Health minister, Lord Hunt, who was responsible for setting up the National Programme for IT, has defended its strongly centralised initial approach but made plain that the future lies with local ownership.

Speaking to the opening session of the Healthcare Computing 2007 conference in Harrogate, Lord Hunt, back at the Department of Health after a 20 month gap, said: “I don’t think if we had carried on the way we were carrying on we would not have made progress.”

But he admitted: “At the time I always knew there would be issues about engagement at local level. There would always be an issue about the thousands of systems being run locally and the change that [the National Programme for IT] would represent to people locally.”

He emphasised that the next phase of the programme would be about local ownership and said that NHS chief executive, David Nicholson, had called a meeting of acute trust chief executives in April to talk through the programme.

Local ownership, he said would require capability at local level to accept responsibility and buy-in and commitment from trust boards.

His reflections came in response to questions at the end of his address from Jane Hendy of Imperial College who said she had been researching the national programme for three years and found a great readiness and willingness from chief executives to engage – but not much to engage with.

She said: “People need a time table and they need to know where they are going with this.” In particular there was a need for guidance on patient administration and clinical systems.

She said the lack of implementations of new clinical systems represented a threat to patient safety and there was a lack guidance on what to do about that.

Lord Hunt said he agreed there had been a huge change of attitude. “We are in a position to have a grown-up conversation with those who will be responsible for the success of the next phase.”

In his main address to the conference, Lord Hunt, set the IT programme in the general context of efforts to produce “faster, better and safer care” with more money, new hospitals, the development of services like NHS Direct, care pathways and the integration of services across the primary, secondary and tertiary fields.

“I’d argue much of this has been underpinned by the IT programme, but we also know that IT could do so much more to enhance the quality, safety and experience of patients,” he said.

He said the NHS as a whole was moving towards system reform with less central direction and diktat and a more localised approach based on national standards, regulation from bodies such as the Healthcare Commission, provision of money and the use of IT systems.

He gave an upbeat account of progress in areas such as GP2GP transfer of electronic records and the newly-announced pilots for the summary care record.

However he also listed challenges that remained:

• The whole question of local ownership which, Lord Hunt said would be a major priority for him and David Nicholson;

• Doing too much too quickly. Lord Hunt said: “It’s clear we have not kept up with a programme that was always going to be ambitious.” He mentioned particularly delays in patient administration systems.

• Consent and confidentiality. Public confidence was paramount, Lord Hunt said.

• Constant criticism from commentators. “It’s not escaped my notice that some media coverage has not been entirely positive,” said Lord Hunt wryly. He added: “One of the things I want to do is engage in that debate. I don’t think we have anything to run away from.”