Adrian Midgley wrote:
>
> Health service administrative organisations are changed a  little slower
> than underwear, but are far from constant.  And the persistence of
> information between two avatars of essentially the same admin-org is
> similar to that on underwear.
>
> And that is the way the admindroids taking control of each new spasm
> like it - each wheel is reinvented, every 3 to 5 years.
>
> I agree about the technical reasons, but continuity is a huge merit.
>   
no argument there; I am thinking about:
a) security: the main mode of information theft/hacking is physical 
theft of media/computers. Easy to do in many GP surgeries
b) 24x7 IT support, OS & tool upgrading, backup, disaster recovery, etc. 
Too hard for many practices to do reliably.
c) the level at which tools and services are paid for. Each individual 
GP clinic could do it, but one level up is likely to be better.

My view would be to make PCTs do the job we want them to do in the new 
world....

- thomas

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