Glad to see the American Cringe is still working well among British managers: "Federal"? What in UK is "federal"? No wonder he can not organise the UK systems, not even aware of his own country's organisation. Hundred languages outside the cities? Even in the vast majority of British cities and towns this is far from true outside certain Interest Group propaganda. In the countryside I know, in Devon, Oxfordshire, parts of Wales, North, the only two languages are "high" English (cf. High German) and variants of British dialects or Welsh with all speaking English. As someone else said, the national language is English (as spoken in Britain, not as on American television). I believe immigration for permanent immigrants assumes they will learn the national language.
These CIOs etc. should be required to live and work in small towns well away from London, Manchester, Birmingham and the like and to speak English rather than American, integrate into their own culture and "feel the pain" of the usual, everyday life of most people, using the same internet access, facing the same daily questions and problems, waiting times and physical distances .....
I am lucky: I live in a continental country where, when ill (as recently), the big problem is to hold off the next appointment wih a specialist until I can make suitable arrangements at home and at work, where no such things require the internet (after all, I suspect that even today the majority of people would not use it as a first or perhaps any option - never learnt, no time, no inclination, bad connectivity, suspicion, want to speak to a person, find the forms incomprehensible, inadequate, need help ...). I just see the doctor, undergo his examination, pick up the medicine/go to the physio. etc. and done. Ever tried getting your back injury diagnosed/treated over the internet? How about a blood sample? How about the doctor simply seeing your complexion and posture? As for the forms: usually incomprehensible terminology and often lacking any obvious logic while making unwarranted assumptions about the user's knowledge of jargon, systems etc. or insultingly stupid.
The internet may seem to offer a cheap option, just not very effective, secure, confidential or reliable or, much of the time, comprehensible. Even these wonderful, all-encompassing DBs seem to fall short of the simple card index and patient's file a lot of the time. Good for Microsoft and government ministers though.
I am a highly experienced, working IT nerd with extensive non-IT experience so I have got a highly developed sense of cynicism about the real effectiveness of "technology" in government and management at much other than offering a great alibi for ineffectiveness, gross negligence and idiocy, e.g. the more General Practice is computerised, the less contact with and response from their doctors my family and friends seem to get, even the very ill no longer getting home visits or seeing the same GP twice consecutively; computerised money trading, banking etc. hardly saved us from recent events: indeed, they rushed us faster into them and helped to obscure or enable the sleights of hand that caused them. Why? Too often the designers and implementers lack experience outside their technology and age group, lack realistic specifications or reviews or are, so often, incompetent, lazy and unimaginative, just like the CIO in question.
I believe in good IT as an effective tool. I just do not believe the grandiose claims made for it at all levels by people often too inexperienced or too young to know any other way, especially in the field of national DBs and systems to manage our health and wealth.
Anyway, I fear a really effective, national system: that level of control over knowledge of me by a really faceless bureaucracy is a horrible thought, together with its requirements to inform the system of every change in one's life and the implied control.