THE cost-saving initiative of out-sourcing medical notes to India for typing is facing major problems. An internet link used to transfer patient information from Lister Hospital to India has failed to meet the needs of East and North Herts NHS Trust, both in terms of speed and capacity. The Trust had hoped to save as much as £1million by axing 15 medical secretary posts and outsourcing their work. However, a medical secretary from Lister said: "After the medical secretaries were made redundant it was discovered that the NHS server for the typing to be sent over the internet to India could not cope with this system. Medical secretaries are being told that the typing will be kept at the Trust for us to type, as done in the past."

Danny Mortimer, the Trust's director of human resources, said: "Like any project of its size, there will always be initial teething problems."

"Nationally the NHS is experiencing problems with this link, both in terms of its speed and capacity of transfer of information across the internet. Contingency plans are being considered locally by the Trust, including using a separate, secure link to the internet for the medical transcription service until the problems affecting it are resolved nationally. The Trust has introduced the medical transcription service because it knows that it will save money, while at the same time providing a consistent, high-quality service. This is proving to be the case already, although more work remains to be done."