NHS 'wastes millions' on computers for GPs: Doctors' systems are ineffective and incompatible, experts say. Tim Kelsey reports
Tuesday 04 May 1993
In the last three years, the Department of Health has spent an estimated pounds 86m on computers for GPs, for no significant improvement in administration. In spite of pleas from the medical profession, the Government has refused to develop standardised national computer systems and left individual GPs with the responsibility of choosing computer hardware and software.
Incompatibility of systems means that GPs are unable to exchange information with each other, hospitals or the Department of Health.
Dr David Tod, president of the National Association of Fundholding Practices, which represents GPs who have opted to become fundholders, said: 'We couldn't persuade the Government to produce national software. It didn't have the knowledge, interest or inclination.'
The incompatibility of GPs' systems means the Department of Health still has to rely on manual collation of national statistics. Doctors fear that the ability of the department to identify and respond quickly to outbreaks of epidemic disease, like meningitis, is no better than it was before the introduction of computers.
Dawn Primarolo, a Labour health spokeswoman, said: 'Thalidomide would have been picked up if there had been a network available. There is still no adequate way of providing national figures on immunisation . . . The solution is a system whereby all doctors and clinics and hospitals can communicate at speed.'
The Department of Health does not even have any idea of the extent of computerisation among GPs. It launched a survey this month to try to find out. The last survey, in 1991, revealed that 63 per cent of GPs had computers or shared facilities with other practices.
The department reimburses doctors for their expenditure on computers. In an attempt to encourage GPs to become fundholders, they can claim for all their costs. Non-fundholders are only able to claim 50 per cent.
An analysis of the most recent Department of Health figures shows that, on average, fundholders were claiming pounds 20,180 - four times the amount given to non-fundholders. Fundholders accounted for about 11.2 per cent of all GPs by April 1992 - but received nearly 34 per cent of government computer expenditure. According to Dr Tod, the proportion of fundholders is now 25 per cent, and the department forecasts fundholders will receive more than 45 per cent of its expected pounds 34.3m outlay on computers in 1992-93.
Nick Gill of Systemscraft, a computer consultancy, estimates that computer costs could have been reduced by more than half if there had been a government tender for a national system. 'This is an opportunity of volume purchases being literally squandered,' he said.
One non-fundholding GP in London said there were 104 software packages available to GPs. The Department of Health questionnaire identifies 41 - most of which are not compatible with each other. And while most GPs keep written records as a back-up, it is not mandatory.
Dr Tod believes the Department of Health is beginning to realise the need for compatibility and better control of information services within the NHS. But upgrading systems to make them communicate with each other is likely to cost the Government as much as it has already spent.
Leading article, page 17
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