursday that they will speed up the scrapping of the National Programme for IT (NPfIT)  after a review concluded “there can be no confidence that the programme has delivered or can be delivered as originally conceived”.

It confirmed earlier reports that the central part of the scheme, allowing NHS staff across England to access any patient’s details, was unworkable while costs had increases and deadlines were missed.

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”


NHS hospitals crippled by labour’s PFI scheme

Patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes the Health Secretary warns.NHS hospitals crippled by labour's PFI schemeAndrew Lansley says he has been contacted by 22 health service trusts which claim their “clinical and financial stability” is being undermined by the costs of the contracts, which the Labour government used extensively to fund public sector projects.

The trusts in jeopardy include Barts and the London, Oxford Radcliffe, North Bristol, St Helens and Knowsley, and Portsmouth.

Between them the trusts run more than 60 hospitals which care for 12 million patients.

There is already evidence that waiting lists for non–urgent operations have begun to rise as hospitals delay treatment to save money. Adding to this are growing fears over the impact of the financial crisis on care this winter.

Under the PFI deals, a private contractor builds a hospital or school. It owns the building for up to 35 years, and during this period the public sector must pay interest and repay the cost of construction, as well as paying the contractor to maintain the building.

However, the total cost of the deals is often far more than the value of the assets. As a result, Mr Lansley says, the 22 trusts “cannot afford” to pay for their schemes, which in total are worth more than £5.4billion, because the required payments have risen sharply in the wake of the recession.

Mr Lansley said: “Over the last year, we’ve been working to expose the mess Labour left us with, and the truth is that some hospitals have been landed with PFI deals they simply cannot afford.

“Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse. Tough solutions may be needed for these problems, but we’ll help the NHS overcome them. We will not make the sick pay for Labour’s debt crisis.”

He said hospitals would not be allowed to collapse financially.

“There are many hospitals that are well run, do not have a legacy of debt and do have projects which are perfectly sustainable. My point is that we have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future. We can only do that if we work closely with them,” he said.

“This is about making very clear that we are not only working on unsustainable PFIs, but also working with legacy debt that the NHS has been left with, working on the IT programmes which were on an unsustainable scale of contractual commitments that didn’t meet the need of the NHS’s customers.

“Across the board, we have to tackle Labour’s legacy of poor value formoney and debt.”

Over the next few weeks, Department of Health officials and executives at the 22 trusts will develop detailed plans for dealing with the crisis. Their proposals are expected to include significant cost–cutting and the renegotiation of PFI contracts.

Money will also be moved from NHS trusts that are in better financial shape to cover the debt costs at those that are struggling. However, officials are braced for the need to use Whitehall funds to bail out some hospitals.

Among the trusts which have contacted Mr Lansley to inform him of their severe financial problems are several London institutions, including South London Healthcare, Barking, Havering and Redbridge, and North Middlesex.

Outside the capital, other trusts to have approached the health department include Wye Valley, Worcester Acute Hospitals, Mid Yorkshire, and Walsall.

After the general election last year, Mr Lansley ordered officials to establish why some NHS hospitals were under–performing. The health department is assessing the financial position of every hospital. It is understood that the PFI costs have emerged as a leading factor in poor patient care in some areas.

The Health Secretary decided to disclose the list of hospitals in difficulty and is expected to announce the rescue plans for each trust next month.

Taxpayers are having to pay more than £200 billion for schools, hospitals and other projects whose capital value is little more than £50 billion.

In one example, a hospital in Bromley, south east London, will ultimately cost the NHS £1.2 billion, more than 10 times what it is worth. Another hospital was charged £52,000 for maintenance that cost £750. The annual cost of the schemes is almost £400 for each household.

The public payments for PFI deals are typically linked to inflation and therefore the cost to taxpayers has increased by up to a third since the beginning of the credit crisis, according to the National Audit Office. Last month, MPs on the Treasury select committee effectively called for a moratorium on new PFI projects, which it said were “like a drug” as the costs were not apparent at the outset.

George Osborne, the Chancellor, has tightened the rules on the deals.

Earlier this year, John Healey, the shadow health secretary, admitted in an interview that Labour ministers had failed when negotiating the multi–million pound schemes for hospitals.

“There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts at the outset,” he said.

Companies who run PFI schemes boast profit margins of up to 71 per cent on the projects, but have come under growing pressure from MPs and ministers to return some of their “windfall profits”.


Weight Watchers twice as effective as nanny state advice for obese

Obese patients who enrol on commercial programmes such as Weight Watchers lose twice as much weight as those just given advice by the nanny state and doctors research suggests. Weight Watchers twice as effective as nanny state advice for obese A paper in the The Lancet found that overweight people who spent a year attending group meetings, being weighed regularly and following diet tips lost an average of 11.1lb (5.06kg).

This is twice the 4.9lb (2.25kg) shed by those who received weight-loss information at their local doctors’ surgery.

In addition, those on the Weight Watchers programme had lower cholesterol levels and smaller waist measurements, making them at lower risk of developing diabetes and heart disease.

Academics commenting on the study say public sector health services – such as the NHS – should consider paying for patients to attend private weight-loss classes than providing treatment themselves.

The study was carried out by Dr Susan Jebb at the UK Medical Research Council in Cambridge and colleagues but funded through a grant from Weight Watchers itself to the MRC.

It states that 1 billion people worldwide are overweight and 300 million obese, putting them at high risk of illness and early death and placing a heavy burden on healthcare systems.

The researchers took 770 overweight and obese patients, mainly middle-aged women, in Germany, Austria and Britain and gave half of them free access to a Weight Watchers programme while the others received “standard care” through their GP.

Those on the commercial scheme were encouraged to attend weekly weigh-ins as well as counselling and group support meetings, and were able to monitor their food intake and activity levels online as well as access meal ideas and take part in community discussions.

After 12 months, weight loss among those in Weight Watchers was “significantly greater” than those given GP advice, and they were twice as likely to have lost more than 5 per cent of their initial bodyweight.

In addition, their insulin, glucose and total cholesterol levels were found to be lower while their waist circumferences had dropped by an average 2.2in (5.60cm) compared with 1.2in (3.16cm) among those on the GP course. Both groups ended up with lower blood pressure.

The researchers say the commercial programme could be more successful at changing people’s behaviour because it offers more frequent weighing and peer support.

The paper claims it could also prove cheaper, at about £50-60 for 12 weeks, because it involves larger groups of people.

The authors conclude: “Data from our study suggest that referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale.”

Kate Jolly and Paul Aveyard from the University of Birmingham write in an accompanying opinion piece: “Evidence that weight loss achieved by fairly brief interventions can be sustained long term without continued support would be valuable.

“However, present evidence shows that the commercial programme assessed by Jebb and colleagues provides a more effective weight management service than does primary care, and is widely available. Such programmes are likely to be an important component of the medical management of obesity in primary care.”

Previous research had suggested that nanny state schemes to “bribe” the obese into losing weight, currently on trial in the NHS, were just as effective as programmes such as Weight Watchers.


NHS to abandon £12 billion IT project as a labour failure

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.NHS to abandon £12 billion IT project as a labour failureThe integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”