Labour's multi-billion- pound project to create the NHS's first ever national computer system "isn't working and isn't going to work", a senior insider has warned.
The damning verdict on the ambitious £20 billion plans to store patients' records, and allow people to book hospital appointments, on a central computer network has been delivered by a top executive at one of the system's main suppliers.
Andrew Rollerson, the health-care consultancy practice lead at the computer giant Fujitsu, warned that there was a risk that firms involved in the project would end up delivering "a camel and not the racehorse that we might try to produce".
His bleak assessment was delivered in a speech on the health service's national programme for IT that he delivered to a conference of computer experts last week and which is reported in today's Computer Weekly magazine.
Fujitsu is one of the main firms involved in the project after winning a £896 million contract to deliver systems in the South of England.
Mr Rollerson underlined his message with a series of downbeat slides, including one showing a huge oil tanker being hit by a tidal wave, one with the word "Lost?" alongside a picture of a desert island and one with a man walking a tightrope.
Another slide declared "visionary leadership is still missing" alongside the famous World War One poster of Lord Kitchener declaring "Your country needs you".
His presentation even featured a picture of a huge alligator with the message "We have become obsessed by the alligators nearest the boat." The final slide showed two women mud-wrestling and asked: "Where would you rather be?"
In his speech, Mr Rollerson voiced concern at the direction of the NHS programme and the lack of vision on how the health service can make best use of new technology.
"What we are trying to do is run an enormous programme with the techniques that we are absolutely familiar with for running small projects. And it isn't working. And it isn't going to work," he told his audience.
"Unless we do some serious thinking about that — about the challenges of scale and how you scale up to an appropriate size — then I think we're out on a limb."
Mr Rollerson added: "There is a belief that the national programme is somehow going to propel transformation in the NHS simply by delivering an IT system. Nothing could be further from the truth. A vacuum, a chasm, is opening up."
His comments are the latest sign of problems in the ambitious project, which is expected to cost the taxpayer around £7.6 billion more than estimated.
Last year it emerged that there had been 110 "major incidents" involving the system in just four months.
A letter signed by 23 leading computer scientists urged the Commons health select committee to launch an inquiry to "establish the scale of the risks" facing the project.
Stephen O'Brien, the shadow health minister, said: "Even those from inside the programme are now telling the Government that it is coming apart at the seams.
"This is another example of the heavy-handed, top-down failing approach of this Labour Government."
The Department of Health last night insisted that the programme was a pivotal part of NHS reform.
A spokesman said: "David Nicholson, the chief executive of the NHS, is fully committed to the national programme for IT as it is a necessary part of modern health service.
"He sees this as one of his key strategic priorities as it is key to the successful delivery of patient centred care."
So there you are: one of the government's key strategies for the NHS is falling apart.