I like most of your points, but I do object to being called a wage slave ... I have 2 kids, a current partner and an ex wife. I do not go to work because I want to, but because I need to to pay my mortgage and put food on my table. If that makes me bad, then tough s.... Do you attempt to stop the system, or change it from within ? Fairly fundamental question. For those of us who work in this shoddy excuse for a project, we try and do the best we can, and you sure as hell won't be able to stop this juggernaut from without unless you happen to be, oh, prime minister or something. Even Helath Secretary won't do, since you'll just be reshuffled as a luddite. I do not have the power to stop it from within, change the specifications or to do much more than kick and shout about the implications in my area of expertise. Occaisonally, I get to do that at a quite high level, but not often and those who get paid more than my paltry £15kpa do not often listen (they know more than I do, since they get paid more, of course). What I can do is ensure that anything I am involved with is done with the patients interests at heart and to the best of my ability. In my sphere of influence, that meant making sure that there were business processes to sort out what happens when things go wrong and patient records on the system get confused and mixed up, which will happen. I would agree wholeheartedly with your assessment of a 'big bang' project scenario. There are potential improvements in electroniky stuff in the NHS, but not if it is done this way with a political agenda rather than patient care as a driver. Rant over. Back to my hole, now.