On Tue, 4 Aug 1998 20:01:07 +0000, [log in to unmask] wrote:

>What is the problem?

No problem!

 >Plainly the NHS is NOT at present achieving the kind of management of
its internal information with the present level of input

Yes, yes....

>I see nothing wrong in attempting to get an informed estimate of what the spend ought to be, by comparing the NHS with other sectors

Nothing wrong at all...

>And I see nothing wrong in making it clear that this will need to meet end-users' real neds if it is to gain acceptance.

Nothing wrong at all...

>That is a policy decision which I cannot take;

Aha!  I knew there was a punch line :-)

>but I can point out what the likely level ought to be.

By all means.  But unless those who can make policy decisions actually
(a) hear you (and us),  and,  (b) act on that information,  i.e.,  say
loud and clear that there is 1.2 billion for NHS IT,  I am afraid we're
all pissing in the wind :-)


>> Do you really believe the HMG spinners can all of a sudden conjur up
>> 1.2 billion out of no where?
>
>Yes, I do.

How?  I mean,  how do you actually see that?

The most we have seen publicly announced was 150 million.  Even that is
still vapour-money.

Has anybody seen a penny of that 150 million?

>I would like to see a proper estimate of the current rate of input to IT services.

Me too ;-)

>I would be surprised if it came out at less than 0.5 Billion each year, say 1.25%.  I am suggesting that it needs to be roughly doubled.

That wish,  my good friend,  shall remain wishful thinking for the time
being and probably for a long time to come,  if not forever.

>my kind of thermo-dynamic approach, looking at what goes on 
>elsewhere, is a proven effective means of assessing likely scales of 
>expenditure.

I have no problems with that at all and I understand the process fully.

>That doesn't mean that either is wrong;  just different ways of looking at different aspects of the same overall problem, namely "How to make the NHS more effective"

Here we diverge,  Mike.

I think the overall problem,  in common with all developed countries
is: 'how to afford health care?'.

In the case of the UK,  the problem that *any* government has to
tackle,  sooner or later is:  'how can we afford universal free access
to health care?'

Here are some prognoses about various health care systems from 'The
European' (27 Jul-2 Aug):

- Germany:  in rude health
- France:  sick and broke
- Holland: well but mean
- Sweden: fair
- Italy: on last legs
- Britain:  50 and feeling it
- Spain:  needs a siesta
- America: good but costly

The cost of health care in Britain is set to rise on a divergent course
from earnings.  There will come a crunch point.  The Poor Law will be
enacted again.

Yes,  by all means spend whatever it is on NHS IT.  It really makes
little or no difference when we continue to pretend that God is an
Englishman and all is well on earth :-)

I never actually said what should or should not be spent on this or
that.  My mind is on other things.  Like,  *the processes* I am
interested in are about planning for that crunch point! 

Ahmad



________________________________________

Dr Ahmad Risk
http://mednetics.org
home: +44 1273 748198
work: +44 1737 240022
fax:  +44 1737 244660




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