The material, covering the period from the inception of the programme in 2002 up until 2007, was released in response to a Freedom of Information Request. Gateway reviews, which are designed to test the business case for projects at various different stages of their lifecycle, are not normally published.

The documents revealed that stakeholders and health officials have long had doubts about the NPfIT suppliers - of which only and are left - and have questioned whether the programme can ever deliver value for money.

Nearly a third of the 31 reviews are so severe that they gave a 'red light' to elements of the programme, which means there was a need for immediate remedial action and serious reconsideration of the NPfIT progresses.

Since the start of the programme the British Medical Association, representing doctors, has repeatedly questioned the systems being used and the management of suppliers.

Dr Grant Ingrams, in the NHS IT working group at the BMA, today told : "From the start we said that it was an ill conceived programme, that single unified systems were not workable, and that interoperability of local systems was better. Then they created local monopolies with only one lead supplier in each area."