[log in to unmask],Net writes:
>From: [log in to unmask]

>You have my sympathy.  I am not sure what the views of most GPs are 
>in respect of the present system under which they act as small 
>'businesses'.  
They think it is infested with stupidities and with much pointless
activity.
And oppose any change<g>

>This is a large part of the reason why I believe it would be far 
>better to fund NHSNet centrally, using top-sliced funds, and make the 
>sevice free at the point of use.  I suspect that at present we have 
>something rather near to the worst of both worlds, 

Fairly standard.
THe problems include th esize of the top-slice being liable to be
large, no doubt the scottish NT boxes include a lot of admin and
connection and training in their £7k quoted cost, but...

And the service being offered is not really one the non-cognoscenti GPs
want, since they don't really want any of it, and nor is it the one
that us here want - I want a medium to wideband connection for voice
and data via the fibre-optic cable recently laid outside boith home and
surgery, not a connection over the less than impressive looking now
ISDN, through the Betamax Net.

>I think it is all a great shame, especially in view of the relatively 
>small fraction of the total NHS budget, or even of the existing NHS 
>spend on IT, that is at stake.   If we restrict ourselves just to 
>GPs, most of them will have bought about £5K worth of equipment 
>(hardware + software) each;  

Yes.  But paid about £20k.  (remember it is per practice rather than
per GP.)

>assuming that GPs are no different from 
>the rest of the IT using sector, they will be spending about £5K each 
>year on supporting and exploiting this.  

Ho ho ho ho ho ho ho ho ho
If only.

Another discouraging factor is that few of us believe that even if we
connect to NHS Net, install MIQUEST and generally do the pervasive
standardised network thing, that the NHS admin and management will use
it either to dissemninate information, or to ask questions - we are
used to crudely drawn demands for information which just misses fitting
ht eRFA and otherwise defined categories in the systems we run, and
thus requires hand processing.

Indeed, my local HA has long insisted on computer printouts of child
immunisations being handwritten onto the lineprinted form they send
round.  THe software turns out a duplicate of that form, but that is
too easy.



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