Prescriptions OT ish

Aug 08, 2026 Last reply: 4 weeks ago 43 Replies
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I was being hyperbolic, but you see it with companies like Google, Amazon.

Stripe is a good example. You probably haven't heard of it, but it sells software that handles customer payments. When I were a lad everyone wrote their own payment process systems. However, because processing customer payments is largely the same for all systems it makes sense for one company to do it right and then sell a system to everyone else. It is not practical for everyone to reinvent the wheel. Because Stripe can spread its development cost across thousands of systems it can afford to spend huge amounts on development, huge amounts on getting it right. It then becomes very difficult for any new startup software organisation to develop a new product to compete. If someone employs you as a programmer they wonder why you can't develop are the features Stripe offers, in a few months, they don't appreciate the massive amount of programmer time Stripe invested in getting where it is. So, software has a very strong monopolistic tendency.

Even if at the moment there are a few companies competing, if one fails it isn't possible for a new one to take its place. The number of competing companies has a tendency to decrease.

It will probably be worse with AI. This is an existential threat. However, our politicians don't talk about it. They are busy talking about migrants in boats, early release from prison, or getting us involved in some foreign war. The UK political system is worse than most countries for distracting the population with trivia.

Apologies, I forgot who your were,

Golly. Someone hasn't got rodders in their kill file?

I haven't seen a post from him in years...

Rubbish. Much further than that.

Remember, there is *NO* comparable commercial IT system on the scale of the NHS, with 80+ million active records. Not even the banks (rarely more than 10 million accounts) come anywhere near it.

Simply keeping the data and systems secure is a massive exercise, then add on the high turnover of staff as front-line people come and go resulting in a permanent (re)training exercise.

I suspect the people who criticize NHS computer systems the most have only ever worked on Mickey-Mouse commercial systems. The NHS IT requirements dwarf them. Do people have any idea how much data a high-resolution Xray generates, never mind a CT or MRI scan ?. All this is stored and available to hospital staff online, and it all has to be securely backed up and made secure from hackers too.

Now add on all the GP practices and other non-hospital treatment facilities, and the added complexity of sending reports and test results back to the GP, and also to those patients who have chosen the online route. Simply a gargantuan IT exercise.

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