Intended for healthcare professionals

Soundings Soundings

Challenge and change

BMJ 2003; 326 doi: (Published 18 January 2003) Cite this as: BMJ 2003;326:171
  1. Colin Douglas, doctor and novelist
  1. Edinburgh

    Here in Auchendreich, far removed from the frenetic pace of events common in the great teaching centres, we pride ourselves on taking the longer view. This is in part a feature of the innate stolidity of the semi-rural Scot, and in part a matter of evidence based realism: our flagship new hospital, opened only last May, was, after all, in its planning stages for more than 30 years.

    So at all levels there is recognition that it takes time to achieve real change in complex healthcare systems, and our chief executive's rather low key new year message acknowledged this.

    Few were surprised to learn that DreichNet 2000, our long awaited area-wide total IM&T solution—offering real-time clinical imaging facilities, management level videoconferencing, and airline style booking systems even for our most remote psychogeriatric day hospital—is not now expected to go live much before mid-2005.

    The imminent departure of our area head of IT to a challenging new role with the betting industry, and the still unexplained disappearance of her former live in partner—upon whose software company the whole system depended—should, the chief executive explained, be seen positively: a real opportunity to step up the momentum of the project, currently being overseen on a part time basis by Miss MacPherson, formerly chief records officer with the old Auchendreich Healthcare Trust, who has kindly agreed to postpone her retirement for at least six months.

    IT apart, there were one or two points in the new year message that gave grounds for concern. A new finance director, an exiled Scot working somewhere in England, will not now be joining us, having been offered a greatly improved package by his current employer.

    On a more positive note, our deputy medical director, recently promoted to a post in the west that will allow him to spend more time with his 10 metre ocean racer, is to be replaced by an innovative job share involving a consultant and a general practitioner: a widely hailed and progressive appointment, which will become effective as soon as issues arising from their contemporaneous and unexpectedly prolonged maternity leave can be resolved. But as our chief executive put it, up-scaling both our flexibility and our productivity will be key to success in the Greater Auchendreich Health Board Area in the year 2003.

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