Recent advances

Consumer health informatics

BMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7251.1713 (Published 24 June 2000)
Cite this as: BMJ 2000;320:1713

Recent rapid responses

Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on bmj.com. Although a selection of rapid responses will be included as edited readers' letters in the weekly print issue of the BMJ, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window.

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Dear Dr Smith,

One of the most interesting uses of the Internet is as a forum for public debate about healthcare (1).

The BMJ rapid response page is a good example of this approach. It is open to anyone and responses are linked to authoritative and peer reviewed articles. As a result, it provides an opportunity for informed and free debate which has few, if any, precedents.

Primary Care Groups will need to make difficult decisions about the allocation of limited resources to primary care development, commissioning of services and health improvement. An ageing population and increasing treatment costs have led, for the first time, to explicit rationing of drugs such as the Zanamivir for flu and sildefanil (Viagra).

Rationing could widen further the gulf between those who use the service and those who provide it. In order to prevent that happening there needs to be inclusive debate in which the community as a whole decides on the values which it expects to govern the delivery of healthcare (2).

Yours sincerely,

Dr John Hopkins

(1) Hopkins J Could the Internet become a forum for public debate on healthcare quality and funding? Br Journal of Healthcare Comput Info Manage 2000; 17(4): 29-30

(2) Smith R Stumbling into rationing. BMJ 1999; 319:936

Competing interest: Writer of a health news web site.

Competing interests: None declared

John Hopkins, General Practitioner

Darlington

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