Think about all the stress of putting your latest IT change plans into action. Now, think about how much worse it would be if you had to do all the IT change for the past five years in one year.

Imagine, therefore, what it must be like trying to implement 10, 20 or even 30 years’ worth of IT-enabled change in one enormous project. That is the challenge of the £12bn NHS National Programme for IT (NPfIT).

This controversial project is a microcosm of all the technological, cultural and social changes that IT has helped to bring about in a typical international corporation, but magnified by the vast scale of the health service with more than one million potential users.

NPfIT has generated a lot of negativity among doctors, and it is generally accepted that the programme failed to fully engage health professionals with its plans. NHS clinicians are notoriously distrusting of centrally imposed initiatives, and overcoming that natural resistance should have been a priority. But that is in the past, and there are signs that attitudes are changing.

When HM Revenue & Customs (HMRC) famously lost CDs containing 25 million child benefit records, there was an inevitable backlash against anything involving the government collecting electronic data about citizens, and the plan for electronic patient records came under particular scrutiny.

Not that long ago, you would have expected the medical profession to be among the loudest clarion calls against this much-criticised plank of NPfIT. But the reality has proved to be different.

Doctors.net.uk is an online service that claims to have 80 to 90 per cent of the UK’s doctors signed up as members. Users like the fact it is a peer-to-peer service, connecting them via email or discussion forums with the people whose opinion they respect the most ­ their fellow clinicians.

According to Dr Shaibal Roy, the director of clinical engagement at Doctors .net.uk, traffic to the site spiked hugely after the HMRC debacle, reflecting the concern felt about electronic records. But Roy told Computing that the opinions expressed were more balanced than many critics of the programme would have you believe. Of course, there were those virulently anti, and those equally forcefully pro, but in general there was reasoned debate about the challenges and lessons to be learned.

Roy says doctors have a straightforward attitude to technology. When asked what they want from an IT system, their response is: “We want it to work.” And there is growing recognition that the NHS cannot insulate itself from the trends affecting society, and in particular the growing technology literacy of the public.

It is absurd to imagine that by 2020 the NHS will not have secure access to our electronic medical records wherever and whenever it is needed to deliver an effective and efficient service.

The organisation has limped along by automating back-office administrative tasks while shunning the potential of modern IT. But for all its faults, perhaps NPfIT is starting to achieve one thing that could be critical to the future health of the NHS ­ a reasoned, balanced debate about the role of IT.

I’m up on my high horse and going to have a rant now. Just how annoying is the national newspaper coverage of technology? An example earlier this week typified the sort of lazy, negative, narrow-minded, and downright unhelpful sort of articles you see so often.

On Wednesday, The Times, no less, the UK’s most famous and revered newspaper, ran a front-page lead story stating that Microsoft is developing software for “remotely monitoring a worker’s productivity, physical wellbeing and competence.”

In the article, headlined as “Microsoft seeks patent for office spy software” it told how Microsoft is developing this “Big Brother-style software”. The story included a series of quotes from employment and privacy experts not surprisingly stating what an awful and probably illegal thing this would be.

Absolute scare-mongering drivel.

The story was based entirely on a patent application from Microsoft, one of thousands it registers every year. Every major IT firm does the same – HP, IBM and so on – applying for patents that may, or may not, one day lead to actual products.

There is no evidence Microsoft is developing the software, nor that it plans to use the application in the manner described. Indeed, much of the functionality described already exists, and it wouldn’t be that difficult for an enterprising software developer to build a PC to do much of what was described – monitoring heart rates, stress levels, concentration levels, and so on.

This is what journalists call a “child might die” story – one possible outcome of an unlikely sequence of events extrapolated from a minimal series of facts.

Now I know I am on my high horse here, but please don’t get on some of yours in response to this post. I am not a Microsoft apologist, far from it, and I’m not defending Microsoft in any way. And I’m sure there are those readers who could find ways to criticise some of what they read in the specialist IT press too. But what frustrates me no end is to see the way that technology is covered in the national mass media.

It is good news that there is now a national debate on the social impacts of technology. It is bad news for everyone in IT that the underlying tone is based on utter technophobia and the assumption that more technology in our lives is a bad thing.

The one exception seems to be Apple, coverage of which is so fawning that it assumes every idea that comes out of Steve Jobs and his team is amazing, fantastic, unique and earth-shattering.

The same issue of The Times also claimed that “The days of leaving the house to rent a video were declared over yesterday, when Apple announced a new online rental service.”

Well, I don’t know about you, but I sort of thought I could already watch pay-as-you go movies on my TV thanks to Virgin Media, my cable provider and the company with the most gob-smackingly awful customer service in the world. Sky has been delivering such a service for even longer, as its millions of Sky Movies Box Office customers will tell you. So, thanks for the innovation, Steve. Even good old BT can give you a set-top box to plug into your broadband connection to download movies.

Given the ubiquity of technology in everyday life, and the increasing popularity of technology among consumers, it would be good to see that reflected more widely than just in an IT advocate publication such as Computing.

The national media has, unsurprisingly, been full of politicians and commentators calling for the identity cards and NHS electronic records programmes to be reviewed or even scrapped, in light of the outbreaks of “lost” data caused by the missing HM Revenue and Customs CDs.

Shadow home secretary David Davis wrote in The Sunday Times that “we need serious restrictions on the transfer and sharing of such information. The current casual and careless practice is intolerable.”

There is no doubt that Davis is right on this point of principle, and the debate over the security of government databases is a vital one.

But let’s think carefully about some of the facts. Patient records were lost by nine NHS trusts ­ each of which no doubt had different IT and processes in place to cater for data protection. In one case, the records lost were paper-based.

The problem with the lost 25 million child benefit records is not with the database, it was that technology was not better used to protect it.

Secure file transfer and encryption are available ­ the problem was the lack of management controls and processes over the use of that data.

There is a strong technical counter argument to the anti-database cries ­ most of these issues have come as a result of a lack of management control and a patchwork of unco-ordinated databases.

And as we spend more time online, a standardised system for electronic personal identity management in our dealings with government ­ and even the private sector ­ is surely inevitable, whatever form it takes.

The goal is a system that gives each of us the ability to personally manage our electronic identity ­ an individual firewall around all the data that matters to you. That technology does not yet exist in the mainstream, but offers a vision of a secure future. Whatever the government does now should be seen as steps on that path.

The political rights and wrongs of ID cards or electronic patient records is a different debate.

The argument must not be about whether databases should exist. The objective is to make sure that secure, better managed and well-controlled databases exist.

What does 2008 hold for IT leaders? Let’s not talk about technology predictions this time, or go through a list of patently obvious forecasts or frankly ludicrous recommendations. Most IT leaders are more than capable of understanding what their technology priorities are for the year.

But what will 2008 mean for your job?

There has been plenty written in the past few years about the changing nature of the chief information officer (CIO) role, the need for more business knowledge, and the importance of soft skills. But did we see last year the first evidence of a more significant change in the role?

Perceptions of IT leadership are shifting – from above and from within.

Boots and House of Fraser dispensed with the CIO / IT director role last year. Technology is still just as important to their businesses, but they felt that the end of a major investment programme meant that top role was no longer needed, handing IT responsibility on the board to the finance director.

Separately, research by Harvey Nash and PA Consulting last year suggested that turnover in IT leaders is increasing fast - 23 per cent of UK CIOs have been in post for less than a year, compared to just four per cent in 2005 - with a further 34 per cent expecting to change employer this year.

Then look at one of the highest-profile CIOs in the UK, Colin Cobain at Tesco, who announced his departure in November after completing a major project for the retailer’s US business.

Put these strands together and you have a radically different perception of the IT leader’s role starting to emerge.

The job seems to be diverging into two types of individual.

First, there are the IT change managers – people whose expertise and motivation comes from starting and completing major technology transformations, but who balk at the thought of simply keeping the lights on.

Then you have the steady Eddies, whose skills are focused on running a world-class operation, delivering the best IT support and maximising the existing investment.

Boots and House of Fraser have, arguably, turned to the latter. Cobain is unquestionably an example of the former. Indeed, the now-departed Boots CIO, Rob Fraser, was another whose focus seemed to be the delivery of change, so perhaps his leaving was not so unexpected.

IT has a long history of navel-gazing about its role in the boardroom, and perhaps the emergence of these two leadership profiles reflects that dilemma.

In organisations where IT is seen as central to change, you tend to find CIOs in the boardroom. Where technology is seen as supporting the business, the IT manager tends to report to the board. As the role matures, perhaps the old definitions will no longer be relevant and we will instead talk about two distinctly different job titles.

So what lies in store for you in 2008? Are you excited by the prospect of IT-led change because of the benefits for your CV and the chance to move to pastures new? Or does the thought of delivering long-term, day-to-day IT excellence motivate your working day?

Perhaps it will soon be the case that fewer and fewer IT leaders will be answering “yes” to both questions.