RATS DESERTING THE SINKING NHS IT PROJECT

Computer Sciences Corporation (CSC), the US software group, was left to pick up the pieces yesterday after Accenture walked away from the NHS's troubled 12.4 billion pound IT modernisation project. In the most serious blow yet for the controversial project, which has been beset with delays and glitches, Accenture said that it would bow out, leaving only three key suppliers - BT, Fujitsu and CSC. The move comes months after the American consulting group booked a $450 million provision for expected losses from the work, blaming the late delivery of key software designed by iSoft.

Although Accenture's work, worth about 1.97 billion pounds, will be picked up by CSC, its move to extricate itself from the programme at such an advanced stage raised questions about the feasibility of the procurement terms and the ability of the Government to hit the planned budget and 2010 deadline. Under the terms of the project the risks associated with it, such as extra costs and delays, lie firmly with the companies involved instead of with NHS Connecting for Health.

The switch is the fourth such upset - BT and Fujitsu have both been forced to switch software sub-contractors and CSC has ditched ComMedica in favour of GE healthcare. The problems recently led BT to install a new chief executive for its London work. However fears that iSoft, the troubled healthcare group, would be dealt another blow receded yesterday when it emerged that its work with Accenture on the project would be transferred to CSC by January.

Richard Bacon, Tory MP and a member of the Public Accounts Committee, said: "The decision by a firm as big as Accenture, and for whom the Government is such a big customer, to quit is an eloquent testament to how difficult it is to do the project the way the Government is trying to do it."

However, Connecting for Health, the agency that runs the programme, insisted that the removal of Accenture would not increase the bill for the project or threaten its deadline. It is delayed by two years already but CfH insists it will make up this lost time. Under its settlement Accenture will keep 110 million of the 173 million pounds it has been paid by the NHS and pay back the balance. It said it would not be liable for any further penalties and any potential legal action has been abandoned

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VICTORIA (AUSTRALIA) GETS IT WRONG

Two current reports below

Health critic faces sack

A public hospital doctor who defied a Bracks Government gag on hospital staff to become one of its most outspoken critics faces the sack. Dr Peter Lazzari claims he is being silenced, with the state election less than two months away. But the Eastern Health network said an investigation into allegations of breaches of protocols made against Dr Lazzari had nothing to do with his activism. The doctor has vowed to fight the allegations and has been "unequivocally" backed by hospital colleagues.

Dr Lazzari, a senior specialist physician at Angliss Hospital in Melbourne's outer east, has spoken out on several issues since defying a gag in 2003. In July, he called Premier Steve Bracks a "funeral director", blaming health system shortcomings for 500 patient deaths a year.

This week, Angliss bosses asked Dr Lazzari to respond to the alleged protocol breaches and warned he could be sacked. Dr Lazzari said he could not comment on the allegations, but said they were ludicrous. "This is a deliberate beat-up to try to stop me from speaking out on issues which are critical to life and death," he said.

Eastern Health spokeswoman Beth Excell said: "There have been a number of allegations made against Dr Lazzari and the hospital has a responsibility to investigate. "We are working through these with Dr Lazzari, but none relate to his choice to speak publicly about health issues." Opposition health spokeswoman Helen Shardey said: "This is an outrageous persecution of a genuine, passionate and brave surgeon who is prepared to speak out on important health issues."

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Patient had to bring her own mattress

A terminally-ill woman with spine cancer had to buy a new mattress because her hospital bed sagged. Nurses encouraged the new mattress to be brought into Frankston Hospital, she said. Joy Murray, who has breast cancer that has spread to her spine, entered hospital on September 11 because of agonising back pain. But the 64-year-old says the mattress she was placed on had a 15cm dip and it put her in worse pain. Mrs Murray said nurses offered extra morphine and told her there were no spare mattresses.

When she suggested her husband, David, buy a new one, she said they encouraged her. Mr Murray went to Frankston's Clark Rubber the next day and bought a $139 mattress, while staff dumped the discarded one.

Mrs Murray, back at home yesterday, said she had never experienced anything like it during 18 years of hospital stays. Peninsula Health medical services director Dr Peter Bradford said Mrs Murray was offered four other mattresses. Opposition Health spokeswoman Helen Shardey said Mrs Murray "has endured a great deal and it's a very sad state of affairs when hospital patients are forced to buy their own mattresses".

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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