Jeremy Laurance: Doctors' illegible notes will be with us for years

For the past 30 years the NHS has been trying to modernise its communications and update its computer systems and each time it has ended in disaster and cost millions. The latest attempt, a £12.7bn project to link the country's 35,000 GPs with 300 hospitals and provide electronic versions of all patient medical records, has been similarly blighted by delays, cost overruns and cancelled contracts.

Tony Blair, then prime minister, declared in 1997 that the electronic record would mean that "if you live in Birmingham and have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you". The plan nearly foundered because of fears about confidentiality. The British Medical Association insisted patients must give explicit consent to having their records posted online. That dispute was resolved when it was agreed patients would be asked at each consultation if the clinician could look at their record.

But the programme has since been beset by technical difficulties with connecting so many disparate users. The NHS is the largest employer in Europe, dealing with millions of patients each day and poses one of the toughest IT challenges in the world.

The original aim was for the systems to be complete by 2010. Smaller installations have gone reasonably well but the major city hospitals have proved too big a nut to crack. Today's figures revealing just 160 organisations operating the electronic record – most of them GP practices – shows just how far there is still to go. That well-thumbed packet of barely legible doctors' notes will be with us for years yet.

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