> 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!
> JK wrote
> 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.
The problem as I see it is that IS developments are breaking down all
the old institutional boundaries or at least need to if the
macro-economic benefits are to be realised. Unlike the internet where
development can expand into areas where new alliances / institutions
can be freely developed in health we have a mature institutional
structure designed to be robust with well developed defensive
reflexes which inhibit radical change. Paradoxically the
introduction of market style micro-economic mechanisms into the NHS
have probably made it more resistant to change than ever -
necessitating more political pressure (ie financial manipulation) to
drive through change.
The question which we are presented with is to
resolve the issues of necessary central control and direction (eg
standards to allow interworking) with devolved ownership and
delivery. All this in a situation when the number of people with the
breadth of knowledge to understand the problem is probably
in the order of a couple of thousand or so.
"I have yet to see any problem, however complicated which when you
looked at it in the right way did not become still more complicated."
Poul Anderson
Life is going to be very interesting for eth next decade or so.
Rick
Dr Rick Jones
Director of Chemical Pathology and Immunology
Institute of Pathology
Tel:(44)-113-233-5677
Fax:(44)-113-233-5672
http://www.leeds.ac.uk/acb
http://www.ifcc.org
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