Book excerpt: Although officially 'dismantled', the National Programme for IT in the NHS continues in the form of separate component programmes which are still racking up big costs. The original contracts with CSC totalled £3.1 billion for the setting up of the Lorenzo care records system in trusts in the North, Midlands and East. Despite the contractor's weak performance, the Department of Health is itself in a weak position in its attempts to renegotiate the contracts. It couldn't meet the contractual obligation to make enough trusts available to take the system. We still don't know what the full cost of the National Programme will be. The Department's latest estimate of £9.8 billion leaves out the future costs of Lorenzo or the potential large future costs arising from the Department's termination of Fujitsu's contract for care records systems in the South of England. Parliament needs to be kept informed not only of what additional costs are being incurred, but also of exactly what has been delivered so far. The Department estimates £3.7 billion of benefits to March 2012, just half of the costs incurred. There is still a long way to go before government departments can honestly say that they have learned and properly applied the lessons from previous contracting. Given the Department's track record with the National Programme, it is very hard to believe that the paperless NHS towards which the Department is working has much chance of being achieved by the target date of 2018