Thought for the day: Small is beautiful

What is the difference between the NHS IT programme and the old Soviet Union? Very little, says Maldwyn Palmer.


What is the difference between the NHS IT programme and the old Soviet Union? Very little, says Maldwyn Palmer.




For those of us who have worked on large governmental IT projects the present strategy for the NHS is becoming painfully similar.

The old Soviet policy of central control is rearing its ugly head yet again. The premise that only large schemes can be solved by large companies has not proved successful to date.

 The basic requirements are that data appears in the same format and input and reporting should be available and simple. To assume that only big corporations could handle this basic need is facile and dogmatic.

There are lots of companies and systems that already have a better handle on the needs of hospitals than any new Johnny-come-lately. The only necessity is that a common transit system between centres is in place. XML or, perhaps, a MXML (Medical XML) would provide the exchange medium and standardised codes for patients and medicines would ensure uniformity.

How health units purchase software and support should be up to them and not forced on to an uninvolved and generally cynical service. Requirements should be from the users as they use it. Cries of " but that is what we are going to do!" are not very convincing. The larger the project, the less "real" people get involved.

This means there will be different systems to support and some will be better than others, but organic growth will sort the wheat from the chaff. The big argument is that one centralised command system will produce easily supportable and updatable set of rules and software that will be easier to control.

My answer to this is, ha, never seen it yet, doubt if I ever will. If you contact your local supplier he will bend over backwards to help you while some big monolith organisation will blend you into its CRM mixer.

It may be treason to advocate going back to smaller and independent suppliers but, with the internet and broadband offering instant communication, it is time to see the future.

Personally I believe things should be getting smaller and smarter, but then I am not the CEO of a multinational company with shareholders to feed.

What's your view?
Which is better for business - one centralised command system, or a selection of smaller ones? Tell us in an e-mail >> reserves the right to edit and publish answers on the Web site. Please state if your answer is not for publication.

Maldwyn Palmer
was one of the first people to use the C programming language in the UK. He wrote the original mobile phone texting software for Orange and ran his own consultancy during the dotcom boom. He now writes technical articles and humorous books.

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