To fax, or not to fax? The technology row enveloping the NHS

In the debate surrounding the NHS’s outmoded telecommunication methods, it seems that the majority of individuals support giving the boot to the service’s fax machines – all 8,209 of them – than preserving them for posterity’s sake. Speaking to the National Health Executive, Liberal Democrat MP Julian Huppert denounced ‘paper-based systems’ as ‘unwieldy and difficult to use’. Richard Kerr, chair of the Royal College of Surgeons’ Commission on the Future of Surgery, opined that fax technology is ‘archaic’ and its juxtaposition with developing AI and surgical robots is ‘ludicrous’. Indeed, the executive chairman of the Integral Medical Holdings Group Jason Zemmel’s comment is a perfect summary of the antipathy felt toward the dated practice:

“There is an absolute requirement to provide a 21st century solution to primary care in the NHS. Whilst the service is starting to recognise the importance of technology, this highlights how far we still have to go to ensure that the NHS keeps pace with the complex, changing demands of patients in today’s digitalised society.”

In short, old-fashioned technology is holding the NHS back, both financially and in terms of efficiency. Whereas an email costs nothing to send, envelops and stamps must be paid for to distribute hard copies – a burden that will not cease unless the healthcare service modernises its technological facilities. Whatever one’s opinion of the man, ex-health-secretary Jeremy Hunt was likely onto something when, back in 2013, he proposed that the NHS ought to have gone paperless by this year.

On a similar note, the use of pagers, of which there are 130,000 in circulation within the NHS, are not only costly (racking up an annual bill of over £6m) but unsupportive of two-way communication. This only fuels the fire of those who, justifiably, argue for a complete overhaul of technology in the service – especially in light of revelations that clinicians are using apps such as SnapChat and WhatsApp to transmit information without permission to do so. The reason? They are frustrated at the inefficiency of faxing and the like, and have rebelled against it.

However, there is still a case for the defendants here. For all the flack they have received in the mainstream press, pagers don’t deserve their bad rep, which ignores how small, light and adept at quickly assembling medical teams the devices are. It is well worth remembering that, in terms of the ‘extra security requirements’ referenced by  , the chief information and digital officer at the Oxford University Hospitals Trust, fax machines have the upper hand. It is safer to communicate confidential information by fax, not email, given that the latter could be accessed more easily. Furthermore, after the transmission of information, faxed copies can be stored in files, meaning that they are much less, if at all vulnerable to deletion, ransom or the prying eyes of hackers. Yes – the ghost of last year’s cyberattack still unsurprisingly haunts the minds of those in charge.

To address the title question, the best answer would probably concede that, in some form, the NHS does require something of a technological makeover. However, this does not mean that all fax machines and all pagers need to be scrapped – how else would hospitals and clinicians cope in the event of a power failure and loss of connectivity? Or something as simple as misplacing their smartphone? They would not; only then would the critics of the NHS’s present technology realise that perhaps they were too stern-worded in their earlier condemnations.


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