In many cases the requirement is for careful evaluation to find measures which give the best protection, accepting that limitations are set by the state of staffing and funding. Such an outlook is generally more honest than signing up to stringent requirements, knowing that the implementation is bound to have some serious shortcomings. Our view is that primary care should concentrate on extending its existing practices on confidentiality to embrace all computing, as and when it is introduced, and that this may often mean that strong reliance is still placed on human discretion rather than on formalised controls built into the computer system. Where networked access is being planned between agencies, various kind of system barriers will be needed, but these should be built around the concept of mediation by someone within a local trusting group. Some alternative proposals.
Information is often obtainable from more than one source.
If irksome barriers are put up between users and a computer system, and users feel they particularly need an item of information, the most likely outcome is that they will seek out different routes to it. It follows that every primary care agency has to look at its information holding in totality. The need to harmonise computerised and non-computerised approaches is in any case recognised in the provisions of the recent EU Directive on Data Protection. The dividing line between type of media is becoming blurred, for example through the use of computer indexes for paper records, or computer files based on document images. In most cases, there will be a slow, step by step, progression towards wider use of I.T., as each agency in turn acquires the necessary skills and technology.