15 March 2007

IT's Got to be Local and Open

Nice story in the Guardian today about a local UK health system that works - unlike the massive, doomed, centralised NHS system currently being half-built at vast cost. It makes some important points:


Next week the annual Healthcare Computing conference in Harrogate will buzz with accusations that the national programme has held back progress. There are two reasons behind this charge. First, under the £1bn contracts signed early in the programme, hospitals have to replace their administrative systems which record patients' details with systems from centrally chosen suppliers. As this involves considerable local effort for little benefit, progress is painfully slow. The second problem is the potential threat to confidentiality arising from making records available on a national scale.

Quite: if there is no local benefit, there will be no buy-in, and little progress. Think local, act local, and you get local achievement. The other side is that if you impose a central system, security is correspondingly weaker. Hello, ID card....

Of course, there are many areas where you want to be able to bring together information from local stores for particular purposes. That's still possible - provided you adopt open standards everywhere. Hello, ODF....

2 comments:

BirminghamDan said...

Hi Glyn... Interesting to hear your view about localisation. It's clear how it can be better than stiff nationalist regimes. But I think the best solution has got to incorporate both central governance and regional governance, with a seamless flow of authority, focusing on empowering without taxing the end user. Kind of like the Wikipedia style. Do you see a Wikipedia-style NHS hitting the streets in the 21st century?

glyn moody said...

I think you're right: there has to be some central government input, not least because they're paying the bills. The problem is that the current approach is centralisation above all - notably in insanely huge, and insanely insecure projects like the ID card database. We need a good swing in the other direction before there will be any hope of balance.