Public Domain

Limpopo is one of South Africa's poorest provinces. There are a lot of useful things its health service could do with £14 million in overseas aid. It decided to spend the money on computers.

The Limpopo integrated hospital information system, conceived in the honeymoon of democratic South Africa in the early 1990s, was Africa's largest healthcare informatics project by far. The idea was to computerise 42 hospitals, creating electronic health records that could be called up wherever they were needed.

To IT firms, it was a lifeline. With the NHS market in the doldrums following some well-publicised disasters, UK sales teams promptly relabelled themselves "EMEA" (Europe, Middle East and Africa), and headed south. After a fiercely fought procurement, the contract went to IBM. It was worth nearly £14m, some 2.5% of the province's annual health and welfare budget - a higher percentage than the NHS was spending on IT at the time.

The first hospital on the system went live in 1998, with the others due to be computerised over 18 months.

It didn't happen. As soon as the rollout began, it ran into problems. The hospitals lacked proper computer rooms, air conditioning and power supplies. One shared a circuit with the local bakery, which caused power surges when the ovens were switched on each morning.

Systems were not ready. According to an evaluation: "Many of the modules that were proposed in the initial plan were not created in time. Certain key aspects of the system were not given adequate attention, such as reliability and ease of making printouts." In some hospitals, systems were down for six weeks at a time.

The original contract ended in 2000 and the project was re-tendered. The new contractor, Ethniks, tried to introduce a new system. It failed, too. A formal review suggested "irregularities" and recommended that the project be put on hold, payments stopped and money already forwarded recovered.

All this is on the public record because the Limpopo project was unusually - perhaps uniquely - well scrutinised. British researchers saw the project as an excellent chance to evaluate the impact of IT on health in the same way they would study the impact of any other medical technique, with a random controlled trial. The results, published recently in the British Medical Journal, make uncomfortable reading. "In the 24 study hospitals that had the system installed, we found no significant differences in the quantitative outcome variables analysed." In other words, the technology - even when actually installed - made no measurable improvement to the practice of health care.

Limpopo Province isn't England. But the project's overall aims - to make records available wherever patients are treated and to cut waiting times - were similar to those of the £2.3bn national programme for IT in the NHS.

Ominously, the researchers conclude that the reasons for failure in Limpopo were "similar to those in other countries".