The Tory Party have had a brilliant idea that will be tightening the sphincter of every IT specialist in the land. Perhaps we should call them the SupposiTory Party. Enraged by the sheer waste that is Nu-Labour’s IT policy, they have put up a web site – MakeITbetter – inviting the public to comment on ways in which economies could be made in the government IT programme.

We think there’s a better way. Not only is it possible to develop a more ambitious, cost-effective and transformative vision for government IT, but we believe that it’s also possible to pursue a completely different approach to making policy. Rather than the traditional closed approach to policy making that this report typifies, we want to throw open the process and allow people to contribute their ideas on how policy should be designed. In the post-bureaucratic age, we believe that crowdsourcing and collaborative design can help us to make better policies – and we think this approach should begin now.

Since your intrepid Ms Raccoon is currently carrying out an in-depth investigation into the French medical service, my thoughts naturally turned to the £20 Billion disaster otherwise known as the NPfIT, or ‘how you get the right patient’s notes into the right Doctor’s hands at the right time’. The NHS system was a colossus known as Spine.

Once the NHS Care Records Service is fully implemented, having each patients summary record stored on the Spine will mean that wherever and whenever a patient seeks care from the NHS in England, those treating them will have secure access to summary information to assist with diagnosis and care. The summary record will also point clinicians to where full local records are held. This should provide safer, more joined up care.

The French have faced the same problems, and have arranged a system so beautiful in its simplicity, totally secure, utterly efficient – the notes are available instantly, no matter whereabouts in the country you happen to be, they don’t turn up en masse in recycling plants, they are never mislaid in pub car parks, sold onto third parties for dirty money, misfiled, nor unaccountably lost in the post as they travel from one Doctor’s surgery to another. They don’t get confused with another patient’s notes, they are always completely up to date, there is no extraneous information included regarding the wart you had on your nose when you were 13 1/2 to confuse the Doctor. They don’t require an army of secretaries to write letters, somehow stuff another four pages into the bulging file, or enter data.

Best of all, it doesn’t cost the tax payer a penny to run, entirely, utterly free. Eco-friendly too. What more could anyone ask?

Let me tell you how it works. Let’s assume that you have another wart on the end of your nose. You’ve been to see your Doctor, and he wants some blood tests done, and an x-ray. They’ve been done and now, two days later, you have a 7pm appointment to see your Doctor again to discuss the results.

At precisely 7pm (another French innovation, perfect time keeping, gets both Doctor and patient in the right frame of mind) a hand glides silently forward and place in front of him the results of the blood test and the x-rays. Just yours, no one else’s, nothing to do with the time you got a dose of something unpleasant when you were at Uni, just precisely the information he requires to deal with the, ahem, small problem on the end of your nose.

How do they do it? Here I have a small problem. I’m not sure whether to e-mail the answer to the SupposiTories, or whether we should form the ‘Raccoon Insight Centre’ and apply for a massive grant. I’ll tell you how they do it, and then we can decide what to do next. You’ll kick yourself when I tell you, its s-o-ooo simple.

When you first went to see the Doctor, he sat at his desk and clicked the mouse on his computer a couple of times. Accessing some central computer? Not a bit of it. In the interests of your enlightenment, I got him to show me what he did. He clicked on an icon that said Blood tests. He ticked a couple of boxes, clicked on my name, and out of his printer slid a sheet of paper authorising me to have some blood tests. He did the same thing with an icon marked x-ray. No typing involved. No Secretaries. Then comes the really innovative bit. No Postage! He handed me the two sheets of paper!

At no cost to the tax payer, I convey those slips of paper round to the blood laboratory, and then to the x-ray department. I put my medical card in the machine, so the system knew that I was entitled to free medical treatment – see! we’ve just knocked out those secretaries that have to chase up foreign patients who don’t pay their medical bills – and sat down in front of the x-ray technician. He consulted the ultimate Oracle on what precisely needed x-raying, not a bulging set of notes belonging to someone else, or a groaning IT system that was on strike at that precise moment, but me! Little Me. Cute Huh?

He does his x-ray, and five minutes later he emerges and says – either – that’s just a dirty mark on the end of your nose, no problem, in which case I don’t need to bother the Doctor again, no three week wait for the results; or he says, terribly sorry, your nose is about to fall off, can I recommend you make an urgent appointment with either …or ….or….. and he hands me the x-rays. I trot off to one of the expert nose Doctors he’s just recommended me to, cunningly concealing about my person all the information they require. My blood tests, my x-rays, and my medical card entitling me to expect them to do something and be quick about it.

Should I decide I might go home to my Mother for some tender loving care, I ignore his suggestions, get on a train, and go and see the nose Doctor near my Mother’s house, the other side of the country. Still saving the taxpayer a fortune, because all the information this nose Doctor the other side of the country might require is right there in a dossier in my suitcase.

If the wart gets so big overnight that I cannot face going to see the Doctor, I phone him up and he comes to see me at home. (For the benefit of younger readers, this is called a ‘home-visit’, used to happen in the UK until they decided that having people call ambulances or screaming round to the A & E department was a more convenient way of dealing with people who were too sick to make it to the doctor). There, in my home, the same silent hand reaches under the bed, grabs my dossier, and then glides forward and gives the Doctor precisely the up to date information he needs to treat me.

My hand, my body, my notes.

Is that just too bluddy simple for the NHS? Am I missing something here? How much should we charge them for saving them £20 Billion?

Sabot
December 2, 2009 at 13:49

Wonderful, isn’t it. And they even record how much you paid the doctor and the pharmacist, and then send you your money back, straight to your bank. You don’t have to do a thing.

I still can’t get over this. I might start going to the doctor more often, he even tells me what’s wrong with me in French, so I get a free French lesson as well.

Rog
December 2, 2009 at 13:52

Wot! no translating into 82 different languages? No queuing behind ‘pregnant women of the world unite’?
We recently moved from the east of England to the west of England. Two months on my partner’s medical notes have still not arrived and she has been told they possibly never will.
She has a serious illness and all medical notes now start from day 1 again.
Bet your really jealous of our system.

Vimes
December 2, 2009 at 13:56

With respect, anyone who uses the word “crowdsourcing” shouldn’t be trusted to organise the proverbial in a brewery – how hard can it be and what could possibly go wrong?

Gloria Smudd
December 2, 2009 at 14:33

Sound of hammer hitting nail squarely on the head, Mme Raccoon.

microdave
December 2, 2009 at 15:04

I can see a problem with this if it were ever introduced in the U.K. Oh, sorry, EU regions 1-8 or whatever we are now.

This wonderfully simple system assumes that the patient is actually responsible, and capable of thinking for him/herself. As we now have a generation who have to be told what to do, and demand instant treatment when they get a sniffle, the risk that the wart may actually be something worse could lead to mass panic….

And think of the carbon footprint with all those sheets of A4!

Fred Thrung
December 2, 2009 at 15:27

Welcome back Ms Raccoon! I reely reely hope you will continue to keep an eye on Thaddeus (and Gloria, bless!) and interject from time to time.

I’ve been there too (not France, but similar system). I have a skeletal thing which needs to have an eye kept on it. When I came back to the UK after my first extended absence I handed my most recent Xrays (one month old) to my new doctor. He handed them back to me, said they weren’t acceptable (foreigners don’t know as much as we do), and sent me to the local hospital to go through the NHS system which we all know and love. So additional Xrays (thanks, NHS) and an unneccessary wait to get the results back.

I still have *my* Xrays from the other country, but since I can’t see my UK Xrays, I cannot check progress myself. So I need to bother my GP who has better things to do than a blink test on a couple of photos.

RogerDodger
December 2, 2009 at 16:42

She’s back…

Masterful work.
As much as it pains me to learn about society from the French, we are so many many miles wide of the mark in the UK.

john ward
December 2, 2009 at 17:45

Good to see that Treasury lies about ‘