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Commissioning power? More hassle!

General practice IT is 20 years ahead of hospitals. For those of us who are not nerds it has been a slow and painful process. This is normal for any development in IT. The techies tell us what we want and need ­ instead of listening ­ and we adjust.

That said, through repeated feedback we have made some considerable progress over 20 years. Many GPs are now completely paperless with excellent quality data and fully-integrated IT systems.

Hospital consultants would die for a system like ours. Their systems are haphazard, confused and non-integrated. The data is often confused, duplicated or disconnected.

So why has the new IT project completely ignored the expertise of GPs who are the one success story in NHS IT? There are some blindingly obvious weaknessess in the NPfiT that no one is talking about. The most worrying is: who is responsible for the data? Data quickly accumulates and someone (not an IT system) has to take responsibility for it, both to resolve identification issues and to sift the data so that it is stored in a useful and understandable way.

The latter is a clincal task and GPs have alot of experience in this area. So why haven't they been asked?

There are other potential showstoppers. On a system with potentially a million end users, is confidentiality really possible? Do me a favour and keep my records off it.

We already have an alternative in the internet that is free and has all the same advantages and disadvantages. So we plan to spend £6 billion on another Big Bang IT system that probably won't work and the potential users don't want and haven't been consulted on.

It makes the Millennium Dome look like a sound public investment. Does Gordon Brown know he could save a few bob here?

Dr Matthew Shaw

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