Letter: Computers in the NHS: compatibility, communications and confidentiality

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Sir: I was surprised to read (4 May) your report and leading article claiming that the National Health Service 'wastes millions' on computers for GPs. The cause of my surprise was how little the Independent appears to know about what is going on.

Let me address the claimed 'waste'. This is based on two premises: first, that considerable savings could have accrued had the centre purchased uniform software and hardware, and second, that the systems GPs have bought are useless because they cannot all communicate with 'each other, hospitals and the Department of Health'.

Past history has shown that centrally determined products rapidly fail to serve their purpose and become dated. Your leading article itself recognises that this way 'invites disaster'. GPs are served by a competitive market. That is the best way of ensuring value for money.

The prime purpose of GP systems bought to date has been to improve the internal processes of practices. This they have done well and many practices will extract even more from them as experience builds. They were not bought for electronic communications with hospitals and others. The real waste would have been to invest in that area when

neither GPs nor hospitals were ready. The facilities would have lain idle.

However, the time is now upon us when GPs, hospitals, family health service authorities and others are looking to build up electronic communications in the coming years. In anticipation of that move, and the increased complexity it entails, the NHS Management Executive has a comprehensive programme to ensure national standards:

national requirements for GP systems were published on 30 April. From 1 April 1994 compliance will be assured through an accreditation scheme and accreditation will be required for GPs to be reimbursed for part of the costs of purchases;

because of increased complexity an evaluation scheme for GP schemes is to be inaugurated during this year;

the national standard for electronic messages has been decided (May 1992) and standard messages for GP referrals, discharges etc, are being developed;

trials are under way for electronic claims and patient registration between GPs and family health service authorities, and software from suppliers is being tested. National roll-out of the system begins next year.

All these initiatives have the backing of the medical profession and of suppliers, and have been discussed at a number of national consultative conferences to which the press have been invited. Where was the Independent?

Yours sincerely,


Under Secretary of State

Department of Health

London, SW1

5 May