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If only because no-one will do it, here's an attempt to piss into the prevailing wind on GP-UK. ----------------------------------------------------------------------- Starting point: improving communication will be a good thing for healthcare. Assumption: developments in technology can be exploited to improve communication. Tricky bit: the NHS family operates a myriad of internal computer systems. Making them all use the same system is not an option. Thing to avoid: anarchy of incompatible communication. Reason: B cannot receive anything from A, greater costs to the NHS as a whole, inability of local clinicians to judge whether local standards are safe. Solution: specify the bits in between these computers, i.e. the standards which must be used if A is to be able to receive something sent by B. Helpful extra: make available communications services which incorporate the said standards and which can be bought by A or B. Another helpful extra: use the communication infrastructure to also offer web stuff. Insurance: set up more than one communication service to ensure competition, but make sure that they inter-operate. All done by: pan-NHS and profession organisations. IMG and Royal Colleages. Who else? So far, so good. Or can this logic be challenged? No? Well then the unhappiness must be to do with making it happen. Several categories of unhappiness exist: 1. The standards are daft. Anyone got better standards which meet basic criteria such as proven robustness and availability/ cheapness of software products which support them? 2. Security and confidentiality related to communication is a worry. Well, it's now being addressed. Leaving the major threat: dodgy practice internal to each organisation. 3. The wrong suppliers are offering the communications services. Are their contenders to BT and Mercury operating nationally, especially when they submitted the best tenders? 4. The prices are staggering (at last, says Ahmad!). The prices quoted by Ahmad certainly are staggering - if compared to Demon, Compuserve, etc. But the key thing is that these prices are for a lot more than Internet, which essentially is offered as a freebie. So the comparison is spurious. And anyway, considered NHS-wide, such prices are maybe of the order of 0.00001% percent of the total budget and save many times that amount while improving healthcare. 5. The NHSweb, being an intrAnet ring-fenceded by firewalls, is the wrong approach. How else to safely get helpful web page stuff to the clinical coalface? 6. Not enough's being done to ensure everyone in the family gets hooked up. (if it's such a good idea, then why not come up with the dosh to kit everyone out and pay their running costs?) Head office doing this means no local control. Plenty examples of previous disasters of that ilk. PS I don't work for IMG and can't therefore speak for them. Scotland has it's own strategy. In many respects the words above apply. ;-) Alan Hyslop Computing & IT Strategy Management Executive, NHS in Scotland. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%