BRITISH COMPUTER BLOWOUT

Doctors are cautioning that a failure to consult staff and patients over the new multibillion-pound NHS computer system will add to a 2½-year delay announced by ministers. The British Medical Association (BMA) said that patients should be asked for consent before their details were put on the national electronic database. But the Government, which is planning to presume patient consent, said that this would take up extra time for doctors on a system already suffering serious delays.

The price of an electronic system to keep records is set to rise from 6.2 billion pounds to about £20 billion, Lord Warner, the Health Minister, said yesterday. The system, which will computerise records for 50 million patients, will not be ready until 2008, and is likely to be criticised in a National Audit Office report next month.

Hamish Meldrum, chairman of the BMA’s GPs Committee, said: “Family doctors are concerned that this scheme . . . is trying to do too much too quickly and could threaten patient confidentiality.” The program, Connecting for Health, has four main projects: online booking; centralised, electronic medical records; e-prescriptions; and fast network links between NHS organisations. A spokesman for the Department of Health said: “The NHS IT program is one of the largest IT projects in the world and will revolutionise patient care. As with any large, complex program there will be difficulties.”

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U.K.: Patient surgery choice extended

Surprise! A choice between a dirty State-run tweedledum and a dirty State-run tweedledee is not attractive to patients

Patients are to be given a choice of hospitals across England for operations as a key NHS reform is expanded. Ministers will announce later that the 32 foundation trusts will be added to the list of local hospitals patients currently choose from. From the start of this year, people have been able to choose from at least four hospitals for elective surgery. But patient groups said people tended to want to stay local so the extra choice would not mean a great deal. Patient choice has been one of the government's key reforms to make the NHS more patient-friendly.

Since January, patients have had a choice of at least four hospitals for treatment, one of which can be a private centre. Many primary care trusts included more than the minimum of four on their lists, to which they will now add the 32 foundation trusts, top performing hospitals which have been given more autonomy than other hospitals. By 2008 patients will be able to choose any hospital in the country.

But despite the government's enthusiasm for the reforms, opinion polls have consistently rated it as a low priority for patients. The Department of Health's own research published at the launch of patient choice in January found that eight out of 10 knew little about it. And only 14% would be prepared to travel outside their area for treatment.

The roll-out has also been hampered by delays to the 6.2 billion pound IT upgrade. As part of the project, a system called choose and book was meant to set up to allow appointments to be made online. But only a quarter of GP surgeries had the system in place at the beginning of the year and a fifth still do not have it, the latest figures suggest.

Patients Association chairman Michael Summers said: "We were very much in favour of patient choice when it started. Patients have told us that they appreciate having choice of local hospitals. "However, it also seems they are not all that interested in being able to go to hospitals anywhere in the country. "People don't want to travels miles and miles. There are exceptions where this will not be the case, but on the whole extending the choice does not mean a great deal to many."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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