Leading Article: Prescribing the right computer

TWO YEARS ago the National Audit Office pointed out that the National Health Service could save millions of pounds by buying some of its supplies centrally and in bulk. Now it emerges that the same mistakes which were made with nappies and cornflakes are being made with computers. Almost pounds 70m has been spent on computer equipment by GPs in the past two years: the Department of Health (which is to say the taxpayer) has subsidised this, but no attempt has been made to save money through bulk purchasing or to draw up the sort of simple central guidelines which would ensure that the money was well spent.

Clear central decisions are especially important here because money wasted on computers is wasted several times over. First there is the cash, taken from other, more deserving causes, which is spent on systems that cost far more than they might have done if bought in lots of a thousand rather than dribs and drabs. Then there is the time invested in choosing wrongly; the further time invested in learning how to use a system that never quite does what was expected; finally comes the time and money required to start all over again.

The health service is meant to be evolving towards a decentralised and flexible internal market, but such a market, if it is to work well, will be crucially dependent on plentiful and cheap information of the sort that can be supplied only by computer networks.

There is one respectable reason for the Government's inaction so far: any attempt to impose a single hardware standard on GPs would invite disaster. In the fast-moving and confusing world of computer technology, any government that attempted to bet large sums of taxpayers' money would be almost certain to get it wrong. Yet there is a great deal that could and should be done to help GPs to make informed choices. At present, as our report today makes clear, many doctors feel lost in a cloud of confusing and, for all they know, incompatible choices.

The first thing that the department should do is to make it quite clear why it wants GPs to buy computers in the first place. What are they meant to achieve? Computers that do not communicate with each other are almost useless. Yet there seem to be no national standards that would, for example, enable GPs to link up with hospital systems. These are technical matters, which is why doctors should not have to bother with them. Instead, the Department of Health should establish standards for the exchange of information.

Once it has drawn up guidelines about what computers are expected to achieve, it should also make a shortlist of approved software and hardware that could be used to do the job. Items on the approved list could be bought in bulk, which would generate considerable savings in time and aggravation as well as money, as any doctor coming up against a problem would know that other users had been there before and could help.

Doctors are trained in medicine, not in computer science. They deserve expert guidance in this field - not least because the results of their individual decisions must work well together if the internal market is to deliver the goods.