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Choose and Book System

Volume 492: debated on Tuesday 12 May 2009

5. What proportion of expenditure on the NHS IT programme has been incurred on the choose and book system to date; and if he will make a statement. (274102)

Spending on the development, delivery and maintenance of the choose and book IT system to March 2009 was £134 million. As at 31 March 2008, which is the latest date for which an estimate of the overall local and central expenditure on the NHS IT programme was made, the National Audit Office estimated that a total of some £3.55 billion had been spent on the programme.

I am grateful to the Minister for that reply. I speak to a lot of GPs, as I am sure all Members do, and the impression that I get from them is that patients prefer their GPs’ advice. GPs know their patients rather better than do software systems, which often override patient preferences anyway. In view of that, and given that the system has had a long time to bed in, is the Minister content that it is giving real value for money?

I am slightly puzzled by the hon. Gentleman’s question. There is no contradiction between using choose and book and giving patients choice; in fact, choose and book is a vital component in helping GPs to ensure that their patients are given choice. If, as he says, there are GPs in Cornwall who are not offering their patients that choice, I find that as unacceptable as he does. If there is a problem with the choose and book system whereby slots are not becoming available, which may be what he wants me to address, that is an issue that the local primary care trust needs to address. The latest figures for Cornwall that I have show that it is one of the highest performers in the country on choose and book, with up to 80 per cent. of GP referrals being made through that system. It therefore sounds to me as though both choose and book and the choice system are working pretty well in Cornwall.

My hon. Friend is right to introduce technology into the national health service, particularly in these formats. However, given that according to the National Audit Office the figures are running at £3.5 billion, has he analysed the benefit that is derived from such schemes compared with the cost of investing in other parts of the NHS? There is a great feeling that IT is overtaking many other aspects of clinical care, and that many local needs could otherwise be met through those funds. Is he convinced of the value for money of this funding?

There is no doubt that an initiative such as choose and book is cheaper and easier to use and helps to enable the choice system or other elements of the national IT programme such as picture archiving, which is incredibly important and successful around the country. No one can have any doubt that these initiatives have not only improved the quality of patient care but are saving the NHS a lot of money. At this stage of the national programme’s development, it is difficult to quantify the total benefit in terms of economics and patient gain, but every day patients and clinicians are benefiting from the advantages that the computer system provides to them. There are still many challenges ahead—I do not duck those at all—but countries all over the world are considering this, including Barack Obama’s America, where people are looking to introduce a similar sort of national computer system into the American health care system as the one we have here.

More than three years ago, Tony Blair promised that patient choice would be a key driver of reform, but in February this year the Minister had to admit that the choose and book system was being used by as few as 12 per cent. of GPs in some primary care trusts and that a mere three PCTs had, only recently, hit the Government’s downgraded target of 90 per cent. usage, which was meant to be reached two years ago. Given that doctors are finding that the system is slow to use and crashes frequently, will the Minister tell the House the average percentage of GP referrals that are now being made through choose and book, and whether he thinks that this is yet another example of his failure to deliver?