The British Medical Association (BMA) is furious at remarks made by the NHS's most senior IT executive, in which he likened the organisation to the National Union of Mineworkers during the 1980s.
His remarks relate to a recent computer upgrade in hospitals and doctors' surgeries, and the BMA's contribution to the new system.
Taking part in a debate organised by the New Statesman magazine, Richard Granger, director general for NHS IT, said: "There are some blocks to radical structural change. I have encountered an incredibly powerful union, comparable to the National Union of Mineworkers, and that is the BMA. We have had very complex demarcation disputes that govern who can order what, who can do what, and they get into price per job negotiations ... It really is a rate-limiting factor on change in the public sector."
An edited transcript of the debate, printed in this week's New Statesman, has enraged the BMA. A spokesman said: "It is a completely unfair criticism. Obviously we have been raising doctors' concerns about the National Programme for IT but to suggest that we are being somehow obstructive is completely unfair."
The NHS said remarks by Mr Granger - who made his reputation implementing public transport Oyster cards and congestion charging on London's roads - had been "heavily edited and the full context is therefore missing". A spokesman declined to elaborate on what the full context had been.
A Mori poll for the NHS found in January that enthusiasm for Mr Granger's National Programme had fallen sharply among many health service staff, particularly managers and IT executives. The survey suggested this was in part down to delays to the programme, the largest non-military IT project in the world.
One senior hospital consultant, who asked not to be named, told the Guardian that new software packages were overly time-consuming and prescriptive. "The new system demands much more information to be inputted but it is not clear whether much of it will be of any use to clinicians."
A second senior consultant said: "The 'good old days' were not that good, but they were better than where we are going." Attacking what he called the National Programme's "conveyor approach to care", he said: "That might be fine for junior nurses in training, but it is going to stick in the craw for already overworked people who know what needs to be done and who don't need their hands held. ... If they put in place any of the [IT] hurdles that seem to be coming our way then there will be a downing of tools."
In response to criticisms over delays, Mr Granger promised in July that at least 21 acute hospital trusts would have basic patient-administration systems up and running by the end of this month, in addition to an existing 12. The NHS had initially planned to have more than 100 acute hospitals operating patient-administration systems and clinical systems by April this year.
Patient-administration software is one of the first building blocks of the National Programme for IT. It handles appointments and patient movements around hospitals. There have been just three more patient administration systems operating in acute hospitals since Mr Granger's pledge in July.
