Letter: Doctors' computers programmed for success

Sir: Your leading article and Tim Kelsey's report (4 May) on the computerisation of general medical practice give a deciedly misleading impression of what has undoubtedly been a remarkable success story. Fourteen years ago, only four general practices used computers. Today, more than 75 per cent of GPs possess computers, and more than 40 per cent use them in the consulting room. No other country in the world can demonstrate such a high uptake of computers by doctors in clinical practice as the UK.

The benefits for patients have included the achievement of record coverage levels for immunisation and cervical screening, and improved monitoring of prescribing. A clinical coding system, the Read classification, has been developed in general practice and adopted by the Department of Health for use throughout the NHS.

These achievements have occurred with practice-based computers, before the introduction of computer networks. To say that 'computers that do not communicate with each other are almost useless' is nonsense. However, the full benefits of computerisation will indeed be seen only when information can be transmitted from computer to computer, and the Department of Health has therefore sponsored a number of trial projects, and is defining communication standards and giving GPs guidance about the specification they should look for when purchasing computers.

Family doctors are independent contractors who make their own choices about investment in their practices. Some 47 per cent of practices were already computerised as a result of the commitment and enthusiasm of GPs by 1990, when a scheme for the partial reimbursement of GPs' computer expenses was first introduced. The imposition of central purchasing would have restricted choice and inhibited development and innovation in what has proved to be a very healthy market. It is far better to allow GPs to purchase systems that meet the needs of their individual practices - a policy that has proved of great benefit to practice organisation and patient care over the past decade.

Yours faithfully,

J. W. CHISHOLM

Deputy Chairman

General Medical Services

Committee

British Medical Association

London, WC1

6 May