Many of the factors central to the crisis in the health service can be just as readily identified in the government's approach to NHS IT, says Dr Liam Fox MP

Detailed analysis of labour's handling of IT in the NHS reveals striking parallels with its overall approach to running the NHS. Neither picture is in the least bit rosy.

The government's solution to the crisis afflicting the NHS has been to preserve its monolithic, centralised and politicised structure, and to throw more and more money at it. Such is ministers' incompetence that the NHS is now simply silting up - the more they do, the less difference it makes.

Many of these failings can be identified just as readily in ministers' approach to IT in the NHS. Labour's term has been characterised by a combination of eye-catching announcements designed to win approving headlines, and purportedly relevant and ambitious targets intended to show a government with a clear view of what is needed and well on course to achieving it.

Beneath that thin veneer, however, the reality is very different. By their own admissions, ministers have been reluctant to engage in serious thinking on IT. Their targets have, to use New Labour jargon, been "re-defined" and "re-scheduled" - you and I would call it missed.

Then Health Minister Gisela Stuart gave the game away at the Healthcare Conference 2001 in Harrogate. She said that, to the NHS, IT means "very thick, technical papers" which senior ministers "struggle to understand", or "disasters"? To ram the message home, in early 2001 she pointed out that her ministerial colleagues "struggle to stay awake for more than 10 minutes when IT is on the agenda".

Nobody should therefore be surprised to learn that the government fell very far short of hitting its most recent IT target. Under the NHS Plan, 35 per cent of NHS Trusts were supposed to have had some level of an electronic patient records (EPR) system by April 2002. In fact, only about five per cent did. And only five Trusts had complete systems in place. The draft implementation strategy document on IT being publicised early this Summer, Delivering IT in the NHS, stated that the deadline of 100 per cent implementation will be pushed back from 2005 to 2007.

In a desperate attempt to cast ministers in a good light, much work is currently being carried out on a number of pilot IT projects. But rather than saving ministers' bacon, these schemes will merely compound their misery. In Wessex, the selected software specialist lacked adequate resources, and was later sold on a number of times. Its counterpart in the West Midlands filed for bankruptcy after being chosen. And the performance of one of the key suppliers to the Edinburgh Royal Infirmary has been sufficiently poor for questions to have been tabled in the Scottish Parliament.

Delivering IT in the NHS announced what it termed "ambitious" plans to improve IT provision. These included doubling the current level of spending on IT, in order to pay for such developments as EPR, digital prescriptions and booked admissions. In true Alan Milburn style, this was accompanied by stories of the Health Secretary demanding £5 billion from the CSR to pay for it. As we now know, Gordon Brown turned him down. Given the fact this money didn't materialise, we must assume that the DoH's technological ambitions will remain just that - ambitions.

In any case, with or without the £5 billion, close observers of the NHS IT situation remain sceptical about the government's plans. The Chairman of the NHS Chief Executives' IT forum, Dr Richard Gibb, recently pointed out that "attempts to ring-fence IT money in successive financial years have failed".

Scepticism is also rife about the companies being brought in to deliver the IT agenda. As the media has already pointed out with some bemusement, most of the firms identified have already been involved in one or more previous government IT fiascos - EDS and the Child Support Agency, Siemens at the Passport Agency, IBM in the privatisation of the National Air Traffic Services centre at Swanwick, and SEMA in ill-starred projects for the Department for Work and Pensions. These companies' poor track records hardly inspire confidence.

Not even the government's own IT experts back its approach. Robin Guenier, appointed by the DTI as Executive Director of Taskforce 2000, recently wrote: "The government's plans for NHS IT may be well-meaning, but the basis for change is not supported by the available evidence...and it will harm the service and patients."

All of the failings I have touched on here are borne out time and again in our discussions with those responsible for IT at the working level in the NHS. We hear repeatedly that responsibility for IT seems to have slipped through the net, and that even when capital is made available for investment in IT, it frequently is not accompanied by the recurrent funding needed to operate it.

The conclusion is clear. Just as only the Conservatives recognise that meaningful and far-reaching reform will produce the type of healthcare the British people deserve, likewise, only we will adopt a coherent, rational and integrated approach to the IT element of that strategy.