The benefits for patients have included the achievement of record coverage levels for immunisation and cervical screening, and improved monitoring of prescribing. A clinical coding system, the Read classification, has been developed in general practice and adopted by the Department of Health for use throughout the NHS.
These achievements have occurred with practice-based computers, before the introduction of computer networks. To say that 'computers that do not communicate with each other are almost useless' is nonsense. However, the full benefits of computerisation will indeed be seen only when information can be transmitted from computer to computer, and the Department of Health has therefore sponsored a number of trial projects, and is defining communication standards and giving GPs guidance about the specification they should look for when purchasing computers.
Family doctors are independent contractors who make their own choices about investment in their practices. Some 47 per cent of practices were already computerised as a result of the commitment and enthusiasm of GPs by 1990, when a scheme for the partial reimbursement of GPs' computer expenses was first introduced. The imposition of central purchasing would have restricted choice and inhibited development and innovation in what has proved to be a very healthy market. It is far better to allow GPs to purchase systems that meet the needs of their individual practices - a policy that has proved of great benefit to practice organisation and patient care over the past decade.
J. W. CHISHOLM
General Medical Services
British Medical Association
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