Think about all the stress of putting your latest IT change plans into action. Now, think about how much worse it would be if you had to do all the IT change for the past five years in one year.

Imagine, therefore, what it must be like trying to implement 10, 20 or even 30 years’ worth of IT-enabled change in one enormous project. That is the challenge of the £12bn NHS National Programme for IT (NPfIT).

This controversial project is a microcosm of all the technological, cultural and social changes that IT has helped to bring about in a typical international corporation, but magnified by the vast scale of the health service with more than one million potential users.

NPfIT has generated a lot of negativity among doctors, and it is generally accepted that the programme failed to fully engage health professionals with its plans. NHS clinicians are notoriously distrusting of centrally imposed initiatives, and overcoming that natural resistance should have been a priority. But that is in the past, and there are signs that attitudes are changing.

When HM Revenue & Customs (HMRC) famously lost CDs containing 25 million child benefit records, there was an inevitable backlash against anything involving the government collecting electronic data about citizens, and the plan for electronic patient records came under particular scrutiny.

Not that long ago, you would have expected the medical profession to be among the loudest clarion calls against this much-criticised plank of NPfIT. But the reality has proved to be different.

Doctors.net.uk is an online service that claims to have 80 to 90 per cent of the UK’s doctors signed up as members. Users like the fact it is a peer-to-peer service, connecting them via email or discussion forums with the people whose opinion they respect the most ­ their fellow clinicians.

According to Dr Shaibal Roy, the director of clinical engagement at Doctors .net.uk, traffic to the site spiked hugely after the HMRC debacle, reflecting the concern felt about electronic records. But Roy told Computing that the opinions expressed were more balanced than many critics of the programme would have you believe. Of course, there were those virulently anti, and those equally forcefully pro, but in general there was reasoned debate about the challenges and lessons to be learned.

Roy says doctors have a straightforward attitude to technology. When asked what they want from an IT system, their response is: “We want it to work.” And there is growing recognition that the NHS cannot insulate itself from the trends affecting society, and in particular the growing technology literacy of the public.

It is absurd to imagine that by 2020 the NHS will not have secure access to our electronic medical records wherever and whenever it is needed to deliver an effective and efficient service.

The organisation has limped along by automating back-office administrative tasks while shunning the potential of modern IT. But for all its faults, perhaps NPfIT is starting to achieve one thing that could be critical to the future health of the NHS ­ a reasoned, balanced debate about the role of IT.

What do you think? Read my blog at http://editor.computing.co.uk