Th systems thinker John Seddon has a talent for confronting ministers with unpalatable truths. His latest newsletter describes how he confronted Health Secretary Jeremy Hunt as he announced that all patients records would have to be digitised. Has anyone met a doctor or ambulance man who actually faced a problem that digital records would have solved, he asks? He suggests not.
But the confrontation with Hunt ended with Seddon pointing him in the direction of an American report which explained that computerised records were intended to save the US health industry $81 billion, but now turn out not to have done so. Worse, the hospitals which digitised the fastest have cost more.
I hope Hunt really considers this report because there is here a fundamental truth, which Seddon has been pedalling but successive governments have been deaf to. Expensive IT solutions that prevent systems from dealing effectively with diversity - the range of human requirements that different people come up with - will end up locking in costs. Customers who don't fit start bouncing around the system and creating costs with each bounce, what Seddon calls 'failure demand'.
What is infuriating about all this, from a UK point of view, is that the coalition understood that the New Labour regime had introduced inflexibilities into the way public services ran. They realised they made services more expensive, and they began to remove the targets which were at the heart of the inflexibility.
But there was a big BUT. They failed to construct a narrative which explained what had gone wrong with services in the Labour years - and why they were so expensive and ineffective. And worst of all, they swallowed whole the Labour caboodle of massive IT solutions and merged back office services which were the source of so much trouble.
So the inflexibilities continue, and they harden and the costs rise - and, just when services most need to be able to deal effectively with diversity (delivering the Universal Credit, for example), the disastrous old solutions are trundled out again. Often what deals with diversity most effectively, and cheaply, is a human being with the responsibility to act as they see fit.
IT has a critical role to play, but not everywhere. In the wrong place it builds in organisational stupidity.
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