Are BT and C&W the NHS dreamteam - or the stuff of nightmares?

Just over a month ago Richard Granger - the director of IT at the NHS or, put another way, the UK's highest paid civil servant at Europe's largest organisation - laid down a stark warning to suppliers: deliver, or else.

He had taken up his post in the summer, against a backdrop of failed or failing public sector IT projects and a need for the government to do a bit of delivering itself - on its promise to improve the country's public health service.

So we liked the idea that suppliers would be kept in check, with those not performing jettisoned.

Today, the NHS Information Authority has announced it is upgrading NHSnet, with the help of two giant and well-known companies - BT and Cable and Wireless. We wish all parties well. The UK deserves and needs a modern health service where the latest information and communication technologies allow healthcare professionals to do their jobs well.

But can these two telcos deliver?

The answer is a 'Yes, probably', alongside a more desperate sounding 'Let's hope so because if they can't who can?'

The rollout and upgrade of the technology demanded by the NHS is beyond the scope of most providers. There are international communications companies with the wherewithal to take on fat contracts of this type but they won't have the necessary local knowledge and anyway, aren't we always appalled at all those public sector contracts going to overseas coffers?

And on the subject of overseas providers, an alternative might be to hand a giant services company a contract to bring together the necessary hardware, software, personnel and integration to make something like NHSnet work. Before you ask, yes, CSC and EDS are two such giant providers which count the NHS as a customer, and there are plenty of others eager to get a piece of the action. Unfortunately most have a number of failures to their name.

BT and C&W are the obvious choices here. It is understandable the state is hedging its bets by using both. Having a single supplier for such a huge project would be asking for trouble. But ask this: if things go awry, would there be the will to send a provider packing? Now there's a question for Mr Granger.