The fuss about the EMIS system is not just a technical matter. What it shows is that the NPfIT management has no respect for the existing practices which keep the NHS going. Whether these practices make use of computer systems or quill pens, the same factors still apply.
This contempt for what exists is typical of "modernisers", but it misses the point that existing practices, however apparently "old-fashioned" do at least work. They therefore constitute a viable system.
Our attitude at ABS is that existing practices embody an unconscious wisdom which has evolved over a long period of time. Taking the trouble to study them with humility is the first step to gaining the understanding which enables one to see how the system could be helped to evolve to its next level.
We use Beer's Viable System Model as a guide to understanding how to identify the elements which make the system work, so that we can enhance these to make it work better.
Ignoring what is already there shows disrespect for the people who make the system work, and is insulting to those who care about offering a better service.
Obviously, if there is no understanding of what makes the system work now, the risk of breaking it accidentally when trying to reform it is enormous.
Does this ever figure in the assessment of project risks?
Without a sensible model of what it takes to make an organisation viable, how can any of this work hope to succeed, except by accident?