AR wrote:
>>It's the 'how' that's worrying me a lot. The documents don't actually
>>say where the money is coming from, unless I missed it!
Many clinicians, especially GPs, wanted eg NHSnet costs to be "free"/
"ringfenced"/ "centrally-funded" In a cash-limited NHS (with the lowest
annual uplift we've seen for many years) these terms only mean that someone
central has decided that they should be spent on IT rather than on other
expenditures intended to improve patient care. It is not all clear that this
is a better way of spending money on patient care than leaving it up to
clinicians closer to the patient.
Economic arguments favouring the central decision include traditional
econonomies of scale, and, interestingly, networks where there may be a
common good which is linked to the number of other users. (See Justin Keen's
paper in the BMJ.)
However bandwidth is now cheap and ubiquitous...and we have only ever had one
comms project that was significantly troubled by a lack of network.
Economic arguments against the central decision can be found in most editions
of Computer Weekly or the reports from the Public Accounts Committee.
Jonathan Kay
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