the purpose of a system is what it does
Now this is absolutely terrifying; the Tory policy on what to do with the NHS National Programme for IT is apparently to give everyone’s data to “Google or Microsoft”. And that appears to be it. This is deranged in several ways. First of all, MICROSOFT??!!! What the fuck are they THINKING? You know, the people whose crappy browser and crappier operating system gave us the current malware ecosystem. The people whose business model is to make it too technically and legally difficult to ever change your mind.
It is fashionable in some circles to moan about “freetards” and Wikipedia being a “cult”, but as Stafford Beer would say, the purpose of a system is what it does.
MS products have been triumphantly successful in a couple of things – inducing people to buy ever more aftermarket security products from other American proprietary software companies, scaring them off going to the competition by making all their file formats very slightly incompatible with everything else including other versions of their own products, and generally maintaining the public belief that computers are terribly mysterious and frightening and that they must expect the experience of using them to be painful and unpleasant. This belief is very useful if you want to sell products on “user friendliness” (i.e. pretty graphics) or if you want to sell things to them in general.
Similarly, the original MS business model was to give away the software-development kits in order to attract as many developers as possible to make applications for DOS or Windows, which would attract people to buy the operating system they ran on. Unfortunately, since the mid-90s, they have been far more successful in fostering a shadow developer ecosystem, dedicated to exploiting the possibilities offered by the bugs rather as the official developers were dedicated to exploiting the possibilities offered by the APIs. I’m sure they didn’t consciously seek this…but see the Beer quote above.
Anyway, the purpose of the Google system is to sell advertising and they make absolutely no bones about that. This, of course, has consequences for the wider health system; the NHS is unlikely to be buying lots of ads to go next to your Google Health file. The people who do that are US drug companies, who are allowed to market direct-to-consumer with well-known and mostly terrible effects on the nation’s health. Why would a political party led by a former commercial TV executive, whose head of fundraising is the owner of an advertising agency, perhaps be interested in this? Anyone? Have the Midlands Industrial Council already banked the cheque?
But what really horrifies me about this arse-awful Sunday for Monday job is that it shows clearly that the Tories involved simply haven’t read the brief, or aren’t capable of doing so. Microsoft and Google’s embryonic health products consist of a single sign on and Web user interface for individual medical records. That’s it. But NPfIT is gigantically more complicated than that. It includes a medical record system. It also includes Choose and Book. It also includes a comprehensive workflow system for the entire NHS; to be clear, the biggest and most complex enterprise workflow installation in the world.
Google does not stock and does not sell anything like that; MS doesn’t do that much of it either. If they had said IBM, SAP, or BT Global Services I’d have been slightly less horrified; it would have shown that they were not particularly interesting or innovative (conservative, indeed), but had at least done a minimum of reading. And they don’t appear to be aware that the medical records (the Spine) are one of only two services in the project that have actually gone live.
But then, I suppose, if the records hadn’t already been filed in BTGS’ data centres, it would have been a sight harder to think about privatising them. The purpose of a system, etc.
It’s often the least well thought out eye-catching initiatives that say the most about the thought processes that underly them. Is it possible that quick-fire press releases are where the political system dreams?
(Meanwhile, the Thunderer comments thread is actually surprisingly sensible.)