Diolch, Dirprwy Lywydd. Thank you for the opportunity to speak today about the Public Accounts Committee inquiry into NHS Wales informatics systems. Members will recall that last November, the Public Accounts Committee published one of its most damning report to date. In fact, 'scathing' was used to describe our 23-page analysis of NHS Wales informatics systems—NWIS for short. 

In committee, the chief executive responsible for hosting NWIS described its ambitions as world leading. However, we do not consider this to be the case, and in fact, our report highlighted a raft of problems with the dysfunctional, outdated IT systems that support our NHS. Our report made uncomfortable reading. Initiated by the auditor general’s report into informatics systems in NHS Wales, our inquiry found that many of NWIS’s digital projects are behind schedule, and some are only on schedule because their timescales have been re-ordered to show them on track. Lines of accountability are unclear, there is widespread dissatisfaction across the NHS at its performance, and major systems have repeatedly given up the ghost and with worrying regularity.

It's a matter of great concern to the committee that NWIS, first envisioned in 2003, has been unable to keep pace with advances in technology. While the technology products we have available—day-to-day use has changed beyond recognition in that time. Medical staff in Wales are still struggling with outdated IT systems that don’t deliver on their promises. And in fact, just after Christmas last year, it was reported that NHS Wales still has over 1,000 fax machines in use at hospitals and GP surgeries, with £550,000 spent on supplies since 2015, and one GP describing them as 'relics' that needed getting rid of. I'm sure you'd all agree that, particularly in a time when an e-mail offers a quicker and more secure means of transferring patient information, this is an unacceptable situation.

Sadly, these sentiments echoed throughout our inquiry. We heard how front-line medical staff are struggling with archaic and fragile IT systems. In some instances, this had led to treatments for chemotherapy and radiotherapy not being prepared on time; patients attending for treatment only to experience delays; and health professionals being unable to access blood test results and patient records. We even heard that some health professionals have resorted to paper-based records because ICT systems were simply not reliable enough. These shortcomings are also contributing to an increased likelihood of error and poor patient experience.  

We do not see how this can be addressed without a radical rethink. In 2016, the total cost of developing and rolling out the new systems needed across all Welsh health boards was estimated at £484 million. But the committee could find little evidence of where the money would come from and whether it would be additional NHS funding or found within existing resources. The budget NWIS operates with is utilised predominately for keep the IT system going. So, we need to find another way to ensure that the necessary innovation is funded.

Our inquiry has also raised serious question marks about the competence, capability and capacity across the health system to deliver digital transformation in Welsh healthcare. And yet, we discovered a culture of self-censorship and denial amongst those charged with taking the agenda forward, in NWIS itself, as well as its partners in the health boards and the Welsh Government.