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Well Darlings,

According to a recent National Audit Office (NAO) report the National Programme for NHS IT must get buy-in from NHS staff and win the approval of the general public if it is to succeed. The originally estimated £6 billion 10 year project has already slid to around 2 years behind schedule (and that's after only being underway for 2 years!) and in these NHS cash-strapped times there are many who fear the money won't be spent on the implementation and training required that (at present) is estimated to bring the total up to £12.4 billion - although some believe between £20 billion to £30 billion might be more realistic.

In April an open letter from 23 academics to the Commons health committee called for a halt to the project pending an independent assessment of its technical viability, and last month Professor Peter Hutton claimed the contracts signed in 2003 did not buy what doctors wanted. Professor Hutton was the NPfIT (National Programme for IT) chief medical adviser until 2004 and described his time there as: "like being in a juggernaut on the M1 - it didn't matter where we went as long as we arrived on time."

At present the names of software companies are flying through people's minds faster than they can learn how to spell them. Cerner claim to have signed a contract with Connecting for Health prime contractor Fujitsu Services Ltd to replace IDX Systems as the software supplier in London and southern England. Now, if you're really into all this you will remember that during the initial bidding between 2003 and 2004 Cerner was shut out, being thought to be "out of its weight class against some of the world's biggest IT companies." Anyone now thinking it must have been on the steroids since those days?

To date, in London the software has been installed in only one new NHS trust. Meanwhile in England's East and North East regions, iSoft, the major software subcontractor there, is reported as also facing difficulties with, we're told, "a patchy implementation record." The chief executive of the prime contractor Accenture in the two iSoft regions, Bill Green, says he is watching the iSoft situation closely, and tells us there are "a series of alternatives and we're prepared to go with those if it becomes necessary." No doubt that will mean even more names to learn how to spell.

Now as if all that turmoil wasn't enough, today we hear the whole idea of a national database is being criticised by doctors, claiming the project will harm patient confidentiality with there being serious issues of security once the 50 million patient records are all stored in such a way. Consultant Michael Foley, a consultant anaesthetist at the James Cook University Hospital in Middlesbrough, is reported as saying: "Workers in hospitals or general practice surgeries might seek inappropriate access to medical records because of curiosity or malice, commercial gain, or simple error. If screens are left on in open areas or passwords compromised, tracing of access for disciplinary purposes would be difficult. If challenged after a breach of security one could argue that data were requested accidentally. I occasionally enter a wrong number into the radiology viewing system and see unwanted images. Such errors are inevitable." He suggests that all the large money being poured into the scheme would be better spent improving patient care. Whoops! Is all this going to turn into: "How to Build a White Elephant in Ten-Plus Years, and in Several Hundred Not-Too-Easy Stages"?

I, personally, wouldn't be too worried about my medical records accidentally being seen by someone in error, although I appreciate there will be many people who would be. On our side of the fence there will be some people in the closet that might fear what those records could reveal, and then there will be those, on both sides of the fence, who won't want their HIV status bandied about. The records will contain many intimate details about people that some will wish to keep very private - things from pregnancies right through to cancers, and including such as past or present treatments for mental health problems.

No, my primary worry is that such a system might be extremely prone to error. Mr Foley admits that he occasionally enters a wrong number and views unwanted material. We all know of the long hours worked in the medical profession, and how often doctors are overtired, don't we? Knowing how easily I make mistakes on the computer when tired, that worries me. At present my doctor knows all about me, and he knows me. If I urgently need medical attention elsewhere in the country they will find my records in association with my doctor's name and the chances of it not being my record turning up are pretty slim. Under the database system where a number will be entered, if that number was entered incorrectly and you were unlucky in having a fairly common name, the odds of treatment being based on a wrong record may not be that great. When we're all heaped in one big pile, I foresee many errors. How often do the DVLC get it wrong? And they don't give blood transfusions!

"Oh, you're not Sole with an R?"

"No, that's not me, doctor. That sounds more like you!"

Mentioning the DVLC has made me think of MOTs. I see doctors may have to undergo a similar system of "roadworthiness" tests soon. In the wake of the Harold Shipman murders, the Government's Chief Medical Officer, Professor Sir Liam Donaldson, has said that doctors may soon have to prove they are safe to practise every five years, with specialists in high risk fields undergoing more extensive testing.

"Good Doctors", the first major review of medical regulation for 30 years, and highly critical of the GMC and medical regulation arrangements, has come up with 44 recommendations to improve matters. One proposal calls for doctors wishing to remain on the register, and therefore able to practise, to regularly renew their licences - with specialist doctors or GPs having to re-certify to stay on the register. In both cases there would be the need to prove fitness to practise, rather than the present system where practising may continue until there is a cause for concern.

It all makes good sense to me - that is providing this MOT is managed better than the one is for vehicles. When you've taken your car to the same garage for two consecutive years, and seen a different mechanic each time, but have been told on both occasions: "It just needs some new trunnions to pass," you get a bit sceptical about the validity of such tests. How many people like our consultant Michael Foley might feel the pressure to keep their mouths shut and to tow the official line in order to pass their test? A new set of trunnions, or even bunions, wouldn't help him much, would it?

This, like the NHS database, might look good being planned on paper, but in practise . . .?

Moving on. If you've been enjoying all the good weather we've had recently, but have found difficulty sleeping those hot nights, then give a thought to Swindon pensioner, Doris Marsh, whose council flat has averaged 100F (43C) for six years, even in the depths of winter. So hot is it in her apartment that her friends and family refuse to visit her. The heat apparently originates from hot water pipes in the walls and ceiling that pass by on their way to serve the other 89 flats in her block. So far Swindon Council have spent £80,000 trying to remedy the situation, without success.

I'll bet the plans for those flats looked excellent - on paper!

And now I really am taking the proverbial: I had to laugh on seeing the news that 2,618 toilets and urinals destined for the new Wembley stadium - a building with more toilets than any other in the world - have all had to be sent back because they bear the manufacturer's name, Armitage Shanks, and so contravene the stadium's strict non-advertising rules. I'll bet that was a rule that looked good too - on paper. I wonder if it will apply equally to coins of the realm and banknotes? They too are commodities that advertise. They show our monarchy and bear the name of the Bank of England (mostly) - but I bet they'll be used in the stadium. They won't be refused!

Finally, and still on the subject of urinals: I see there's a couple of those Kisses type going cheap from a Dutch branch of McDonalds. This follows an American tourist complaining about them to the company's head office once back home. The mouth-shaped urinals, designed by the Utrecht-based firm: "Bathroom Mania!" were once to be installed at New York's John F Kennedy airport, but following public pressure Virgin Airways was forced to scrap those plans. I wonder how good that idea looked on paper?

Considering the Funny Girl's logo, I reckon Basil should snap them up and install them here. I'm sure they'd feel more at home in Blackpool!

Ouch!

See you next week . . .

"The Bitch!" 14/07/06.

About the Author

"The Bitch!", a weekly UK News Review column, is hosted by the author and columnist Michael Knell. These articles appear on the Blackpool Gay Directory website, but are not specifically gay in content. More information on the author: http://www.michaelknell.com and on the directory: http://www.astabgay.com.