DrDoctor Will See You Now

Goldilocks and the Big Shiny Project: Why Government IT Programmes Fail

36 min · 21. tammi 2026
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In this episode of DrDoctor Will See You Now, Tom Whicher speaks with Professor Joe McDonald (clinical psychiatrist; former National Clinical Lead for IT in mental health; advisory board member at The Access Group; and Digital Health royalty) about why large, centralised government IT programmes repeatedly fail, and what the NHS should do instead. They explore the “Goldilocks” project size: when budgets get too large, incentives and behaviours distort, and delivery becomes politically driven rather than user-driven, as well as the current state of UK digital health innovation, where we are seeing major near-term opportunities in ambient voice technology (AVT) to reduce clinician admin burden and unlock productivity. Plus, the longer-term promise of NHS data to enable better treatment decisions and proactive risk identification, cautioning against the ethical risks of LLM-based therapy chatbots for serious mental health needs. Buy Joe's new book FHIR and Loathing in Las Vegas here: https://www.amazon.co.uk/FHIR-Loathing-Vegas-Prof-McDonald/dp/B0FRYDV52G

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