Hi Folks,
I have just been reading Ross Anderson's excellent web pages on cryptography
and security issues at
http://www.cl.cam.ac.uk/users/rja14/

It includes his review of the  review of computerisation of the UK NHS and
the conflicts that arose between the medical and civil service
administrators."Information technology in medical practice: safety and
privacy lessons from the United Kingdom"


Ross has also reviewed cryptographic protocols and may be of interest in the
light of the "hash " discussions currently underway

One particular statement he made some years ago will sound rather  familiar
to this group:

"Building ethical systems is thus a matter of will rather than technology.
This brings us to the last of the
main lessons learned in the UK - an inappropriate systems culture, such as
that of a civil service
department, can fatally undermine the will to build systems properly. Safe
clinical systems require a
design team that can operate openly with a high level of user collaboration
and consultation, just as in
avionics or the nuclear industry. Above all, one must avoid organisational
mistakes that allow clinical
systems development to be hijacked by administrators; many of the NHS's
problems arose from the
fact that its computer department was controlled by the Department of Health
in London whose
principal goal was cost control. Administrative concerns thus naturally came
to dominate the thinking
of its management.

The problem now facing healthcare information technologists in the UK is how
to climb out of the hole
we find ourselves in. We need an environment in which doctors, nurses and
other healthcare
professionals can tell system engineers what they need, and the engineers
can get on with the job of
building it. But given all the interests vested in the old system, this is
turning out to be easier said than
done. "


Best Wishes
Chris Fraser
The Littlefish Health Project
e-mail: [EMAIL PROTECTED]
Website: www.littlefish.au.com
Mail List: www.egroups.com/list/lftalk/

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