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A tangle of IT contradictions

It’s been a week when ministers finally flicked the off-switch on one troubled IT project, and appeared to accept another was being superseded by something sleeker and more modern

It's been a week when ministers finally flicked the off-switch on one troubled IT project, and appeared to accept another was being superseded by something sleeker and more modern. The previous government's flagship HealthSpace site became an early casualty of the coalition's information strategy. Ministers are just as keen as their predecessors to see online access to medical records and email access to practices – but it's going to be done at a pace, and to a specification, that fits GP needs. And the needs are there – some GPs are already exploring use of Skype for online consultations, outside the auspices of any Government IT project.

Then there's the Summary Care Record – the 100-million pound IT project to eat them all. It officially continues to hum along, like some giant, room-sized prototype computer. But the care record was mysteriously absent from the information strategy, and IT enthusiasts and sceptics alike are declaring it has been rendered largely redundant by the rampaging technological advances of the private EMIS Web system.

All this is consistent with the Government's ideological acceptance that a series of independent providers of IT systems are far more likely to quickly and effectively meet the needs of users than a giant, centrally dictated programme. So have we seen the end of health IT systems being imposed upon general practice from on high? Sadly, not just yet.

Over the last few months, Pulse has been tracking the slow decline of another unwieldy Government IT system – Choose and Book. GPs made perfectly plain their distaste for Choose and Book right from the start, so it should hardly have come as a surprise that once payments for its use disappeared, so did referrals through it – down from 57% in 2010 to just 50% now. The Government's response, according to its new doctrine of ‘user knows best', should surely have been to open up the market to new providers of choice-based referral systems, that maybe were user-friendly enough not to need delegating to the receptionist. Instead, in the same week the Government released its information strategy, it put out a new document on choice – threatening that GPs who did not use Choose and Book would be forced to phone round providers individually to check appointment availability.

‘Where Choose and Book is not being used, formal requirements to support greater choice for patients will have to be met by alternative – potentially labour-intensive – methods,' the document stated, ominously.

So one moment GPs are sufficiently IT-literate to make informed choices over systems for electronic records and online consultations – the next they are the recipients of blunt threats over Choose and Book. The Government's IT policy remains a tangle of logical contradictions.

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