Since the mid-1980s, the UK public sector has been the subject of wide-ranging reforms involving the introduction of IS and IT. Change has been sought in the ways that services are managed and delivered, the evaluation of the quality of aforesaid services, and in accountability and costing. One of the most predominant of such changes has been the introduction of competition for services, the motivation of which has been to invite efficiency, effectiveness, and related benefits ensuing from the accrual of economies. Pivotal to such change has been an explosion in the introduction of a variety of information systems to meet such challenges. Focusing on health care, a large part of the work of the health service involves collecting and handling information, from lists of people in the population to medical records (including images such as X-ray pictures), to prescriptions, letters, staffing rosters and huge numbers of administrative forms. Yet until recently, the health service has been woefully backward in its use of the technology to handle information by the standards of private industry. This has been quickly changing in recent years and by 2003 the National Health Service (NHS) spent £2.8 billion annually on capital in hospitals (Department of Health, 2003a), around 10% of which was for IT. In the last 20 years, IT has added 2% to overall health expenditure (Wanless, 2001). This investment is still small by the standards of the private sector, but is all the more significant when we consider that health care is an industry which has been slow to adopt IT and one which presents some of the biggest IT opportunities (Department of Health, 2002).