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At the heart of general practice since 1960

Battered GMC needs to box more cleverly

Biggest pain in posterior ever

It's not going to work. Forgive my pessimism, but how many GPs really do have confidence in their computer system?

I am of course referring to the bold and ambitious plans of the National Program for Information Technology (NPfIT). I don't hold anything against the idea of networking 30,000 GP and 300 hospitals. I just doubt that it is possible in any form outlined. Spending £7 billion or so from the public purse will one day seem like a long lost distant bargain. It will probably cost five times more just to get anywhere close.

Surely this has been trialled and at least tested locally? I'm afraid not. And if precedent is anything to go by it won't be either. Nothing like this on a much smaller scale has ever come close to working.

There will always be huge technical issues. Hospitals and GP surgeries have always been light years apart in electronic terms. For example, we receive lab link results to our system. On a good day this works fairly well, but sending X-ray requests or electronic referrals back works very badly. Recently this got a lot worse and was abandoned when the PCT changed our e-mail server. Simple tasks rapidly become hugely time-consuming when they go wrong.

When it all goes wrong

And when all the technical gizmos go wrong, who is going to provide support for this? Until recently we all phoned our service provider and they somehow managed to tweak or breathe life into the server. Now the margins are blurred and it is becoming common to be caught between the telephone jungle of the provider and the PCT support desk.

Several of the big players have booked their place on this train ride by offering to provide a spine and regional platforms. It was looking good when we even had our N3 broadband installed a few weeks back. The guy had to come back five times ­ you have never seen such a mess of cables. We have a nice new box with flashing lights but with no sign of any connection.

And look at what you've got already. Most surgeries have servers, networks and workgroups cobbled together on a variety of Windows platforms and office editions. PCs in a doctor's surgery are like a lucky dip selection, rarely get serviced or have their programs updated. I bet less than a third of NHS computers have working antivirus protection.

Haunting a generation

Worse still is the issue of training. I bet training has been included in the headline figures. Training money is always included in what you've already had! Computer skills in this country are still pretty basic and the thought of booking a web appointment in less than 10 minutes is pie in the sky for most of us.

I think I underplay this when I say that this is going to be the biggest pain in the posterior for the rest of our working lives.

Come to think, it will probably haunt the next generation of health ministers as well.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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