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UK Health Service Fears Huge Legal Fight Over Unwanted Contracts

samzenpus posted more than 3 years ago | from the read-it-before-you-sign-it dept.

Government 127

DMandPenfold writes "The Department of Health is concerned that Fujitsu, CSC and BT would team up against it in a multibillion pound legal fight, should it decide to scrap the disastrous NHS National Program for IT. Fujitsu walked away from a £709 million contract in 2008, and remains locked in legal wrangling with the government over claims for the majority of the value. Today, MPs urged the government to seriously consider abandoning the program and therefore to consider terminating the remaining CSC and BT contracts, worth £3 billion and £1 billion respectively."

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related? (2)

rbrausse (1319883) | more than 3 years ago | (#36983070)

I read the summary and "disastrous NHS National Program for IT" reminds me of UK Taxpayers' Money Getting Wasted On IT Spending [slashdot.org] .

both sides are to blame here - government agencies are often really bad in project management and contractors are abusing this...

Re:related? (4, Insightful)

TheRaven64 (641858) | more than 3 years ago | (#36983144)

This is a different kind of problem. The government generates huge sets of requirements and then gives a contract to a company with a track record of failing to meet the requirements, then acts surprised when the project fails.

The NHS system is particularly irritating, because their current system is a room full of folders containing paper. It would be trivial to deploy a database system to store the more relevant information (although the storage requirements if you want to store x-rays and CT scans get insane) in a way that's easy for doctors to access. The software is only a couple of months work for a single programmer and could be deployed by the existing IT staff. It would then make life easier for everyone involved.

Instead, the government specifies a system with an insane list of requirements for a huge number of unusual use cases, and then wonders why the project fails.

Stupid start to it anyway (0)

Anonymous Coward | more than 3 years ago | (#36983250)

They SHOULD have started with defining an electronic format that all the records could be stored in.

THEN pay for a project to convert the documents into that format. And while that's underway, work on letting each trust work out who would do the work to get a product reading that format.

But no, they wanted the whole lot done in one go.

Because a project that big looks important and can ONLY be solved by a vast corporation.

Re:Stupid start to it anyway (3, Informative)

Kalriath (849904) | more than 3 years ago | (#36983388)

Actually, the worst part is that healthcare IT has very good specifications already. In fact, all the standards needed to implement a system like this with maybe half a million pounds (initial buildout - scaling would of course cost more) exist. HL7, CDA, and multitudes of other specs already solve all the problems with storing EMRs, and there's several solutions already from some big name vendors already to solve the problem (where I work, we use Agfa).

Re:Stupid start to it anyway (0)

Anonymous Coward | more than 3 years ago | (#36983484)

Agreed - the specifications are already there and that's where the government should have left it. They should have mandated that any medical company which wished to join the NHS programme must implement those specifications (perhaps even specified UI guidelines so that doctors could use different systems without having to re-learn those systems) and then left it to the medical companies to slug it out and compete for contracts on a local level. This would have promoted competition amongst the existing suppliers as they would have to ensure their system complied in order to continue to make sales.

Instead of this they became convinced that to do it right the whole software infrastructure had to be homogenised and this job could only be managed by big companies (BT, Accenture, Fujitsu etc) who were brought in and paid billions to do what the smaller companies were already doing.

Instead of GP's and hospitals being allowed to purchase their own system (as happened previously), they were forced to use whatever system the Health Authority for their area had chosen to use (i.e. whichever big company had been awarded the contract for that area). Some of these systems hadn't even been written yet, yet established systems which GP's were happy with were being thrown out to make room them!

And now several years down the line people are finally waking up to the fact that this whole idea was rotten from the start, yet the big companies are still able to walk away from the mess and take a whole load of money with them.

The architects of this farce should be lined up and shot and the Government should never ever award contracts to BT, CSC, Accenture or Fujitus ever again.

Re:related? (5, Interesting)

myurr (468709) | more than 3 years ago | (#36983302)

Whilst you trivialise the problem to a degree (scalability and reliability of an NHS sized system is not trivial) it still shouldn't take a small team more than a few months, and a budget in the hundreds of thousands of pounds, to build such a system. This could then be incrementally evolved over time on a budget in the hundreds of thousands per annum (maybe low millions depending on speed of development). You do then have the data entry problem to consider, but that is surmountable for a fraction of the budget of these big IT solutions.

However that's not how the government thinks. They want to go all encompassing from day one, speccing out a bloated and unworkable unholy mess that the end user doesn't want or need, and certainly doesn't understand, that takes a budget several orders of magnitude more than is required. Then throughout the project more and more people will hear about it and give their input or point of flaws, causing massive amounts of feature creep and confusion, affecting budgets, delivery time lines, and ultimately the quality of the end product.

As a final anecdote, as a small web agency we once were involved in the build of a website for a London borough. We were in competition with some much bigger agencies, but we went back with a good proposal, some great design concepts, and what we felt was a fair budget. The decision maker loved our whole proposal except for the cost - he actually made us double the cost of the build, simply because that then matched his budget so that it wouldn't be cut the next year (spend it or lose it!) and because it brought it in to line with the bigger agencies (so his managers wouldn't think our offering was less feature rich because it was cheaper). This way of thinking is not unique to the the public sector but is endemic throughout it, and the big suppliers prey upon this.

Re:related? (1)

TheRaven64 (641858) | more than 3 years ago | (#36983544)

(scalability and reliability of an NHS sized system is not trivial)

Depends on what you're doing. I have a friend who works in the medical records department at the local hospital. A lot of her job involves running from one end of the hospital to the other because the doctor needs a specific file in 10 minutes and only just realised. A system where every doctor had a tablet PC of some kind and could call up all of the records in a hospital would be really simple to design and deploy. It wouldn't have to cover the entire NHS, just the one hospital. That's only a few TB of data with a few hundred users. Once the records are in electronic form, the next step is defining formats and protocols for exchanging them between hospitals, GPs surgeries, and so on.

If one hospital had paid for the development of such a system and specified that they own the copyright on the resulting code, they could have released it under an open license and other hospitals could have used it easily.

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36983768)

that would not meet confidentiality guidelines anywhere. A doctor only has permission to access his own patients' records, not everyones. Administrators should not have access to patient records either. If the ipad is stolen, or borrowed, does the new user get access to all patient records, or does the doctor end up entering password 70 times a day? etc... etc...

It's non-trivial, but there are lots of such systems out there, It's hard to see why they could not work with some of these efforts and bring in systems incrementally, for a lot less money:

http://en.wikipedia.org/wiki/List_of_open_source_healthcare_software

Re:related? (3, Informative)

Richard_at_work (517087) | more than 3 years ago | (#36983890)

In current systems, a doctor in a hospital can access basically any patient entered into that hospitals system - but when the audits bring that access up, and it will within the week, you have to be able to justify the access pretty damn well or you will face a disciplinary.

Actually, now would be a damn good time to explain how most UK hospitals work...

During the day, all departments are staffed, with consultants, registrars, Foundation Year 1 and 2's.

At night, most hospitals run "Hospital at Night", where everyone buggers off home aside from half a dozen or so junior grade doctors (consultants and permanent registrars stay on call, but you literally have to call them, training scheme registrars and FY2s get to run the hospital) - who have to cover the entire hospital (aside from A&E and a few very specialist departments).

So, while the hospital may take 400 or more doctors to run during the day, thats reduced to a handful at night - and what that means is that while you may get a doctor who has trained (or is training in) in the department you were admitted to, at night its pot luck.

So that night doctor needs full access to your patient record to treat you, even though they may only ever see you once.

And the paper is encrypted??? (0)

Anonymous Coward | more than 3 years ago | (#36984226)

Because the admin who is running across the hospital with the paper records is holding the plaintext version. They can read it. Someone can intercept the records and read it and when stored, someone can break into the records room and read it.

Or the transfer could be done wirelessly. Enctrypt to the public key of the doctor who wants it, sent it over the air. Sorted.

Re:related? (1)

Richard_at_work (517087) | more than 3 years ago | (#36983848)

If one hospital had paid for the development of such a system and specified that they own the copyright on the resulting code, they could have released it under an open license and other hospitals could have used it easily.

Fraid not for so many reasons - each hospital has its own budget, out of which comes everything from drugs purchases to theatre time to IT systems, so you would end up with one hospital spending the money.

Which means that they would want to use it as a profit centre with regard to other hospitals, so they would sell it to other hospitals. Unfortunately, working practices between hospitals (hell, between departments within hospitals) are very different, so the package would have to be heavily customised for each hospital (.... department) so if you are spending the money making the purchase and then the customisation, why not just do a custom build.

And we arrive at the actual situation within the NHS currently - everyone has gone computerised, they've just done their own thing.

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36983934)

I'm not sure it'd be that easy: there's a lot more to it than just giving doctors access to records. Off the top of my head, even a basic system would have to account for the following things:
1) Data protection: aside from the various UK/EU laws on data protection (e.g. expiry of data, etc), patients may have confidential data (e.g. mental health issues) or be classed as needing protection (e.g. celebrities/politicians/etc). You'd therefore need some way to authenticate the person viewing the data, as well as a way to ensure that they only see the patient's confidential data if it's relevant to the current case. You also need a robust logging system - and even when the person has full permission to access the data, you need some way of ensuring that the tablet can't be accessed by non-authorised people (e.g. a rogue journalist): simply putting a password on the tablet won't cut it. You'd also need some way to disable/lock access to data if the tablet is stolen or if someone attempts to hack into it.

2) Hardware: you'd have to pick a tablet which has good battery life and is highly robust: it's likely to be dropped, thrown about and may well end up covered in various body fluids and/or medical chemicals. It may also need some form of card-reader for the authentication system and it also needs to be small and light if it's going to be carried out for an entire shift; realistically, something like the iPad 2 is too large, heavy and expensive for this sort of use-case - and whatever is picked, if it's based on commodity hardware, there will be a risk that the tablets will be stolen simply for their perceived physical value, even if the hardware/OS is fully locked down to make it useless outside the hospital.

3) Software: an app will need to be written for the tablet; as the data needs to be protected - and there may be some form of physical authentication system - you can't simply serve out HTML from a web-server. The tablet will also need to be locked down, to stop people installing their own software on it; at best, it wastes resources and at worst, it could be a data-stealing trojan horse or virus.

3) Network: you'll need to set up a hospital-wide wifi network; aside from the risk that the wifi signal could interfere with some medical hardware (or vice-versa), there's also the fact that many hospitals are in victorian (or older) buildings, so there may well be issues with getting cabling installed and/or punching signals through the walls.

4) Training: the doctors will probably need training on how to use the tablet, the app and authentication systems, so there's the cost of writing the training documents and the costs associated with the training sessions.

5) Ongoing support: tablet repairs, new tablet builds, software upgrades, etc.

To be fair, none of these are insurmountable - and many may have already been completely or partially solved (e.g. wifi in hospitals, training to use authentication systems), but a solution needs to be found for each which all the interested parties can agree to - the government, the data-protection regulators, the doctors, the hospital management team, the hospital support team, and so on.

And I'd suggest that navigating all of these legal, logistical, technical and process minefields is going to take a lot more than a small team, a few months and a few hundred-thousand pounds...

Re:related? (1)

Captain Hook (923766) | more than 3 years ago | (#36984046)

Most of that could be handled by have something like a Citrix Server and the clients just being cheap access terminals.

No need to worry about the tablet being stolen because the tablet is never given the data (outside of screen scrap from the server).

Re:related? (4, Insightful)

Sad Loser (625938) | more than 3 years ago | (#36983972)


I am a senior doctor in the NHS and am one of many trying to unravel some of this unholy mess to work out which bits are workable.

The obvious stuff - own a basic infrastructure, use open standards, manage contracts tightly and locally, encourage a diverse IT culture within and outside hospitals and use competition to drive down price and drive up performance - this just didn't happen. As the parent says - a centralised system specified by obsessive compulsive people who don't touch patients and with an irresistible urge to gold plate everything.

The NHS doesn't even own the N3 network - it rents it off BT.

We are tied down with a vast number of closed systems that will cause untold unhappiness, waste and frustration in years to come - my hospital is about to go live with CERNER, which has a Windows 3.1/ 'visual basic by a first year programmer' look and feel. It takes >30 seconds to authenticate every time you want to do anything (often)! this alone will steal many hours of medical and nursing time waiting.

They as the parent says, the contracts were poorly specified, carved up by the usual management consultancy clowns and their mates, and then just left to fester.

Unfortunately, the people running the whole thing were not equipped with the mental or managerial experience to make it work. There was one head of IT, Richard Grainger, who might have had a chance at doing it properly from the off, but was brought in too late when the carve up had taken place, and ran away as fast as he could. The rest is history.

What they could have done differently?
1. read ' the mythical man month'
2. pay someone to re-engineer VISTA in c++/ c# / java
3. get some people in who are successful doctors, not just the nearest beardy muppet who doesn't want to touch patients any more.

COI: IAANHSD

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36988496)

Are you sure? I thought I remembered that it was Grainger's idea to hav ethe big contracts? And he certainly had no enthusiasm for clin user input The q that was always on my mind was why they didn't build off the ethos of pry care computing, which by and large works quite well. Emis systm1 etc all do the basics sort of fine and are clinically focused as much as mgmt focused.

Anyhoo the next challenge will be getting some level of integration between pry comm and acute and la and mhts. As that's likely to be clin-driven, at least consent may get sorted this time!

Re:related? (1)

Duncan J Murray (1678632) | more than 3 years ago | (#36988742)

I'd be interested it getting involved, as a Haematology SpR and an interest in open-source and open-standards. I imagined the NHS would be the perfect poster-child for an open-source project funded by the government to create a hospital system, possibly running on linux (if not the terminals, then at least the backend), which could then be used possibly by others in developing countries. It would then be modular, and updateable, and wouldn't result in the NHS relying on one piece of proprietary software, the owner of which would have a monopoly on future service contracts.

Do get in touch!

Duncan.

Re:related? (1)

Shuntros (1059306) | more than 3 years ago | (#36984022)

It's a shame these big contracts are being allowed to tarnish all the achievements which have been made. Digital x-rays, scans etc enjoy 100% coverage across the UK; consultants can get a second opinion from someone 100 miles away in minutes, instead of sending x-rays in the back of a taxi to another city.

Electronic referrals from GPs (family doctors) for hospital treatment are in the tens of thousands per day and GP2GP record transfers for people changing doctors are becoming widespread. All NHS sites are connected by the N3 network.

The big sticking points are the large hospital trusts and their systems; in London and the south the system of choice was Cerner Millennium (a bastardised billing system from the US market not particularly well suited to the NHS), and in the North it was iSOFT's Lorenzo (a web-based system built specifically for the NHS, but built by coders in India who have no idea how the NHS works). In all fairness, despite its lack of suitability Millennium is up and running at quite a number of big hospitals. Lorenzo has been delayed for many years and is only just becoming usable, although it's hardly what one could describe as feature rich at this point in time.

Aside from software issues, one of the major issues the suppliers had was trying to be too helpful; every hospital will insist they are somehow unique and by pandering to every possible requirement the scope of the software build simply exploded.

Trivialising the scale of the task shows considerable naivety in the working of the NHS, but it definitely could have been done at a fraction of the cost. The national-level architecture (NHS Spine) whilst showing its age a little now, is still valid in its construction; a national interchange which any software complying to the relevant messaging standards can interact with.

As you've probably guessed, I'm involved in this particular industry. The intentions from a patient care and modernisation perspective were honourable, but the huge contracts for specific things from specific suppliers were a mistake.

Agreed (1)

Sad Loser (625938) | more than 3 years ago | (#36985178)


digital radiology works, but is generally a standalone system and poorly integrated.

GP to GP transfers - well that would have happened anyway.

Lorenzo is totally dead in the water. Involved in product testing of modules in last 3/12 - doesn't even get to first base. hopelessly broken.

Yes CERNER Millennium works, but is a maladapted dinosaur, with the same evolutionary potential.

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36984170)

There's also another side to the budget process. A project budget usually goes something like 1. define need; 2. define what's need to fit the need; 3. get proposals for budget amount; 4. Submit and then wait. 5. Budget committee meets and funds are budgeted for the project. 6. Wait some more until the new budget cycle (when funds are released) begins. 7. Now that you're free to proceed, you nail down the true amount needed and pick a vendor.
And that's where if you're really good at funding a deal, you get a better price than what you budgeted. You save the company money and your boss asks you why you did such a poor job in coming up with an amount for the budget request. Do it enough times and they start just cutting your budget requests figuring you're over-estimating anyway.

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36984308)

However that's not how the government thinks. They want to go all encompassing from day one, speccing out a bloated and unworkable unholy mess that the end user doesn't want or need, and certainly doesn't understand, that takes a budget several orders of magnitude more than is required. Then throughout the project more and more people will hear about it and give their input or point of flaws, causing massive amounts of feature creep and confusion, affecting budgets, delivery time lines, and ultimately the quality of the end product.

The government don't *want* to go all encompassing from day one - they generally have little choice. A broad objective, broken down into small, iterative steps (which expect and react to failure) doesn't work when you have a hostile opposition party and hyper-critical media that jump on every problem as a sign of total incompetence. A practice ultimately endorsed by the voters.

Until the public's, media's and government's mindset changes, to get any initiative out of the starting blocks, you sadly need the bloated, unworkable over-detail behemoth of a specification.

And yes, I am quite happy to vote for someone I broadly trust and who's principles I am broadly aligned with. "We'll figure it out as we go along" works as a policy for me.

Re:related? (1)

Just Some Guy (3352) | more than 3 years ago | (#36985498)

he actually made us double the cost of the build, simply because that then matched his budget so that it wouldn't be cut the next year (spend it or lose it!)

I genuinely feel sorry for anyone having to work within those constraints, and hope the policies contribute to the (relatively) quick death of their organizations. Here's how my company's budgeting works:

  1. Once a year, the boss asks what purchases we've planned for the next year or so. He uses that to estimate our budget needs.
  2. When we need to make those expenditures, we tell him. If it's a good day in the budget cycle (e.g. we didn't just host a convention a few days earlier), he authorizes the purchase. If not, he asks us to wait a week or so first.
  3. If we need something extra and unforeseen, we tell him what we need and why it will benefit the company. We buy it.

If I show him how I saved money by using our current resources more efficiently, he remembers it come annual evaluation day. His long-term response is to become even more receptive to purchase requests because he trusts me to spend his money wisely.

I understand that managing a large corporation is a lot different from running a small company, but the basic principals stand. If you punish departments for efficiency, you deserve bankruptcy.

Uh huh... (1)

tkrotchko (124118) | more than 3 years ago | (#36983990)

"t would be trivial to deploy a..."

Almost every time someone says this about an IT problem, that usually means they don't understand the complexity of requirements, and you'll end up spending 10x as much as you think you will.

I'm not defending the integrators in this case (we don't know enough about this project to say who is at fault), but there is rarely a large IT project that can be solved as simply as "throw up a data base and...".

Re:Uh huh... (1)

TheRaven64 (641858) | more than 3 years ago | (#36984294)

The point is that a trivial system would address 70% of the needs. A massively complex system would address 100% of the needs. We could cheaply have had the trivial system deployed over a year ago. The complex system is millions of pounds over budget and still not finished.

Which is the better solution?

Re:Uh huh... (1)

mcmonkey (96054) | more than 3 years ago | (#36986204)

Given that these are healthcare-related data with personal identification information, if the 70% covered by the trivial system does not include security, then there's good reason to hold out for the 99.99% solution (no complex system is ever 100%) rather than use the 70% solution in the interim.

Re:Uh huh... (0)

Anonymous Coward | more than 3 years ago | (#36984556)

I dunno. When Accenture takes a 300m hit to back away from the project, hands it to a competitor, then they walk away from the project, and all anyone at NHS can say is, "well the project is a problem because of our evolving needs"... I think we can cut to the chase on what's going on.

The customer is a fucking mess. The job has changed 5,000 times in far fewer days. Nobody thinks it can be "finished" in any satisfactory way, at any price. If they did, they would be happy to do it for contracts that large. This is not the first example of this that we've seen.

Re:related? (1)

LizardKing (5245) | more than 3 years ago | (#36984028)

Instead, the government specifies a system with an insane list of requirements for a huge number of unusual use cases, and then wonders why the project fails.

The contractors are at fault - they bought into a project that was obviously going to fail. They could have done the decent thing, and told government that the requirements needed scaling back, but all it takes is one of the competing contractors to say it was doable and they would all fall in line. Of course, the contracts are so badly written that the contractors can get out part way through, having already made enough profit that any penalties for non-delivery are insignificant.

Then there's the implementation. A former colleague went to work on the NHS system for BT - one of the contractors despite no track record in this kind of system. This colleague was a notoriously sloppy coder, to the point of incompetence, and as a result he had been shunted off of my C++ and Java based project to do trivial PHP work. BT employed him in a fairly senior coding position to do PHP on the NHS IT contract. Shudder.

Re:related? (0)

Anonymous Coward | more than 3 years ago | (#36985566)

The answer is really simple the government tells the unwanted contractors to go frell them selfs and just change the law so they have ZERO comeback their stupid ideas are not working so they have failed so they have forefitted any rights to payment after all that is the sort of stunt they pull on the public so let them have a taste of their own medicine for once see how they like it they wont but all together now You Know What TOUGH suck it in

There was a time when... (4, Informative)

Richard_at_work (517087) | more than 3 years ago | (#36983074)

Summaries actually summarised the article, and not just reposted the first two paragraphs of it...

(The below is my opinion, not a summary of the article)

Basically, what has happened is that the Great And Wonderful NHS Computerised Records System has been in the doldrums for so long that we have ended up with a situation where every GP (community doctor for those not in the UK, they run their own clinics outside of hospitals) and every hospital has implemented their own computer records system, with the large majority of them incompatible with each other.

The only semblance of the NHS wide system to come to light in a customer facing manner has been the emergency care records, which is a computerised subset of your entire record meant to be accessible to every A&E (ER) department in the country - but they still haven't rolled it out to everyone, and it won't be rolled out to everyone it would seem.

It has gotten to the point where the NHS requirements have changed so much that the contracting companies are now walking away from their contracts because they are being asked to do so much more work under the original commitments.

This whole thing has been collossally mismanaged from the start, the current government just gets the blame for the result...

Re:There was a time when... (2)

Spad (470073) | more than 3 years ago | (#36983108)

The whole NCRS project was doomed from the start; they made the assumption that the best way to make clinical records available across the country was by way of a gigantic central database and the proceeded to design it without consulting any of the users, using smartcards that were obsolete before the project started (so they can't be used for anything else like SSO because nobody supports them anymore) and changing the requirements every couple of weeks. Oh, and there's no fine-grained access control so they can't put any Mental or Sexual Health records on it since anyone with access to part of your record has access to all of it.

What they should have done is to define a standard data exchange format, mandated that all local systems supported it and then have a central lookup table for locating where any given record is located, but then they wouldn't have been able to award massive contacts to the usual suspects.

Re:There was a time when... (1)

Kalriath (849904) | more than 3 years ago | (#36983422)

HL7, CDA, and a national private network. Problem solved. Yes, it'll be expensive - but you don't need to "define" anything because everything you need is defined already.

In case you're wondering, I just described New Zealand's entire health system. The central government holds the demographic record, and your GP holds the medical record. Obtaining that record is a simple matter of requesting it from the GP that holds it, who will then deliver it to you via the national health network and it's received in minutes. Not exactly a stretch to change that into YOU holding your record on some sort of card (preferably not RFID).

That's all how it's meant to work of course. Since people are involved, it's not failsafe.

Re:There was a time when... (1)

Spad (470073) | more than 3 years ago | (#36983498)

There's already a national private network (N3) so we're halfway there.

Re:There was a time when... (1)

mcmonkey (96054) | more than 3 years ago | (#36986340)

HL7, CDA, and a national private network. Problem solved. Yes, it'll be expensive - but you don't need to "define" anything because everything you need is defined already.

I was just thinking the same thing, particularly in response to the posters writing that GPs and hospitals have gone forward with their own computerized system that are now not interoperable.

For those who don't know, HL7 [hl7.org] includes, among other things, an XML schema for health care information. Let each office or organization build their own system--with a list of 'best practices' from the NHS to reduce reinventing the wheel--and use the existing standard for inter-org communications.

Re:There was a time when... (1)

Richard_at_work (517087) | more than 3 years ago | (#36983500)

Don't get me started on SSO, my wife changed rotation yesterday, and despite not going outside of the deanery, she still had to submit all the same paperwork yet again, and pick up no less than four usernames and passwords for hospital systems...

Four.

Four, for crying out loud. Without ever having to leave the one building to use them all.

Re:There was a time when... (0)

Anonymous Coward | more than 3 years ago | (#36983376)

Interestingly I have a bit of insight into this as I have a family member who has worked for the NHS for 20+ years in various administrative roles.

It's not only that the technologies being used are incompatible between hospitals, they are often incompatible between different departments of the same hospital! And that is not the worst, the people in the hospitals responsible for technology projects have no idea what they are doing and as such buy stupidly outdated systems which require constant upkeep just to work, the classic example being the hospital where said family member works their 'new' patient records system (called PMS, Patient Management System) which was put in within the last 5 years or so runs under DOS, there isn't a windows client, you have to run it in a command window and as far as they know there are no plans to deploy a windows client.

I'm not surprised the recommendation is ditch it all as a bad idea.

For the amount of money wasted they could have had a bespoke system designed and deployed by now.

Re:There was a time when... (0)

Anonymous Coward | more than 3 years ago | (#36984130)

GP (community doctor for those not in the UK, they run their own clinics outside of hospitals)

GP stands for General Practitioner. It's used outside the UK, such as the US. It's a non-specialized doctor. The opposite of a heart surgeon, a brain surgeon, a back/spine specialist, etc. That last I read about it (admittedly it was a while ago), in the US GP's are the hardest doctors to fill due to the lower pay (specialists make much more money) with the equally high cost of malpractice insurance and the continued culture of suing over every possible thing to make a quick buck. A position where a GP can easily find themselves in as they handle a much wider variety of cases and despite how minor the health need is.

Coupled this with the fact that said GP's, having been bit themselves or knows someone who has, has lead to simple doctor visits costing extreme amounts of money, ie.causing health care prices to skyrocket. "Oh, you have a swollen ankle because you said you twisted it in a hole? Ok. Well, it's probably a sprain. But I'll request you to get an MRI and x-rays just to make sure nothing else is wrong and you better also go see this ankle specialist to get a second opinion and sign up for 30 hours or rehab." It use to be "elevate it and put ice on it, you'll be fine."

If not because the doctor orders you to get a bunch of unnecessary tests, but because the hospital is spreading the costs over many more people and charging you $150 for 5 mins with a doctor for acne creme because it helps off-set the costs elsewhere.

And the sad part is all we keep having this continuing debate that the government should pay for it and not about how we can stop this runaway train of costs. After all politicians won't look at tort reform. Almost all of them are lawyers themselves! (Another major issue in US politics, wealthy lawyers are the political class. Having a discussion about $150 haircuts and flying private jets around the country every week is normal to them.)

*sigh* and people are surprised when grass root movements like the Tea Party pop up. A party supported by both conservative and liberal politically leaning citizens to fight back against the wealthy political elite, but has since been successfully supported by the Republican party, which has made it the enemy of the Democratic party and now it's nothing more than another politically polarized talking point.

but I degrees.

Re:There was a time when... (1)

Richard_at_work (517087) | more than 3 years ago | (#36985362)

In the UK a GP is a specialisation - a non-specialised doctor remains a Senior House Officer, or FY2, and can be employed by a hospital as such (they can make great money doing locum work as an FY2). To become a GP after your FY2 year, you have to go through a 3 year training course to specialise in that area, and GPs get paid quite well in the UK, all things considered.

The real question is... (1)

ArsenneLupin (766289) | more than 3 years ago | (#36983080)

... whose palms were greased to secure the signature of those dodgy contracts in the first place?

Re:The real question is... (0)

Anonymous Coward | more than 3 years ago | (#36983308)

That would be Tony Blair and Gordon Brown (a.ka. the Iron Chancellor) who left this shite fest in place.

BT get shafted? What a shame. (0)

Anonymous Coward | more than 3 years ago | (#36983088)

BT get shafted? What a shame. Couldn't happen to a nicer company.

Disaster that was predicted years ago... (1)

FRAKK2 (166082) | more than 3 years ago | (#36983116)

As someone who worked on the program from nearly its beginning I can tell you, people coould see this road crash coming for years. They tried to do too much in on go. Of course you can blame the Labour party and the suppliers for that. What with the end of Boom and Bust its always easy to pish other peoples money i.e the taxpayers up the wall!

And the amount of ex IT consultants working for the government means that that this kind of debacle happened time and time again , just the same as defence.

As for the contract costing as much to cancel as to complete thats the same trick Gordon Brown used to make sure the new brtiish carriers were built in scotland. Bent as a nine bob note!

Getting paid for things that don't work. (4, Insightful)

tebee (1280900) | more than 3 years ago | (#36983160)

Maybe governments should start writing contracts that only pay up if a usable systems s delivered at the end of it ?

OK know this is a gross oversimplification but at least it would give the people doing the work some decent motivation to make sure it did actually work in the end.

I was brought in as a capacity planner on a former NHS computerization contract about 30 years ago. After 3 months there s was obvious to me that what the were doing, the very silly way they were doing it was not going to ft on the IBM mainframe they had specified to do this.

On pointing this out to them I was told that some very highly paid consultants had said it was going to work and who was I, a lowly contractor, to question their wisdom even though this was the job they brought me in to do.

I was asked to produce some pretty pictures and my contract was not renewed.

Re:Getting paid for things that don't work. (0)

Anonymous Coward | more than 3 years ago | (#36983356)

Nobody in their right mind would agree to that sort of contract. Because any cock-up here is as much a result of shifting requirements as it is incompetence on the part of the suppliers, and that's always the problem with massive government IT projects.

Re:Getting paid for things that don't work. (1)

shortscruffydave (638529) | more than 3 years ago | (#36983888)

I was involved with a UK government contract years ago which followed that sort of model. It was for a system which would interconnect offices across the whole of the UK, and there was a clause that payment wasn't released until at least ninety-odd percent of the user base had access to the system. As it happens, the job got canned part-way through, leaving the prime contractor in the position that they'd spent a lot of money, but not received any payment.

You didn't get a termination clause?!?!?! (0)

Anonymous Coward | more than 3 years ago | (#36984352)

I smell bullshit. A termination clause is normal even when there isn't a "you don't get paid until it works" clause.

Re:Getting paid for things that don't work. (1)

Paradise Pete (33184) | more than 3 years ago | (#36983948)

Maybe governments should start writing contracts that only pay up if a usable systems s delivered at the end of it ?

Sure, you can do that if you're willing to pay ten times as much for the work. And write a complete spec that never changes during the course of development.

So let me get this straight... (0)

Anonymous Coward | more than 3 years ago | (#36984542)

See if I have this right.

IF you're correct and you need 10x the money to agree to getting the work done, then the following options are the only ones on the table

1) You actually NEED 10x the money to do what you said you could do for the contracted price

2) You only have a 10% chance of doing the work you said you'd do

3) You're just making figures up because you DO NOT WANT to have to actually produce the work you said you could

Re:Getting paid for things that don't work. (2)

nedlohs (1335013) | more than 3 years ago | (#36984356)

Maybe governments should start writing contracts that only pay up if a usable systems s delivered at the end of it ?

For which they'd have to pay an order of magnitude more for, possibly more than just trying multiple times and ditching the failures.

And of course no one is going to sign up for it unless the requirement are written in stone at the start. Good luck with getting that to happen.

Re:Getting paid for things that don't work. (0)

Anonymous Coward | more than 3 years ago | (#36988646)

Erm...this was on eof the ideas behind npfit. It has not been a roaring success

the usual pork barrel mess (-1)

Anonymous Coward | more than 3 years ago | (#36983168)

If you'd seen the design... shudder...
A mass of microsoft systems and sharepoint clusters, it just has MS stamped right through it. On a project which screamed foss, it was effectively locked out from participating by the contracts and design chosen.
Now x years later, the ms stuff has turned into the mess we all predicted when the pitches were happening. Plus its been so slow in delivering that meanwhile the world has changed around it and introduced new requirements...

Re:the usual pork barrel mess (2)

phonewebcam (446772) | more than 3 years ago | (#36983312)

s/health/defence

The UK is once again in the ludicrous situation it was in of having actual government ministers go on TV and tell the country it's cheaper to go ahead and build pointless aircraft carriers than stop the projects right now. We see once again the level of courage they had with the banks - who just announced *bonuses*, not investments or redundancy payments, freaking *bonuses*, of £14bn - paid for by the real workers. Announced co-incidentally the day the Murdochs were publicly grilled, so it got little coverage. Thank goodness it's not their money.

I, Pencil: My Family Tree (0)

Coolhand2120 (1001761) | more than 3 years ago | (#36983196)

Once again, this proves anything that needs to get done, gets done, privately (doctors implementing their own electronic database) without the need of government. The government's version is more costly, inadequate, corrupt, full of nepotism and fraud. The private system does what needs to be done without the heavy hand of government, better, cheaper, faster. And all without the threat of force.

This reminds me a lot of the essay I, Pencil: My Family Tree [econlib.org] . Anything that needs to be done can be done better in the hands of private free individuals.

Re:I, Pencil: My Family Tree (2)

digitig (1056110) | more than 3 years ago | (#36983366)

Once again, this proves anything that needs to get done, gets done, privately (doctors implementing their own electronic database) without the need of government.

Except it doesn't do what needs to be done, only the easy part of what needs to be done. It's fine as long as I only fall ill close to home, but if I need to see a doctor when I'm at the other end of the country, well fine, I can see a doctor, but they won't have access to my medical records.

Re:I, Pencil: My Family Tree (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36983474)

You're missing the point. When it becomes necessary to have your records moved around like that, and the need outweighs the cost, it will happen naturally by private hands. It is the path of least resistance. Anything else is going to be fulfilling needs that are not needed (unnatural), like the government providing an education to people who are starving to death.

Nobody is going to know the needs of a system like this better than the people who are running and implementing the system not some government bureaucrat with ulterior motives (nepotism, fraud, corruption) which so often occurs in government. Also, this costly venture by the government has taken away from the people (private industry) who had the best chance to make a usable portable format.

Re:I, Pencil: My Family Tree (0)

Anonymous Coward | more than 3 years ago | (#36983490)

You know, except that after years and years, the private actors have ... an unholy useless mess.
Nice libertarian dreaming, but nope - letting the free (and wildly uninformed) market define standards is not the way to go either.

Re:I, Pencil: My Family Tree (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36983802)

The private industry is bad to the extent that the government has fettered the free market. For instance in the U.S., the government prevents the sale of health insurance across state lines. It causes much less competition and drives up prices.

In the healthcare industry the government regulates everything making it difficult to business at all, because of all the bureaucratic red tape a roll of micro-porous tape that you can get at CVS for $1.50 ends up costing $25.00, and who pays for that? Certainly not the government.

Now lets add the lack of tort reform, allowing for fraudulent lawsuits and ambulance chasing lawyers (the democrat party base) to sue doctors for things like "My child had autism and I blame the doctor for not performing a cesarean section" further driving up costs of private health care.

Next lets add the way the government 'fixes' the medicare price of procedures and does not allow the doctor to charge what he thinks is a reasonable rate for the procedure. Of course 99% of the time the government's rate is much lower than you would charge a private individual, and that's mostly because the loss on government medicare patients is recouped in the cost on privately insured individuals. The end result of this is doctors charging more, and providing less because they are being paid less by the government.

The government takes money from everyone to provide health care for a minority of the people (medicare, medicate, medical) who cannot afford this care- that money, for the most part, would be better off in private individual's pockets some of which would go to pay for better healthcare. I know way too many medicare recipients with $4000 computers.

I could go on and on about how the government fetters the free market system and drives costs up, but I think you get the point. For a 'free market' there is quite a lot of government in there!

Re:I, Pencil: My Family Tree (2)

Arivia (783328) | more than 3 years ago | (#36984522)

I can make words bold too. Fuck off, troll.

Re:I, Pencil: My Family Tree (1)

Spad (470073) | more than 3 years ago | (#36983504)

Anything else is going to be fulfilling needs that are not needed (unnatural), like the government providing an education to people who are starving to death.

Yeah, fuck those guys!

Re:I, Pencil: My Family Tree (1)

digitig (1056110) | more than 3 years ago | (#36983534)

You're missing the point. When it becomes necessary to have your records moved around like that, and the need outweighs the cost, it will happen naturally by private hands.

And what would the driver for that be? I have the need, the doctor bears the cost. Sure, the the people who are running and implementing the system know the needs of the system better than some government bureaucrat, but they have no incentive to meet them. Your sort of free-market libertarianism doesn't seem to have an effective mechanism for dealing with negative externalities.

Re:I, Pencil: My Family Tree (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36983640)

And what would the driver for that be?

I'm glad you asked!

Your need is the driver . Believe it or not, your doctor is trying to serve please you. Adding value added services like portable records do this. And draw your business away from doctors who don't implement this technology. If a doctor not implementing the technology loses too many patients they either a) implement the technology or b) go out of business. Both courses are totally natural and not compelled through the use of force.

How many countless times have you heard private industry boasting technological improvements to ease your life? Do you deny this constant drone of technological improvements being advertised by service providers vying for your business?

Your need is the driver . That same thing that causes all private industry to improve! Read the (very short) essay I, Pencil: My Family Tree [econlib.org] I posted earlier, it explains these interactions in detail.

What sort of strange world do you live in where you trust your life with someone who you don't trust with the money you pay them?

Re:I, Pencil: My Family Tree (1)

digitig (1056110) | more than 3 years ago | (#36984244)

Your need is the driver . Believe it or not, your doctor is trying to serve please you.

I'm sure my doctor is -- she seems to be a nice person. But I'm not sure I would be her choice of charity donation.

Adding value added services like portable records do this. And draw your business away from doctors who don't implement this technology.

My doctor has pretty much all the business she can cope with, and so has no incentive to draw more business. Besides, I would need to know when choosing a GP everywhere that I might visit in the future, to check that they had data sharing with doctors there. Doesn't work.

What sort of strange world do you live in where you trust your life with someone who you don't trust with the money you pay them?

Perhaps you should read the original article, and learn that it relates to the UK, and that I don't (directly) pay my doctor. The good news for me is that I only pay (through taxation) a small fraction of what folks in the USA pay, for comparable health outcomes (or have the costs gone down significantly with Obamacare?). You see, your system only works if there is an oversupply -- the good doctors have significant spare capacity -- which is inherently inefficient. And, as I said earlier, it doesn't deal with negative externalities.

Re:I, Pencil: My Family Tree (1)

CrimsonAvenger (580665) | more than 3 years ago | (#36985140)

(or have the costs gone down significantly with Obamacare?)

Latest I've seen show indicate that costs are going to go UP significantly with Obamacare.

Of course, part of that is that Obamacare included Medicare cuts as part of the cost-balancing, and the Medicare cuts are unlikely to actually happen (in general, contrary to popular rumour, Medicare cuts in the budget don't happen, because Medicare payouts are low enough now that many doctors won't take Medicare patients) since that would cause even more doctors to refuse to take Medicare patients (slightly misleading: they cannot, by law, ditch an existing Medicare patient, but they can (and do) refuse to take NEW Medicare patients).

Re:I, Pencil: My Family Tree (1)

tazan (652775) | more than 3 years ago | (#36986716)

It hasn't happened yet and it's not likely to on its on. I just had records from my doctor sent to a specialist. It took 6 weeks. There's no incentive for my doctor's office to speed this up. If anything the incentive is to make it more difficult so you won't change doctors.

Socialism Sucks (-1, Troll)

Coolhand2120 (1001761) | more than 3 years ago | (#36983352)

This reminds me of what Frederick Bastiat (1801-1850) [wikipedia.org] said of the subject Socialism. Below is a link to his complete book "The Law" (in HTML format) and the specific part it this article reminded me of. The UK government in this situation is (attempting) to fulfill a need of society by commissioning the construction of a piece of 'public infrastructure' that the government deemed the society needed. A rather costly venture to be sure. But from whom did the government take this money? It takes it from the people who would have otherwise been implementing what was really needed, and who eventually did with what little the government left them.

The natural course of things, what Leonard E. Read called "the invisible hand" [econlib.org] , would have created the fully digital medical system that the government legislators commanded through the threat of violence (pay your taxes or else!) that an unnatural (Sc. useless, uncalled for) system be created. The end result, as so many other government ventures end, was a mess so epic that only the forceful hand of government could compel otherwise intelligent individuals to such total folly.

From The Law by Frederick Bastiat. [constitution.org]

The Vicious Circle of Socialism

We shall never escape from this circle: the idea of passive mankind, and the power of the law being used by a great man to propel the people.

Once on this incline, will society enjoy some liberty? (Certainly.) And what is liberty, Mr. Louis Blanc?

Once and for all, liberty is not only a mere granted right; it is also the power granted to a person to use and to develop his faculties under a reign of justice and under the protection of the law.

And this is no pointless distinction; its meaning is deep and its consequences are difficult to estimate. For once it is agreed that a person, to be truly free, must have the power to use and develop his faculties, then it follows that every person has a claim on society for such education as will permit him to develop himself. It also follows that every person has a claim on society for tools of production, without which human activity cannot be fully effective. Now by what action can society give to every person the necessary education and the necessary tools of production, if not by the action of the state?

Thus, again, liberty is power. Of what does this power consist? (Of being educated and of being given the tools of production.) Who is to give the education and the tools of production? (Society, which owes them to everyone.) By what action is society to give tools of production to those who do not own them? (Why, by the action of the state.) And from whom will the state take them?

Let the reader answer that question. Let him also notice the direction in which this is taking us.

Re:Socialism Sucks (5, Insightful)

splutty (43475) | more than 3 years ago | (#36983668)

I'm sorry, but you particular view of the world breaks when people need to work together that have no reason to work together other than that 'The People' would like them to.

Localized private companies don't want to invest money in being able to exchange data with other localized private companies (possibly in a completely different country), since they don't have any use for such a system.

And if you get hit somewhere where the local company doesn't have coverage, and you unfortunately die because you're hyper allergic to penicilline.. Well. That's not their problem, now is it?

That's what you have government for, to have some sort of control over all the little fiefdoms. Although I agree with you that what government tends to do nowadays is far overreaching.

Re:Socialism Sucks (0)

Coolhand2120 (1001761) | more than 3 years ago | (#36983900)

Name a single example where private individuals failed to step up to the plate and deal with a real problem?

Today, if I change doctors, and I have numerous times, they request information from my last doctor, this system, that has been around for as long as doctors have been around, has yet to fail me. As far as allergies are concerned, people with unusual or extreme allergies carry around a medical bracelet or necklace that describes the allergies. Furthermore, if you cannot be identified because you are without ID and unconscious, the bracelet would be far more valuable than a unfetchable medical record.

The Electronic health record [wikipedia.org] has been around for a long time, with numerous private sponsors and a half dozen viable standards for use. And now the government wants to "revolutionize medicine" by giving us "electronic health records" as if the private industry hasn't been doing this for decades. Oh and by the way, we're paying for the government to invent "electronic health records" as if it didn't exist. Do you really think that govenrment buricrats are going to contrubute to this system? I think they will decimate it as they do with everything else they touch.

But if you still think the "government way" is better, check out the number of private companies offering:

Now, compare this to the number of government's anywhere offering any of this. Draw your own conclusions.

Re:Socialism Sucks (1)

Dog-Cow (21281) | more than 3 years ago | (#36984072)

Pollution.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36984428)

99% all solutions for pollution in existence today have come from the labor of private individuals, without being forced to do so by the government. How can you government is superior? Are you suggesting that the government has a "magic" power plant does not pollute that private industry is incapable of using? A car that runs on air? What is this thing that the government has that you think private industry is incapable of possessing?

The strictest socialist government in the world is also the world's worst polluter, while most free market companies promote their 'green initiatives' without force from the government. Why? Because they think it will help promote their public image which will result in more profit. Because their customers demand it. The solution to smog did not jettison as a projectile from a government gun, but though talented engineers in private companies. Do private companies pollute? Yes. Does the government pollute? Yes. Is the pollution of one somehow inherently less toxic than the other? At least with private industry polluting there is recourse if their actions have harmed you. Can you say the same about the government?

Re:Socialism Sucks (1)

NeutronCowboy (896098) | more than 3 years ago | (#36985378)

99% all solutions for pollution in existence today have come from the labor of private individuals,

Citation needed.

Are you suggesting that the government has a "magic" power plant does not pollute that private industry is incapable of using?

Strawman.

What is this thing that the government has that you think private industry is incapable of possessing?

Rhetorical question, based on complete ignorance of the reason behind government.

The strictest socialist government

Citation needed that that is China (on multiple levels).

in the world is also the world's worst polluter,

Citation needed.

while most free market companies promote their 'green initiatives' without force from the government.

Citation needed.

Because they think it will help promote their public image which will result in more profit.

Citation needed.

The solution to smog did not jettison as a projectile from a government gun, but though talented engineers in private companies.

Citation needed.

At least with private industry polluting there is recourse if their actions have harmed you.

Citation needed.

Can you say the same about the government?

Rhetorical question, based on complete ignorance of how government works.

Wow, that was fun. You made every factual statement up out of whole cloth, and are ignorant of the most basic premises behind government AND private enterprise.

I'm sad to say, but you're a shining example of what passes for a Libertarian in the US: Ignorant and full of strawmen and rhetoric based on ignorance.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36986762)

Since the government in the U.S. does not control or own any industry, it follows that all innovations for any industry come from private industry. I was being kind when I gave the government %1, but I would say the burden of proof is on you to prove the 1%, the 99% is self evident. The DOE does not make anything the EPA does not make anything. If you still need a citation, I'll need to know how you want me to quantify it. I assure you, no matter how you count it, innovation belongs to private industry.

Are you suggesting that the government has a "magic" power plant does not pollute that private industry is incapable of using? Strawman.

No, this is not a straw man, this is in fact the core of the argument. I need to know why you think the government can do "it" better than private individuals. What does government posses that private individuals do not?

Rhetorical question, based on complete ignorance of the reason behind government.

I have read more volumes about government than I even care to list here. From Plato to Hobbes to Locke and just about everything in between. Literally dozens of books including ones that I disagree with like Bossuet, Blanc and Marx. That you declare my ignorance on the subject based on that statement speaks volumes about you.

in the world is also the world's worst polluter Citation needed that that is China. The strictest socialist government Citation needed that that is China (on multiple levels).

I guess you've never been to China. [rediff.com]

China is the world's worst polluter nation with the highest overall annual emission of greenhouse gases (6,018 million tonne).

And it really does suck: Environment in the People's Republic of China [wikipedia.org] . Did you know, that in China, they use what's called night soil [wikipedia.org] ? That is, they use human fecal material to feed their crops. Now, I'm not sure how you quantify "strict'. So here's a try Highest number of people annually executed [wikipedia.org] , massive Religious intolerance [religioustolerance.org] the adoption of the Communist [wikipedia.org] form of socialism, the strictest form of socialism, dictating the eradication of all other political thought. I can go on if you require more citations. Ever hear of Tibet?

while most free market companies promote their 'green initiatives' without force from the government. Citation needed.

Here's about 25.7 million [google.com] You can go though them. But I'm telling you now, it would be more difficult to find a company that doesn't have some sort of "green initiative"

Because they think it will help promote their public image which will result in more profit. Citation needed.

All of the results from the link above were about companies trying to promote their public image through green initiatives. And they do speak for themselves.

The solution to smog did not jettison as a projectile from a government gun, but though talented engineers in private companies. Citation needed.

Oh? I thought it was the car companies, GM, Ford etc. that made the cars. Am I mistaken? Doesn't GE, Honeywell, Westinghouse and many other private companies make the power plants and other equipment that we use? I can list private companies all day that make equipment we use, but can you name a single government entity that created anything?

At least with private industry polluting there is recourse if their actions have harmed you. Citation needed.

Seriously? Just type in this pattern #disease# lawyer. Here's one for you to get started mesothelioma lawyer [google.com] Ya, you can use the legal system for recourse if a company wrongs you.

Can you say the same about the government? Rhetorical question, based on complete ignorance of how government works.

Ever hear of the right of citizens to redress grievances [wikipedia.org] with the government? It is not a rhetorical question and the answer is sometimes yes and sometimes no. And you say I'm the one with complete ignorance on how government works! My point is that the government has the right of sovereign immunity [wikipedia.org] while a private company does not.

Wow, that was fun. You made every factual statement up out of whole cloth, and are ignorant of the most basic premises behind government AND private enterprise.

I'm sad to say, but you're a shining example of what passes for a Libertarian in the US: Ignorant and full of strawmen and rhetoric based on ignorance.

I hope now that you've placed your foot squarely in your mouth. I've backed up 100% of my assertions with facts. That you didn't know the facts, while I did, sort of makes you the ignorant one. But I don't want to get into name calling, just keep it civil.


My question to you: now that I have provided what I think is more than enough citations to backup everything I said, do you now take on my point of view? I doubt I can change your mind, only you can do that. And to that end, I suggest you honestly sit down and read The Law [constitution.org] It's not even 50 pages long if you double space them, and in the time it takes to argue with me, you can read one of the books I draw my arguments from and sort of "skip the middleman".

Re:Socialism Sucks (1)

NeutronCowboy (896098) | more than 3 years ago | (#36987840)

Since the government in the U.S. does not control or own any industry, it follows that all innovations for any industry come from private industry.

Only by a very narrow definition of industry and control. What do you call SEC and EPA regulations?

Are you suggesting that the government has a "magic" power plant does not pollute that private industry is incapable of using?

Do you know what a strawman is? It's an argument that no is making, created for the sole sake of knocking it down. The quote is a strawman, because no one is making the argument you're making.

What does government posses that private individuals do not?

Really? You're asking that question? I'll just put out a really, really obvious example: what's more effective, a private individual shooting at trespassers, or the US Army shooting at trespassers?

I have read more volumes about government than I even care to list here.

Notice I didn't say anything about your reading habits. Merely about your knowledge. The two are not identical. Quite obviously so, in your case. And for the record, I probably read more than you.

Stuff about China

I'm shocked that you actually have citations. Too bad you didn't read them. Your rediff link, for example, points out that there are multiple definitions of polluters, and under one of them, Australia is actually ranked #1, and China #44. Things are never as easy as they look. This is no clearer demonstrated than with capital punishment and imprisonment. Did you know that the US has more prisoners per capita than China? I'll just point at Wikipedia, since you seem to be fine using that as a source (I'm sure you know it really isn't). China is so big that a lot of national numbers are misleading. Finally, you clearly didn't read the Wikipedia entry for Communism, because China isn't communist. It very much is its own form of government, rooted in a few thousand years of government and philosophical traditions.
Again, it goes to show that reading is not the same as understanding.

Here's one for you to get started "mesothelioma lawyer"

And why is that effective? Because of government laws. Find me something that shows you have guaranteed recourse outside of getting any government agency involved - recourse being made whole.

Google link

Google is not a source. Don't be lazy.

Ever hear of the right of citizens to redress grievances [wikipedia.org] with the government?

So you're saying, it kinda works like lawsuits or anything else? Shocking. Furthermore, I was looking for something much simpler. Look up the concept of voting.

I've backed up 100% of my assertions with facts.

Yeah... about that. Your sources didn't even support the assertions you were trying to back up with them, if they didn't flat out contradict them. Good job.

And to that end, I suggest you honestly sit down and read The Law [constitution.org] It's not even 50 pages long if you double space them, and in the time it takes to argue with me, you can read one of the books I draw my arguments from and sort of "skip the middleman".

I find Proudhon more convincing than Bastiat, which isn't saying much. Bastiat, while certainly able to see the fallacies of socialism taken too far, is unable to follow his own arguments to their logical conclusion. Furthermore, he commits the sin of building a great theoretical construct of the law that completely ignores the realities of human nature. You can argue that we should all aspire to be great people, but the reality is that most of us aren't, and will never be. As a result, his basic premise that government non-intervention will always lead to the optimal human development is a complete non-starter, and renders his entire concept unworkable. In that sense, I find him actually worse than Rousseau. At least Rousseau's Candide has a certain poetic and literary charm.

Re:Socialism Sucks (1)

bagorange (1531625) | more than 3 years ago | (#36984082)

Name a single example where private individuals failed to step up to the plate and deal with a real problem?

I presume you are American.
Your country has large numbers of people who cannot quit jobs they hate because they need health insurance from a large employer. They cannot consider working for a small business. (This is the experience of someone I know directly.)
Large numbers of your population have no insurance at all.
Your country won't have decent public transport because it's for teh commies. You would rather fund the arabs more than use more efficient transport.
Let me guess - these are not "real problems" ?

Roads in areas without dense population in my country won't be paid for without taxpayers, people who live in rural areas of my country benefit from subsidy from the more densely populated and "profitable" areas.

Interestingly, here in civilisation people did stand on the crease and solve the problem like the brave individuals they are - they elected successive non-libertarian governments.

The Sacred Market (Blessings and Peace be upon its Holy Name and Works) is part of the mental framework that you use to justify your utter selfishness.

Re:Socialism Sucks (1)

Anonymous Coward | more than 3 years ago | (#36984160)

I live in the UK and i am no fan of the NHS, its outcomes are some of the worst in the western world and the staff in my experience are rude, unsympathetic and terminal jobsworths.

I now have private medical insurance for my family due to the utter incompetence of the NHS, if I or someone i loved were ill i would genuinely be frightened for their safety being treated in an NHS hospital.

Re:Socialism Sucks (0)

Anonymous Coward | more than 3 years ago | (#36984378)

Anecdotes aren't data, but to provide a counterpoint, I live in the UK, and without the intervention of the NHS, I wouldn't live anywhere.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36984644)

You present a false choice though. You imply that if NSH wasn't there that doctors would not exist for some reason. I contend that doctors practice in spite of NHS.

Re:Socialism Sucks (0)

Anonymous Coward | more than 3 years ago | (#36984934)

Not quite - what I mean to imply was that if my life-sustaining neonatal incubation wasn't provided by the NHS, it wouldn't have been provided by any doctors due to lack of payment etc.

Not entirely evidenced, of course - which puts it on equal par with your own contention,

Re:Socialism Sucks (1)

NeutronCowboy (896098) | more than 3 years ago | (#36985402)

You present a false dichotomy AND a strawman. In one sentence. Clever. To spell it out for you: Doctors existing does not imply access to doctors. NHS doctors existing does imply access.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36985854)

Where did you get that I implied access to doctors? Or didn't? I made no inference in either direction. I stated that the lack of NHS does not mean that doctors cease to exist. And what's the straw man argument I presented? That doctors operate in spite of the NHS? I think that's a pretty widely held position among doctors in the NHS, not that I've taken a poll or anything, but it's hardly a straw man argument, mostly because it isn't even an argument! But if you need proof of this non-argument, look at the severe shortage of doctors in the UK as proof of a less than desirable environment for doctors.

Re:Socialism Sucks (1)

NeutronCowboy (896098) | more than 3 years ago | (#36986430)

Ignorant AND stupid. Libertarian indeed.

The point that you keep missing - I still don't know if that's deliberate ignorance or not - is that the AC was referring to the fact that without the NHS, he wouldn't have ACCESS to doctors. Something that is very different from doctors not existing, but that has the same impact for him.

I'm sure the next thing you're going to trot out is that it's his own fault that without the NHS, he wouldn't have had the money for a doctor. I mean, infants should be personally responsible for their health care, right? And if they aren't, they should definitely pay for the sins of their clearly worthless parents.

Libertarians, I swear.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36987978)

Ignorant AND stupid. Libertarian indeed.

You sound to me like a 14 year old. Now you may not be 14, but that is how a 14 year old sounds, not a civilized adult. I will respond to you only in an effort to educate you, but really, there is no reason to be so childish.

The point that you keep missing - I still don't know if that's deliberate ignorance or not - is that the AC was referring to the fact that without the NHS, he wouldn't have ACCESS to doctors. Something that is very different from doctors not existing, but that has the same impact for him.

And the point that you keep missing is that he would have seen a doctor in the absence of NHS. NHS does not have a monopoly on doctors. NHS does not have a monopoly on "free" health care. Using your logic, if NHS didn't exist, everyone in the UK would suffer and die if they required a doctor because only the NHS can provide ACCESS to doctors. Using the same logic a tyrannical dictatorship is good because they provided ACCESS to the fire department that put the fire in your house out (fire departments exists in non-dictatorships also so the dictatorship deserves no special praise). NHS and doctors are not inseparable. For instance, in the U.S. we don't have NHS but people in need can ACCESS a doctor free of charge. As far as infants go, in the U.S. we have a safety net called medicaid for people who cannot afford insurance. There isn't a child in the U.S. that goes without medical care. My whole argument is this: NHS didn't save anyone's life, a doctor did. If NHS never existed, a doctor would still save his life And because this is totally hypothetical, I theorize they would have done a better job.

You seem to argue "only NHS can provide ACCESS to doctors", but you must admit that were the NHS to have never existed, something else would be there instead, and no matter what's there, the doctor is the important part, not the government. The government can only hamper and confuse this relationship as they have absolutely nothing to do with it.

Doctor: Your tooth is toast, you need a root canal.
Patient: When can I come in to get that?
Doctor: I don't know, I have to ask the government.


That may sound stupid, but that's NHS. Now in the U.S. the conversation goes like this:

Doctor: Your tooth is toast, you need a root canal.
Patient: When can I come in to get that?
Doctor: Tuesday.

So what exactly is the value added by the government? Ya, I know, you'll say straw man, but that shit happens every day so it's hardly a logical falicy. British are down right famous for their poor dental care, and that is a direct cause of the NHS. When the government takes responsibility for healthcare, they must also take the risk of failing at it, as they have in the case of the NHS. (isn't this article yet one more example of their failure?)

I can't speak for the UK but in OZ they will refuse medical treatment to foreigners who cannot produce a credit card. My close friend was stung by a deadly insect called a "stinging tree" on a trip to OZ, and they refused him treatment for a life threatening ailment until he could produce a credit card, he almost lost his leg. In the end his mother was able to provide a CC over the phone to the hospital. In the U.S. if you're a doctor and refuse treatment to someone who is in dire need, you're going to jail. You cannot be refused service at an emergency room in the U.S. unlike OZ.

Also, non-citizens of this country have the same access and quality of care as any citizen has. Quality so good that people flock from all over the world to come to U.S. hospitals. It may be more costly than what you get in the U.K. but you really get what you pay for.

I hope this now totally refutes the idea that NHS saved him. Here in the U.S. he would have been saved even if he was a non-citizen in spite of our lack of an NHS style system. He's not being saved by the system, but rather in spite of the system. A good doctor, believe it or not, wants to cure disease.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36985672)

Your country has large numbers of people who cannot quit jobs they hate because they need health insurance from a large employer. They cannot consider working for a small business.

The same can be said in reverse. Some leave their jobs to go to a job that has better health care. At least we have a choice. Tell me what your plans are when you find that your health care is poor? And BTW when was the last time you visited a dentist? I pay $150.00/yr for dental insurance through Delta Dental, I pay $20 for a visit, $10 per filling $80 for a crown. I have a cavity so I made an appointment two days ago for today, I could have gone yesterday. I'm just wondering, how long does it take for you to get an appointment with a dentist? The insurer with most denied claims in the U.S. is Medicare, not a private insurer. I already know who is the largest denier of claims in the U.K. and it dwarfs the number in Medicare. I guess there's something to this whole "pay for goods and services" thing. It sort of gives people an incentive to do things. Meanwhile in the socialist countries you rely upon what? The goodness of the doctor? What exactly makes people want to become doctors in the UK? The 8 years of school? The cost of the schooling? It's certainly not the big payout when they get a job like here in the U.S.. But I guess that's why the U.K. has severe shortages of doctors.

Large numbers of your population have no insurance at all.

Anyone who wants health care in this country gets it. Period. Everyone in the U.S. pays into medicare and medicaid. These are for retired/injured and poor respectively. The percentage of people with healthcare in this country is around 97%. That's if you don't count 1) people who have never applied to medicaid/medicare 2) people between providers 3) illegal aliens. These three groups account for about 15% of the uninsured. Another 3% truly cannot obtain insurance for some reason or another. A lot of the time however that reason is often the government preventing them from obtaining insurance, for instance by preventing the sale of insurance across state lines.

Your country won't have decent public transport because it's for teh commies. You would rather fund the arabs more than use more efficient transport. Let me guess - these are not "real problems" ?

There's more socialist logic. Presenting a false choice. So if the government runs things they don't "fund the arabs"? In fact, government tampering with the right to drill for oil domestically is what makes us resort to "the arabs" as you call them in the first place. The enviro-socialist logic being: even with looser environmental controls, that's the "arab's" earth, not ours so our earth isn't harmed.

We are free do do what we want, some people want public transportation and some people want to drive a car. It's called freedom. And how little you know about where I come from. I live in California, the state with the least public transportation among the 50 states. It is said we enjoy driving, and indeed I do. I have a very fast sports car that gets really bad gas mileage, but it makes me happy to drive it, and I happily pay more for that right. But in spite of this and the fact that California has half the population of the UK, we have massive public transportation systems that dwarf the UKs. These systems not only can take you from anywhere to anywhere in this state but from anywhere in this state to anywhere in the union. Here in Long Beach, CA we have the Long Beach Transit, we have the Orange Country Transit and about three or four other independent transit companies operating public bus lines. And that's not counting private companies like grayhound or yellow cabs. We have so many damn bus lines in Long Beach someone thought it clever to even have a UK style double bus line, just for fun. There's also the runabouts, little buses for inter-neighborhood travel, they travel on the same lines for the most part so every other street has bus benches with multiple bus lines stopping there.

Now on to rail. Just in Long Beach we have the Blue Line light rail and the regular blue line, which will get you to anywhere in the LA county area (about 12m people) which connects to the LARGER red line, that's if you need to go a bit further. And of course if you really need to get around you just hop aboard an AmTrack. All of which is public transpiration. And this state is considered the state with the least. If you look at a state like New York, people don't even own cars there, the massive population densities rely solely upon public transpiration (I couldn't stand it myself). The entire state of California is easily navigable via public transpiration, we have twice the area (CA:423,970km2 vs. UK:243,610km2) and half the population (CA:37.2 vs UK:62.2m) we in California are considered among the most taxed in the country (and we are) yet we are still not nearly as taxed as you are, but still manage to squeeze out a public transpiration system that totally dwarfs the UKs in miles of road/rail, diversity of mode, and use of private industry.

Roads in areas without dense population in my country won't be paid for without taxpayers, people who live in rural areas of my country benefit from subsidy from the more densely populated and "profitable" areas.

Road funds in CA are collected via a fuel tax and car registration fees, these funds go to Caltrans who in turn doles them out to private companies to fill contracts on road construction and maintenance. And might I add we have the most and best roadways in the entire world. Hop on the 16 lane 405, or the take the scenic PCH from Mexico to Alaska. I've had opportunity to work in some of the most remote areas of the country (San Bernardino Mountains, 8000ft+) and I assure you there are roads leading to every house and a federally funded mail route to them. That's one of the few "socialist" things in the U.S. constitution. And the few "socialist" things outlined in the U.S. constitution I can stand. Doesn't mean I like it, but it is tolerable. This gross bloating of the roll of government I cannot tolerate.

Interestingly, here in civilisation people did stand on the crease and solve the problem like the brave individuals they are - they elected successive non-libertarian governments.

And you still have the law of succession as a result. You have the house of lords. You have Kings. So hows that civilization working for you? Did the queen use her god given might and power to bring about good fortune upon her subjects? I have never known what it's like to be subjugated. Do you not like people calling you a subject? I can only assume it must suck to be forced to be the subject of someone your government recognized as better than you due to chance of birth. I seem to remember something about the abolition of slavery and freedom of expression, private property, and religion making the U.S. civilized long before your monarchy. And it must suck to still have a backwards ass form of government. I recall a while back the U.S. fighting a bloody war to throw off the yoke of this... "civilization" that you hold so dear. And now you slowly replace your kings with socialist ubermensches and call it progress? Alexis de Tocqueville said the biggest difference between the democracy of the U.S. and the democracies in Europe is that in Europe the government gives up a portion of their power to the people while in the U.S. the people give up a portion of their power to the government. Indeed! That I think is why you are so ready to throw your freedoms away, you really never felt, in your heart of hearts, like you had any to begin with. And I guess in the UK, unless god had endowed you with royal blood, you don't have any real freedom. But hey, don't despair, maybe You'll get a knighthood! Man has no right to own, command or control any other man. Until you outlaw the right of succession, and stop denying that "all men are created equal" you are not, in my opinion, a civilized country.

The Sacred Market (Blessings and Peace be upon its Holy Name and Works) is part of the mental framework that you use to justify your utter selfishness.

I've never heard of "The Sacred Market". And what makes me so selfish by wanting to benefit from the fruits of my own labor? Maybe you would like next to compare how compassionate, in a monetary sense or otherwise, the U.S. is vs. the UK next? Did it ever occur to you that if you had more money (because of lower taxes) that you would also have more money to give to charity? No, I suppose you didn't think about that. Let me leave you with a quote from the great emancipator, the first republican president, Abraham Lincoln (1809–65):

The world has never had a good definition of the word liberty, and the American people, just now, are much in want of one. We all declare for liberty; but in using the same word we do not all mean the same thing. With some the word liberty may mean for each man to do as he pleases with himself, and the product of his labor; while with others the same word may mean for some men to do as they please with other men, and the product of other men’s labor. Here are two, not only different, but incompatable things, called by the same name—liberty. And it follows that each of the things is, by the respective parties, called by two different and incompatable names—liberty and tyranny.

Re:Socialism Sucks (1)

ColdWetDog (752185) | more than 3 years ago | (#36987858)

Now, compare this to the number of government's anywhere offering any of this. Draw your own conclusions.

The conclusion I draw is that your insane libertarian fantasy is just that. For all of these wonderful little demonstrations you've quoted, I don't see EHRs rolled out in a standardized fashion anywhere. If you are correct, there should be some evidence of interoperable EHR adoption by now. Got any takers?

The VA (standards based) doesn't talk to Kiaser nor Giesinger nor Mayo nor even the military system. In your wonderful fantasy land I would expect the VA (US Veteran's Administration, government run) to interoperate with the US Military medical system at the very least. Currently, if you are the local US Coast Guard Clinic and you ask the local VA hospital for a patient's medical record you do get them in a more or less electronic fashion - they're faxed over. Not even plain text computer to computer capture like secure e-mail. Faxed. A presumably dead technology.

There are small demonstration projects. There are NOT large scale build outs. EHRs are (relatively) easy to create for individual hospital / clinic systems. They are very hard to do nation wide. It should not be as hard as it is, but that mostly has to do with the inefficiency of the government in dealing with complex problems. However, your solution of letting the market sort it out has led to no attempt at a solution because there isn't any money in it. And no, claiming to offer an interoperable EHR as an additional 'service' won't cut it - certainly hasn't yet.

Leave the magic wand waving to Harry Potter films.

Re:Socialism Sucks (2)

itsdapead (734413) | more than 3 years ago | (#36983820)

The UK government in this situation is (attempting) to fulfill a need of society by commissioning the construction of a piece of 'public infrastructure' that the government deemed the society needed.

Actually, the real problem in the UK is that, because, since WW2, we have alternated between socialist and capitalist governments, we have ended up with an infrastructure that sometimes combines the social conscience of capitalism with the freedom and efficiency of socialism. We have socialist structures that conservative governments hate and want to fail, but can't openly abolish because the voters actually rather like them (and know damned well that even if they were abolished, we'd only see token tax cuts). We get public money used to engage private contractors, and "commercial confidentiality" use by the government to avoid public scrutiny. We get road and rail transport nationalized by a socialist government, then the profitable bit (road) privatized by the next while rail goes to hell, finally we get rail semi-sold off in a bizarre kludge where one company owns the rails and other companies run the trains on ridiculously short franchises that deter any investment. We get nonsensical "internal markets" set up in the NHS whereby public bodies are supposed to compete like private companies...

Probably the best solution to the NHS would have been to set up a quango which employed its own development team to produce its own system based on an open data exchange standard. A socialist solution to a socialist problem: put taxpayers money in, get a bit of public infrastructure out. Instead, we get a half-baked mix of government bureaucracy and private contracts with "for profit" companies.

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36983986)

Rather than experiment with individuals, why not let the natural course of things take place? You seem to agree that the government can only bungle things, so wouldn't it be better if they were to just step back? Government interference in any industry turns that industry from natural order to chaos by substituting the laws of nature with their own versions, causing uncertainty and inefficiency.

I fail to see the value added by having the government do things that the private individual is perfectly capable of doing himself and better. Is everyone so stupid that they cannot do anything without the forceful hand of government and the infinitely intelligent legislators? And if the people are so inept, how can they be trusted to elect intelligent legislators? That's vicious circular logic of socialism.

I also cannot think of a single example, national defense and courts not withstanding, where the government can do a better job than private industry. In fact, I challenge you to find me a single example..

I patiently await your reply.

Re:Socialism Sucks (1)

bagorange (1531625) | more than 3 years ago | (#36984262)

Roads.
Public transport.
Water supply.
Government built the telephone networks originally in this country, then handed the network to a private monopoly in the late 80s. BT was very profitable at that time.
Not sure if any advanced country has an entirely laissez faire education system? (Private primary and secondary schools have a much easier job - they cherry pick clever children and can discipline and eject the real troublemakers.)

Public service broadcasting provides much better news than conglomerates.
BBC radio is vastly superior to anything on commercial radio. (It does come from an unfair charge - licence fee paid by anyone who owns a TV, regardless of how much bbc they watch or listen to.)
Public libraries (now becoming less used because of the internet, of course.)
Police - I think most people wouldn't want that to be a for profit enterprise.

Some people can understand that the profit motive will not lead to providing all services to all people. Talking to a libertarian is like talking to a religious fundamentalist.

Re:Socialism Sucks (0)

Anonymous Coward | more than 3 years ago | (#36985442)

And, even given all it's faults, the NHS itself is massively more cost-efficient than the American system.

Re:Socialism Sucks (1)

mikechant (729173) | more than 3 years ago | (#36986026)

I also cannot think of a single example, national defense and courts not withstanding, where the government can do a better job than private industry. In fact, I challenge you to find me a single example..

The NHS provides a reasonable level of healthcare to the *entire* population at a cost per head of about 60% of the US system.
I realize you will not accept this because of your ideology, but it commands a *very* high level of support from the UK population which is why right-wing parties who wish to get elected in this country *have* to pledge to defend the NHS (at least the basic principle - free to all at the point of use, paid for from general taxation).
In many countries in Europe even with most of them having right-wing governments, healthcare *is* regarded as a basic government service as important as the police or the army.

I assert that in the UK, the government does a better job of healthcare than the private sector would. I can't prove it of course (as the alternative is obviously untried in the UK in modern times) and you will no doubt rubbish it. But a large enough majority of the UK population agree with me to ensure its future indefinitely, including many of those who wholeheartedly supported the privatization of nearly every previously state owned industry in the 80's/90's.

Re:Socialism Sucks (1)

itsdapead (734413) | more than 3 years ago | (#36986358)

I also cannot think of a single example, national defense and courts not withstanding, where the government can do a better job than private industry. In fact, I challenge you to find me a single example..

I patiently await your reply.

Well, according to the WHO [who.int] the USA spends more per capita on its nice capitalist healthcare system (that the right wing parties are fighting so hard to defend) than any other country, including all the free healthcare systems.

Of course, because that money isn't taxes that's fine and dandy, and everybody has the Gawd-given freedom to cross their fingers and hope they don't get ill.

But I guess middle-class Americans do have good teeth.

Oh, and a few years ago, most of the world listened to the ultracapitalists and removed lots of regulation from the financial industries.

That went well.

What with all the bail-outs needed to keep the credit flowing, is there any truly private industry left any more?

Re:Socialism Sucks (1)

Coolhand2120 (1001761) | more than 3 years ago | (#36987302)

I cannot argue with fact, other than to say, we spend more money and get a better product. We have more MRI machines per patient, shorter wait times to see a GP or a specialist. Really a better quality of service all around. And the best part is if you don't like the health care system you're in you can switch. It is not a coincidence those with money go to the U.S. to get treatment. The U.S. creates more innovate drugs and procedures than any other country. More progress has been made in the U.S. to cure disease than any other health care system anytime in history. If requested I can provide citations for each statement. It even sounds like the most expensive too . On the other hand, a week doesn't pass without reading about some horror story out of the NHS [google.com] , the same cannot be said for the U.S. system. And not only do the middle class have good teeth, with insurance as low as $150/yr everyone has good teeth, that is if they care to go to the dentist that is. (more doctors = more competition = better service and lower prices) And if you don't have enough money, you've just qualified for medicaid! Now your healthcare is free! I'm going to guess you're from the U.K. So it may be strange to you to find out that we have TV commercials made by dentists (and of course other doctors) vying for your business.

Oh, and a few years ago, most of the world listened to the ultracapitalists and removed lots of regulation from the financial industries.

What regulations were removed? There were no loosening of regulations. If there was show me the citation. There isn't a more regulated system than the ones in place for financial institutions. The reason for the collapse, if you care to go back and find out, is largely due to people defaulting on home loans to GSA's (government entities) that the government forced down private banks throats. Because they were GSAs they were not subject to the regulation of the FTC, but to congress, under the stewardship of Chris Dodd and Barney Frank. They first encouraged giving loans to minorities who otherwise would have been turned down (due to poor credit rating) and discouraged any sort of audit of Fannie or Freddie who eventually admitted to "cooking the books". But don't take my word for it, do a little reading. [google.com] . Increasing regulation in an already over-regulated industry to combat government agencies that were not even subject to the regulation in the first place is just wrong. The reason this is 'so secret' is that the main stream media is overwhelmingly liberal [discoverthenetworks.org] and the idea that the GSAs can fuck something so bad doesn't fit their ideology so they report on it as sparingly as possible.

Re:Socialism Sucks (1)

ColdWetDog (752185) | more than 3 years ago | (#36988054)

we spend more money and get a better product.

You really did drink the Kool-Aid didn't you? Too much by far. "A better product"? By what metric? So you can get the MRI that you don't need faster? So you live longer (oopsie), so you have better prenatal outcomes (oopsie again), so you have better mental health coverage (damn, lots of oopsies).

The US health care system is an incredible, expensive, inefficient mess. Yes, part of this is the government's fault. Quite a bit of government intervention has come directly from attempting to reign in illegal (and extraordinarily immoral) practices by the 'capitalists' attempting to game the system.

But I suppose I'm just doing this to practice typing. You're so far over the deep edge on this, so completely off base that I think it would be best if you just switched channels and communed with Ms. Bachman or just went out target shooting with your Sarah Palin blow up doll [hollywoodgrind.com] .

Minimum Viable Product (1)

Anonymous Coward | more than 3 years ago | (#36983364)

I guess no one in the NHS has heard of the term "Minimum Viable Product". Build the simplest thing that works and provides some value to someone, then iterate and improve from there. As the saying goes, "A complex system that works is invariably found to have evolved from a simple system that worked. A complex system designed from scratch never works and cannot be patched up to make it work. You have to start over, beginning with a working simple system."

Re:Minimum Viable Product (0)

Anonymous Coward | more than 3 years ago | (#36985554)

That's crazy talk. Start thinking like that, and it could apply to the NHS as a whole - madness!

Needs an Act of Parliament (1)

maroberts (15852) | more than 3 years ago | (#36983658)

Forbidding the Government to make any contract which it cannot terminate within 3 months of announcing its intention to do so.

Re:Needs an Act of Parliament (1)

Richard_at_work (517087) | more than 3 years ago | (#36984038)

No, you just need to set realistic contracts - here are some restrictions that I have been discussing with others around the military contracts debacle, where entire programmes can go through development only to be cancelled prior to the purchasing phase, meaning the development is wasted money that has still been spent.

1. Set a fixed ceiling for contractor-driven budget overruns, something like 115% of original budget. Anything else after that must be covered by the contractor.

2. Require every change to the original contract to be set under its own budget, with no change to the original contract. This budget has the same cost ceilings as set out in point 1, with the budget being that of how much it would cost over the original budget to implement.

3. Require every contract entered into to have a multi-year operating budget included, with that operating budget ring fenced and planned for in each fiscal year. Any operating cost overruns are subject to the same ceiling as set out in point 1. This stops projects going to term during development, only to be cancelled to save operating costs.

4. Require any contract cancellation to be confirmed by a vote in parliament. This stops partisan cancellations.

How does that sound?

MedXML and P2P protocols (0)

Anonymous Coward | more than 3 years ago | (#36983670)

You just need to define a file format and exchange protocol (including security), the rest can get get done on an ad-hoc basis by each individual healthcare institution. Cryptographically sign the file (and if you want, the trail) to ensure a single up-to-date copy and you're done, no centralisation needed - we could call it.....MedBitcoin?

Governments do IT very inefficiently (1)

Stonefish (210962) | more than 3 years ago | (#36983854)

Governments do IT very inefficiently, they are also clueless when outsourcing but they think that they're good at it. Vendors have teams who manage deals all the time and a government agency thinks that it can draw a team together every few years and not get skinned by the vendors. It a bit like the hometown team going up against a bunch of pros.
Internal government IT departments make these vendors attractive because they're monopolies, if the business want to wind down costs that means cutting services, there are no creative cost effective solutions. For example every innovative IT company over the past decade is using local storage not SANs as they figured out that doing storage the classic tier 1 .. teir n way that vendors said to do it was not economically feasible. But Government and the dinosaurs of the business world are still investing in these technologies.
Government buy software solution that only have a single supplier such are Microsoft, Oracle etc. You will never get a decent price or decent service when there is only one supplier, this is a market principle which governments choose to ignore. Hardware has become cheap because there's multiple supplier but the price of software has increased.
The bottom line is seek commoditisation, make markets work for you rather than against you and finally run software development like a lottery. Small teams of developers can actually out-compete most large organisations if the solution is chunked in the right way.

NHS didn't know what it wanted. (3, Interesting)

Anonymous Coward | more than 3 years ago | (#36984070)

As someone who was involved with the project from early on...

The NHS really didn't know what it wanted, it just knew that it kinda wanted some sort of joined up system, and that it had a massive wodge of cash to spend.
Result? Even when the project was years late, the NHS was STILL delivering requirements.
Add to that entrenched company's refusing to be a part of the project and working against it from the outside (One of the biggest GP software suppliers did this), good old fashioned stupidity, and a reporting structure that was classically backwards, everyone could see it would have issues.

The big suppliers are far more astute than government is. They could see several years down the line that the project would get canned, especially if the Tories got in, so they started building to that conclusion to the project (and turned it into a self-fulfilling prophecy).

One last kick at everyone involved... the GPs themselves. Under the ideas of "privacy", they fought the system wholesale. Despite the system having adequate safeguards in place. The reality is that the system would make it easier to expose bad practice among HCPs, and harder to bury evidence when needed by FOI requests. You can't sell that system to the people who are using it... it would be like making politicians vote for making themselves more transparent. Never going to happen.

consultant analogy (0)

Anonymous Coward | more than 3 years ago | (#36988924)

consultants are like taxi drivers *: they can help you ge tto your destination, but if you don't know where you want to go, they'll be glad to run up the meter by driving all over the place.
* so this analogy sort of involves cars.

Insanely Over Priced (0)

Anonymous Coward | more than 3 years ago | (#36984854)

It's been said already but at the end of the day any database system for archiving records can be put together by a small team of developers in the space of a few months.

The tricky part is scaling but then it's only a matter of scaling the back end database system and any modern database server (even the free ones) is easily scalable these days, the rest is network and connectivity and thats a doddle.

As far as cost goes, I seriously think someone cooked up a price and then added several zero's to the end of it, I cannot fathom how they can achieve a price of several billion GBP for a database project, I imagine several small Caribbean islands were purchased when the monies were handed over...

A lowly NHS service desk worker (0)

Anonymous Coward | more than 3 years ago | (#36988754)

I am a lowly service desk worker at a NHS trust implementing a new system contracted from BT and I can't believe how the system is implemented.

The new initiative to move from an old CLI based piece of software to a 'new' (not really new) GUI proprietary software all has seemed very unorganised.
Trainers have had to force people to use the piece of software in a certain way before it has been rolled out as it is buggy and breaks if you don't follow the exact set of direction. (this does not work, I don't think cerner has heard of HCI). With the issues involving american-english/british-english terminologies and buggy user un-friendly interface, the NHS probably would have done better putting the project on rent-a-coder.
Like others have mentioned, management don't seem to grasp the fact that 10 minutes of extra time in a system will lead to hundreds of thousands of pounds worth of man power. (silver bullet, mythical man month anyone?)

(also.. I was told Fujitsu walked out because they were in a contract where they were going to lose money due to their delays/failings...)

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