The IT chief of the NHS acknowledged problems with its ambitious 10-year modernisation project, but cited progress in installing next-generation medical IT systems throughout England.

Richard Granger said he was pleased with the accuracy of a report released on Friday by the National Audit Office. Granger is a former partner with Deloitte Consulting who took charge of the project in October 2002. The 57-page report highlighted the program's well-known troubles and challenges, but was generally complimentary on its overall management.

Granger, on the other hand, has been the target of bruising British media reports, which consistently cast the NHS project as an expensive bungle. The sharp press reports are a legacy of other over budget and off-schedule public IT projects in the UK.

Speaking at a public sector IT conference in London, Granger said there are two types of journalists, "those who read things that they are then writing about - the NAO report - and then there are those who just write what they think about."

His project, called the National Program for IT, is immensely complex, both in its technical scope and size. "Scale is a big problem," he said. "It is almost impossible to get everything right everywhere."

Granger described the work as a "tricky cocktail," where new IT systems have to function in a medical environment where there is very little tolerance for inaccuracy. Another barrier has been different levels of enthusiasm to use the technology among hospitals, he said.

BT, Japan's Fujitsu, Computer Sciences of the US and Accenture are the four main contractors working on the project in five regions. Those companies have let subcontracts for other services, such as software application development specific to the medical industry.

Many of those suppliers, Granger said, are in "pain" at the moment, but said they are well-capitalised organisations that will pull through.

To shield itself from accusations of wasting taxpayer money, the NHS is delaying payment until systems are up and working. The main contractors are primarily responsible, even if delays come from subcontracted work.

The NAO report said the Care Records Service, an electronic patient records system, is about two years behind, while the network designed to transmit those records, the National Data Spine, is about 10 months behind.

The report presented a revised estimated cost of £12.4bn for the programme.

Granger cited several working implementations. More than 50 percent of hospitals in southern England are no longer using wet-film X-rays, moving toward of a goal of having radiology records accessible anywhere on the network.