The following is the text of an e-mail I received yesterday (09/11/2009).
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As an ex-employee of NEHTA I have been extremely interested in the news of NEHTAs annual report. I was particularly interested that despite almost half the 2008-2009 budget being spent on consultants, the report included no description of what work was conducted by these consultants or why. So, I thought I would share a few insights into the subject.Before I go on, it should be noted that there are a tremendous number of talented, dedicated people in NEHTA who are committed to creating an efficient, workable e-Health Record solution for Australia. Unfortunately, these efforts are being undermined by the sort of mismanagement, self-interest and, in some cases, incompetence in elements of NEHTAs leadership that are the hallmarks of a dysfunctional organization.
The sorts of things I saw resulting from this were:
- No project management processes
- No responses to issues and risks escalated to the project board
- Board decisions not being documented or communicated to the project team
When I questioned management on the lack of a project management system a consistent response was that NEHTA is a start-up, an answer I would find overly flippant in a company trading T-Shirts online but extremely worrying in a project of such national importance.
Obviously, someone had realized that something was wrong though and consultants were brought in to help fix the project by introducing basic project management processes. Were the consultants needed? Yes and no. They shouldn't have been needed but the environment is such that no internal staff could criticize (read: question) management without falling out of favour (and the culture of NEHTA is by no means mature enough for this to be a small thing) and yes, they were needed because no one was able to get anything done as they were being called to do reactionary, 'save the reputation of NEHTA' type of work regardless of pre-existing work they might be doing.
NEHTA is a broken organization. It appears that in the time since its inception no one has considered what must be done to build a functioning organization that is capable of meeting objectives. The public accountability and governance restructures will not occur simply because they would be far too embarrassing for everyone involved, particularly those who are committed to building their own fiefdoms in Australia's E-Health Solution infrastructure.
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What is being reported here is nothing short of a catastrophe and indeed the most serious of public scandals.
If true, and I have no reason to doubt the veracity of what is being said here as it accords with a lot of other things I am hearing, we can only conclude “Houston, We Have a Problem!”
We now understand why there is such a huge consulting bill. The 190 staff, as dedicated as they may be, are so badly led and so badly managed that they are in a loose, loose situation. NEHTA was never designed or resourced with the funds and skills to deliver a large scale IT project like the IHI (or UHI or whatever). That gap has now become apparent it would seem and NEHTA has been panicked into grasping at a huge consulting straw.
The likelihood of substantial delivery of what was intended now seems to be very much at risk and one wonders just what NEHTA plans to do when, come mid next year, this fact, seems very likely to become increasingly obvious.
Other sources keep telling me of the NEHTA approach being one very much of public relations rather than delivery. This approach is, of course, inevitably a disaster. Witness such other examples as Firepower and its fuel additive that saved 30% of your petrol bill and was clearly bunkum!
Why is it the most NEHTA presentations remind me of the foil ware and smoke and mirrors that was beloved of major computer companies in the 1980’s? The answer was that the seriously lacked any real substance.
What to do. It is pretty simple and involves two steps to avoid continued wastage of public money.
First the management and control of NEHTA should be returned to the public sector and second the Commonwealth Auditor General should be asked, by the Commonwealth Health Minister, to undertake a full review of NEHTA’s activities and deliverables (using external expertise if needed) so the public can be assured steps will be taken promptly to keep what is good and valuable from NEHTA and swiftly facilitate it getting back on the track to delivering what is needed.
Can I say if I were the present Chairman of the NEHTA Board I would be pretty worried about how my illustrious reputation may be damaged by this all ending in tears and taking independent steps to assure myself what is needed to be done is being done. It now becomes clear why the NEHTA Board needs an independent management adviser – there is no one internally with the organisational management skills to get this fixed.
I am told that NEHTA presently has a staff turnover approaching 30% annually and given the number of ‘former NEHTA staffers’ who have been in touch that is by no means a surprise. Of itself it is a key symptom of major organisational distress and dysfunction.
Time has come for the public to be assured that all this will be fixed, and soon. E-Health is meant to be about putting in place systems that improve heath and save lives. We need to get back there quickly! NEHTA has now been operational for going on five years and the practical outcomes have been pretty much zero. Time for a reboot!