"the vast and disparate NHS"
Maybe that is the problem, that the organisation is varied and inconsistent. There's no good excuse for the NHS to have so little commonality. It is supposed (broadly speaking) to fix people's health problems. There's established protocols for treatment, there's no reason for the lack of standardisation in organisation, management and governance (or in procurement, systems, buildings, hardware and technology).
Take the not-too-contentious example of hospitals. Every time the NHS builds a new one, (a) they fuck up capacity planning, location, car parking and other easily resolved elements, and (b) they do so each time to a brand new from the ground up design, leading to delays, cost-overruns, and plenty of costly work for untalented architects. All this could be resolved centrally with a portfolio of perhaps five basic designs with some modularity according to the scale and services needed (and also allowing for low cost expansion if needed). Architecture-by-Lego.
So bringing this back to NHS IT, you're quite right that standards based models have worked elsewhere, but really only where failure didn't matter. Look at all the early email clients or servers that have long since vanished - when these folded, a few devs had to find new jobs, and a few loyal customers were pissed off, but nobody died. To my mind the NHS needs common systems, they could be commercially provided (albeit on a regulated asset payment basis to avoid monopoly power), and the NHS needs to be able to have access to the IP (maybe just escrow code) to avoid supplier risk. Of course, that suggests one system to rule them all and in the darkness bind them, and there's a difficulty that NHS Digital is the Sauron of this age - evil, malignant despoilers the lot of them. They all need to go.
A few other things Hancock could do for healthcare would be to unwind all the PFI deals that are leaching money out of the NHS, stop local authorities from charging the NHS rates. And sack all the useless, over-paid, talent free wankers who seem to make up most NHS Trust boards, and replace them with accountable NHS employed managers (who could be and should be sacked if they're crap). And stop the public sector merry-go-round where whenever some overpaid useless twat fucks up, they get paid off, and then land a juicy role elsewhere in the NHS or related bodies.
Here endeth the rant.
Biting the hand that feeds IT
