Thank you for asking for my opinion on this paper. I believe that it is sufficiently original and important for publication in the BMJ.

Scientific reliability: High

Importance: This issue is of relevance to all GPs, and other health care providers, in the UK and overseas. This paper reveals important lessons for all health care services and particularly highlights problems with regional variations and lack of consistent costing and training and access. The cost implications and public health outcomes of the NHS failing to heed the lessons learned in the Scottish experiment are potentially very significant.

Relevance to general readers: This paper will be of relevance to all GPs in the UK and to many other health care workers and health care service providers.

Suggestions on how it may be improved: There is little to add to this well written and well balanced paper. On page 3 there is a statement that 56% of practices were using NHSnet. I believe that the paper actually states that 68% of practices are using NHSnet and that 56% are using in at least weekly.

You might also like to review the paper by Dr Nicola Ellis from Manchester and me recently published in the Medical Journal of Australia (ref: N Ellis, MR Kidd. What lessons can Australia learn from the computerisation of General Practice in the United Kingdom? Medical Journal of Australia 2000; 172: 22-24.)

Michael Kidd

Michael Kidd
Professor and Head of Department of General Practice
The University of Sydney

email: michael.kidd@med.usyd.edu.au

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