Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, November 01, 2009

I Think The Scale of Outrage Can only Build. It will Become Political Soon I Reckon!

Last week I reported on the NEHTA Annual Report.

See here for the link and download:

http://aushealthit.blogspot.com/2009/10/nehta-releases-annual-report-for-2008-9.html

Since then we have had the following appear in the OZ!

NEHTA spends $26m on consultants

Karen Dearne | October 29, 2009

THE National E-Health Transition Authority spent $26.2 million - almost half its $65 million budget - on consultants in 2008-09, compared with just $2.3m the previous year.

NEHTA ended the financial year with a deficit of $2.2m, compared with a $2m surplus on taxpayer funding worth $39m in 2007-08, according to its annual report.

Funding for NEHTA is provided by the federal and state governments under a 50:50 share agreement; the jurisdictions jointly own the not-for-profit organisation and are represented on the board through their respective health department heads.

NEHTA is tasked with developing better ways of "electronically collecting and securely exchanging personal health information", including the delivery of cornerstone projects such as clinical terminologies, healthcare identifiers and secure messaging capabilities.

This year, the new independent chair, David Gonski, was joined by an independent adviser to the board, Lynda O'Grady, in February.

Ms O'Grady is managing director of strategic and operations consultancy Advanced Management Services, and is understood to have held positions with Telstra, PBL and Alcatel.

NEHTA's other large expense was employee and contractor remuneration at $30.2m, up from $27m.

Employee salaries were $21m, while contractor costs were $9.2m; at June 30, there were 190 full-time staff, including contractors.

More background here:

http://www.australianit.news.com.au/story/0,24897,26275833-15306,00.html

There are two major issues that have been running around in my mind about this report over the weekend.

First is the total lack or public accountability regarding the fate of $26.2M of public money. All of NEHTA’s directors have to report to the public on consultancies over about $100,000 in their annual reports. They usually say how much, what the engagement was about and who undertook the work.

So just exactly why does not NEHTA’s Annual Report provide the same detail do you suppose?

The stream of e-mail I have had about this has been pretty excited and deeply angry – and I know a range of politicians are already being asked to either explain this lapse or to ask questions in the big house on the hill in Canberra.

Regular readers of my blog will have noticed the amazing stories coming out of e-Health Ontario where there have been some major tendering irregularities. For those who came in late here is a good link:

Examining eHealth Ontario

Key players in the agency's contract and spending scandal

Last Updated: Wednesday, July 22, 2009 | 10:16 PM ET

CBC News

EHealth Ontario became embroiled in a scandal focusing on more than $5 million in untendered contracts. (CBC)

The revolving door at eHealth Ontario has been spinning quickly since the provincial agency was first fashioned out of the rubble of its failed predecessor.

Premier Dalton McGuinty proclaimed the agency's creation last September and put Dr. Alan Hudson and Sarah Kramer at its helm, in hopes the two health-care problem solvers could turn the organization around.

But seven months later, Kramer became the first to take the fall for a mounting scandal focused on more than $5 million worth of untendered contracts, conflicts of interest and anger over high-price consultants nickel-and-diming taxpayers.

The agency's goals were lofty: create an electronic health record system by 2015, cut emergency wait times and increase patient safety.

Here's a rundown of the predecessor organization, key players and the companies who received untendered contracts.

All the details here:

http://www.cbc.ca/canada/story/2009/07/22/f-ehealth-players-0722.html

As I thought about it I asked myself just when was the last time I saw a NEHTA tender for services or any evidence of proper competitive practice. Sadly I couldn’t remember. Oh dear, and the e-Health Ontario CEO has now gone and ministers are looking shaky. The parallels are amazing.

I am also told the Canadian Federal Auditor General is about to report on Health Infoway – a NEHTA like agency for the whole of Canada. That may make for very interesting reading as well!

Second I was thinking about this new ‘Independent Board Adviser’.

Here is some background:

http://www.pftc.com.au/pftc/about/content.asp?pageid=16&top=&menuparent=6

Lynda O'Grady - Lynda O'Grady is Managing Director of Advanced Management Services, strategic & operations consultants to a diverse range of organisations across a number of industry sectors including ICT, biomedical, manufacturing, retailing, waste and green energy. Lynda has held senior executive roles in Telstra Corporation, PBL and Alcatel. She is a member of the council of National Science & Technology Centre and Advisor to the Board of NEHTA (National Electronic Health Transition Authority).

As Advanced Management Services lacks a web site there is not much more out there!

Just what exactly has Ms O’Grady been hired for? As far as I can tell we are not to know. She is essentially unknown to the Australian e-Health community and does not appear to bring any specific expertise in that area, which was the intent of the Boston Consulting Group recommendation of 2 years ago to expand the NEHTA Board with some independent domain expertise. I am not sure previous involvement with Questacon is quite what we need!

Maybe, as a strategic consultant, she could explain to the Board the scale of public outrage they have triggered by their obfuscatory and totally unsatisfactory Annual Report. The public are only going to be taken for mugs for so long.

The risk of NEHTA blowing up like e-Health Ontario must be rising.

David.

9 comments:

Anonymous said...

A google search flicked up, what must surely be the quote of the century. Ian Reinecke saw NEHTA (Australia) as a “fast follower” as opposed to an “early adopter”.

http://aushealthit.blogspot.com/2007/04/nehta-and-acsqh-e-health-conference-20.html

As you said "The parallels are amazing".

Anonymous said...

Is it too early to be up in arms about the money paid to consultants? While it would certainly be good to know where this money actually landed and to what effect, I suspect that those that are disgruntled are predominantly ticked-off having not been invited to the party.

What is disturbing is the fact that this amount of money could be spent - mostly at the big end of town (eg IBM on NASH), while the vendors actually delivering e-health solutions are "lucky" to be recouping travel costs. It can't be much fun sitting at a table across from a nitwit on $150K (average NEHTA staff/contractor wage based on figures) while you're expected to work for free to do his job.

For what it's worth, I'd much rather see NEHTA pay consultants that can at least be held accountable under the terms of a contract, as opposed to paying their own staff to stuff around for another 4 years.

Anonymous said...

Yes, and that was two and a half years ago when Reinecke made his ‘fast follower versus early adopter comment’ at the NEHTA and ACSQH e-Health conference 20 March 2007.

Anonymous said...

I don't quite know what to make of this - but for some reason I think it is very illuminating. Others may be able to draw some conclusions better than I.

The Department's 2008 / 2009 Annual Report can be found here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/annual-report2008-09

Table 4.3.17 page 297 Shows a comparison of Expenditure on Consultancy Services as follows:
2006-07 $35.02 M
2007-08 $32.97 M
2008-09 $32.10 M

Now these figures relate to a the Federal Health Department which has an Annual Budget many, many, many, many times the size of NEHTA's. The Consultants name, Service Description, Contract Price, Selection process and Justification are all tabulated.

Now compare these figures with NEHTA's $26.2 M for 2008-09 and ask yourself the question:

WHY is a publicly funded entity like NEHTA able to swish away $26.2 M without any detailed explanation whatsoever as to what it has been swished away on whilst DOHA is obliged to provide details of all consultancies?

If the Auditor-General isn't asking the same question he must be away on holiday.

Anonymous said...

Also Google turned up this in a senate committee -
http://www.aph.gov.au/senate/committee/clac_ctte/annual/2009/report1/c

The report provides detailed information on consultancy services let in 2007-08 of $10,000 or more. 450 new consultancy contracts were entered into involving total actual expenditure of $17.51 million. In addition, 187 ongoing consultancy contracts were active during the year, costing $15.45 million.

Total expenditure on consultancies for 2007-08 was $32.97 million - compared with 35.02 million in 2006-07 (pp.263-282).

.............. that is $32.9 million for the entire DOHA budget.

Quite frugal by comparison with NEHTA.

Anonymous said...

Perhaps most of the money has been gobbled up by Medicare Australia as a ? consultant ? contractor to NEHTA to develop the UHI's.

12 January, 2008. Minister for Human Services, Senator Joe Ludwig and Minister for Health and Ageing, Nicola Roxon have welcomed the signing of a contract between Medicare Australia and the National E-Health Transition Authority (NEHTA) for the development of a Unique Healthcare Identifier (UHI) service.

How much was that deal meant to cost?

Anonymous said...

Could most of the money be accounted for by the Medicare-NEHTA UHI development contract?

Medicare to set up ID service Karen Dearne | January 15, 2008

MEDICARE will create individual healthcare identifiers for Australians from personal information held in its databases under a $51.6 million contract with the National E-Health Transition Authority.

Human Services Minister Joe Ludwig said the system would be designed and built by Medicare to support a nationwide shared electronic health records system.

Dr David G More MB PhD said...

If that is the case, why not just say so?

David.

Jim Cocks said...

As I've commented (harped on?) before - the Medicare/NEHTA UHI contract was regulated into existence - no public tender, no evaluation, no public process other than the regulation. Guessing that's why no say so, perhaps?