For whatever reason, things that work in the private sector don't seem to help in the public sector so even when they bring in people with big business experience it fails.
It's usually because the Government has stuck it's oversized oar in.
Lets take NPFiT.
In Scotland, the Scottish Parliament decided they would procure once software solution that would run across all hospitals etc, so that records could easily be shared.
In England, the Government decided that just getting a single software solution would be poor value, and a much *better* way of doing it would be to divide England into 5 "clusters" with each one being managed by a different Local Service Provider. This would keep prices down by ensuring competition and provide much needed redundant backup should an implementation fail.
Some elements were very successful - the National Providers - NHS Care Records Service, Patient Demographic Spine, Choose and Book, NHS Mail.
Other elements of the programme were dismal failures. Fujitsu (the Post Office Guys remember?) failed and pulled out. Accenture failed and pulled out. The 5th cluster didn't even get started. The clusters weren't working so they were disolved in favour of 10 SHAs. Much of the £12 billion spent wasn't on software or infrastructure, it was on management consultants. In the midlands the Community Health Record was supplied by TPP, but in the South and London by Servelec, some places were supplied by Civica and others by Emis. You had multiple different providers all being various levels of difficult in adapting their software to be compliant with the National systems.
A single procurement of a bespoke system to cover all English health providers would have been better and considerably cheaper.
By 2015, for Community Health, London and the South actually had a good system. They were all on Servelec Rio and could exchange records with each other. The new Government scrapped NPFiT and also
ended all contracts. Every Trust then had to go though rounds of expensive procurement to buy new software, or take over the licenses for the existing software and also procure a new infrastructure provider. So instead of all data residing in a large datalake managed by BT, every trust now had to have their own. No more information sharing - loads of cost in buying or upgrading data centres, and lots of project work for the likes of me.
In a personal sense it was brilliant and kept me in work for many years. In a National sense it was a huge amount of money spaffed down the toilet which could have been far better spent if the Government were not obsessed with the free market and competition.