Thought I'd barge in too :-)
>
>
>
> ED:   The simple question is why aren't NHSNet tariffs
> competitive vs other
>
> J:   Because it is faster, more reliable will still be here in 10 years
> never mind 10 months.   See the Economist article of a couple of
> months ago
> about the survival rate of ISPs.
Faster only if using ISDN vs PSTN. Other ISPs also provide ISDN - so this is
spurious
What makes you SURE NHSnet will be around in 10 years? It won't be around at
all unless the NHS community are persuaded to sign up - especially GP/PCGs.
To achieve this you need a reasonable tariff, acceptable CoC & some kind of
service when you do connect. Score so far = 0/3!

> here.   Smtp is good for some things and X.400 is good for others.   I
> prefer to think of X.400 as the Registered Post of Email.
>
> ED: I know all about body parts 14 and 15 and don't much care.
> Seamless handling of attachments is important and the
> implementation of X.400 on NHS net does not deliver.
>
> ED: I accept that X.400 delivery and read receipts provide an
> advantage over raw SMTP. However it is relatively simple to build
> such facilities in at a level above SMTP as we have done with PharMed.
>
> ED: The attraction of Internet protocols (SMTP POP3) over X.400
> isn't about technical capability but about the fact than there
> are large numbers of cheap (if not free) components that use
> these standards which allow suppliers to build affordable
> solutions. The use of X.400 on NHSNet needlessly pushes up the cost.
>
> ED: It seems inevitable to me that Internet standards will
> prevail and their deficiencies will be rectified such is the
> momentum and investment behind them. Sticking with X.400 is like
> sticking with Betamax or OS2 it gives you a possible technically
> superior solution but is simply pissing in the wind.
>
X400 is a de facto NHS standard only because everybody has invested (time,
money & credibility) in it & the DoH (probably quite reasonably) can't now
leave suppliers in the lurch by jumping ship. However X400 offers no real
technical benefits that emerging internet technologies cannot match (or
exceed) eg s-mime. I think X400 is likely to be an interim solution (but
then, isn't everything?)

> JC:   I agree, will a PCG be complex organisation?   200 plus employees
> 100,000 patients?
>
> I see firewalls at practice level not Primary Care Group level.
>
PCGs as an "organisation" - do you really think that's hat they'll be? It
really is too early to say. They are unlikely, certainly in the short/medium
term to function with a single PCG-IT system (we don't even know what the
dataflows will look like yet). So lot's of practice systems sharing SOME
data across NHSnet is the likely scenario - so we need practice-level
security.

+++++++++++++++++++++++++++++++++++++++++++++
+ Dr Alan Hassey, [log in to unmask]   +
+   The Fisher Medical Centre, Skipton      +
+   GP Computer Adviser North Yorks HA      +
+   RCGP Health Informatics Group & JCG     +
+++++++ PGP public key ID: 161BB451 +++++++++