Digital transformation

In June 2019, the States of Deliberation approved a major policy letter putting in place a new structure to support the provision of digital services, supporting the appointment of Agilysis as a key partner in their delivery. The cost runs to over £200m over 10 years and is the biggest contract the States has ever entered into. Here is the speech I made in the debate.

Sir, I have to say that the amount of time and effort that has gone into this project so far has been truly astonishing. The fact it has taken 2 years to get to this stage, which even the bidders have said has been a process like nothing they have experienced before, should give us considerable reassurance. It appears from the 2018 accounts that it cost the States at least £1.1m last year alone and goodness knows what it has cost the bidders. BUT this is a major contract after all.

AND absolutely essential. From an HSC point of view we desperately need our main software system upgraded but, far more than that, for a complete change in ways of working that investment in technology will enable us to make. From digital by default such as sending text messages and emails rather than thousands of letters, from telehealth and telecare to enable people to enable continual monitoring of their conditions, to the development of the care passport and use of robotics. The opportunities in the health and social care arena are massive. I’m thankful for the effort that has been put in up to now to replace the LAN which will be a real enabler, and the recently successful implementation of the MOSAIC system for Children’s services.

So what I am about to say needs to be seen in that context.

As HSC President I met each of the 2 finalists once. They had different strengths and weaknesses but I came away thinking either would have been partners we could’ve worked with. So, to that extent I am quite comfortable with how the process was conducted.

But, in all honesty, I suppose my concern is less with who we partner with and more to do with the States’ role in the partnership and what it is we think we will get out of it.

And I suppose what has started the niggling doubt is the costs. For me the cost projections don’t add up. Well, not literally but metaphorically.

We are told savings will be made, but it would appear from page 41 not until year 7. The problem for P&R is the Medium Term Financial Plan. Savings have to be made to the bottom line.

BUT it is a clear as crystal, at least to me, that the reform dividend is far from guaranteed.  The system can be more effective and efficient, but will the overall costs really go down? How can they when you see what the partnership is meant to deliver? Improved service support, provision of on-island and integrated data infrastructure, maintaining information assurance and security, building digital capability and capacity?

Rarely will increased IT provision lead to reduced costs and I speak as someone who has implemented a few IT programmes – on time and on budget – with the right team around me. Admittedly on a smaller scale, but a few million pounds nonetheless.

More often than not, IT investment is needed just to stand still. From a business point of view it can lead to increased profits, BUT rarely IF AT ALL does it actually reduce expenditure. Certainly that has been true for the States of Guernsey since it bought its first computer in 1968 and when it was said at the time it would mean less need to employ  more staff. The number of which at the time totalled 2, 827 and the Guernsey Press was recommending the use of more consultants to prevent the increasing wage bill.

Moving on to a related issue,  from what I can work out part of the reason for the increased costs is down to the creation of what is described as a ‘small expert team’ to provide service assurance and strategic direction. At a cost of £1.4m that is quite an expensive small team. It is unclear from the policy letter whether this is existing staff, new posts being created, or a bit of both. Given that we are told there has been little in the way of assurance and strategic direction up to now I am assuming quite a lot of that is more new posts. 

The other linked concern I have is in relation to the governance structure that is shown on page 34. The creation of 4 new Boards on top of the three already in existence sitting under P&R does concern me. It would appear we will have an awful lot of people tied up in meetings, writing up minutes and producing lots of schedules. Being seen to be busy and making progress is not the same as actually doing something.

Don’t get me wrong, I do believe that a governance structure is required and that there is the right skill set to achieve it. Previous IT projects have been undertaken on skeleton budgets without the right expertise and have consequently failed, costing the States dearly.

However, this is at a time we are told there are at least 200 posts that can disappear. We have already seen additional senior posts created as part of public sector reform and we will see more under these proposals. At the same time, although we are advised of the, quite considerable oversight structure, we do not know individual responsibilities. Who is accountable? Clearly P&R are from a political point of view, as all these new boards report through to them, but who at officer level? We are after all talking about the biggest programme ever taken on by the States.

Nowhere in this policy letter are individual accountabilities, roles and responsibilities set out other than on page 57 in relation to when the online payments system goes wrong. BUT that is after the event. Who actually are the Partnership Board, Delivery Board, Technology Portfolio Group and Technical Service Management Board? There are a lot of people involved, but where does the buck stop? 

This debate may not be the place to talk about individuals who can’t speak here, but I would like the President to confirm that he would be happy to provide members with such information after today.

The final area I would like to focus on is MedTech. 

I can see real synergies with the finance industry as a relatively low risk investment compared to biotech for instance.

However, other than this buzz word being used here and there, there is little to no detail of what the intention is, which is an incredibly broad and wide ranging but also a highly competitive industry.

What I would welcome is that HSC is kept informed in relation to work on MedTech. We are, under our new model of care, committed to innovation. The desire to take part in clinical trials, for example, is there and the need to do so will, I believe, grow, as we seek to ensure we are adopting the latest technologies not only to support future sustainable but also provide the best care to the people of Guernsey. 

Sir, in summary, I can say that a shake-up of the IT provision in the States is long overdue. The lack of proper focus on it over the last 20 years has been shameful quite frankly. This has reflected the lack of appreciation that you need an effective and efficient back office to get fully customer focused frontline services. This policy letter does represent a step change in thought process as far as that is concerned.

However, the key measurement of success cannot be savings to the bottom line. If it is it will fail like all other programmes before it. No, we have to be open and honest with ourselves and understand that if what we want is for the public sector to be run effectively and efficiently as possible on the back of the latest technology, it will cost more. How much more will depend on how well the programme is managed with P&R really needing to step up to the plate to properly scrutinise and ensure that all the promises being made will actually become a reality and working closely with the Principal Committees.

Sir, I am happy to support this policy letter, but I will be taking considerable interest in progress, not just from an HSC point of view, but for the whole of the States of Guernsey.

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