Re: Warning of major NHS IT overspend

[Roger Hird <[EMAIL PROTECTED]>]

In article <[EMAIL PROTECTED]>,
   Brian Beesley <[EMAIL PROTECTED]> wrote:
> > I think it will be an "at need" system - new records will be added to
> > the database, but old records will only be transcribed when there is a
> > good reason to (for instance, it is possible the "few sheets of paper in
> > a brown envelope" will be transcribed when you move GP, by the simple
> > process of sending the transferred files not to the new GP, but to the
> > central office) 

> The last couple of phrases are one of the bones of contention.

> Why does everything have to be stored centrally?

> Why cannot the files be retained where they are and links made to them
> in the new GP's system?

I'm cautious about getting too involved in these exchanges (I'm really an
amateur) but my own experience of central databases (of the classic sort
on old fashioned mainframes) is that although they sound elephantine and
inflexible they do tend to work and to be "secure" in the I and A sense.

Regarding distributed databases, I was briefly "senior user" for a major
IT project in a government department, which, first, was going to give
everyone networked PCs (that bit worked well and ran on time and to
budget).  The second  phase (I'd moved on then) was going to evolve from
the "old fashioned" national central database to decentralised record
storage around the PC networks, with many records kept on local systems
and, in this case, the promise of some degree of local freedom in the ways
in which local records could be kept and accessed.

Phase simply two proved too difficult, none of it ever happened, and for
years afterwards the central databases continued in use, accessed through
windows on the PCs emulating dumb ICL terminals.  Ex colleagues I've
spoken to still think that trying to merge data kept on a range of local
systems, even if theoretically possible, is extremely difficult and
unreliable.

I think I'm saying that if you want a system giving full access to records
from a range of sources (GP, hospitals, etc) a central database is
probably still the only way that you can do it reliably.

RogerH

-- 
Roger Hird
[EMAIL PROTECTED]
http://www.argonet.co.uk/users/roger.hird
Running Voyager 2.07 and RISCOS 4.02 on an Acorn StrongARM RiscPC