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I hate fax machines. I really, honestly loathe and detest them. They may look innocent enough, squatting there in a corner, occasionally humming to themselves, but I can see through their bland plastic facades to the pulsating malignity beneath. Maybe they aren’t the health service’s single most pressing problem, but they are a symbol of much that is wrong with it.
Certain middle managers will solemnly assure you that faxes are more secure than email. This may be true – but only because, since virtually nowhere except the NHS uses faxes anymore, even if you enter the wrong number your message is unlikely to be delivered anywhere outside the healthcare sector. (Although I gather faxes are still widespread in North Korea, due to that country’s extreme technological and economic isolation. I like to think of Kim Jong Un perusing our misdirected referral letters, doubtless gleaning valuable insights into life under the capitalist oppressors.)
Or your fax might go nowhere at all – unlike with email, you can never tell if it’s sent successfully. If an answer is sent through the same medium, the chances of you ever seeing it are slim. And that’s assuming, of course, that you could persuade the machine to work in the first place.
A transition to email is taking place, but painfully, slowly and erratically. One department I know of prints a defunct email address on its referral forms, apparently to avoid the embarrassment of admitting they haven’t figured out how to use a computer. If, a few weeks after your referral has disappeared into the void you call to enquire after it, they will explain without any perceptible embarrassment that no-one has checked that account for years – and give you the fax number instead.
So why are we stuck with these inconvenient, unreliable dinosaurs? Many of the NHS’s woes are down to resources, but surely maintaining squadrons of increasingly hard-to-source fax machines can’t be cheaper than email? I suspect the key is fear of blame. If you take responsibility for a change in practice, however sensible, then when something goes wrong fingers can be pointed at you. If you stick with familiar usages, however absurd, no-one can accuse you of doing anything worse than your predecessor.
It’s become a cliché that the NHS is one of the last organisations in the developed world to use faxes. Nevertheless, a large number of my non-medic friends – and patients – simply refuse to believe it and assume I must be pulling their leg if I mention wrestling with a malfunctioning fax machine at work. Let’s hope that, for the next generation of doctors, fax machines really will be nothing but a bad joke.
By the Secret Doctor
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