My first 45 rpm record was The Beatles’  Eleanor Rigby in retrospect an odd choice for a child, being written in a mixture of minor keys that go back to the ancient Greeks and with lyrics of loss and death that still evoke sadness

I soon moved on to reel to reel with headphones. It was magic. The sound quality was so much better as the Dolby audio compression got rid of the hiss. You could easily get lost in the sound and “picture yourself in a boat on a river with tangerine trees and marmalade skies ...”.

Next came the Sony Walkman. Its name said it all. You clipped it on your belt, plugged in the headphones and set off. I got a lot of satisfaction listening to the Stones but found it was best to only sing and dance in the privacy of your own home.

The technology moved on. Next came mp3 players and iPods. You could fit your entire CD and record collection on the one device. Moreover you could share it with your friends. Napster revolutionised music sharing much to the chagrin of the music industry. Record companies with the help of Metallica and Dr Dre shutdown Napster and then played whack-a-mole with derivatives like Gnuntella, Freenet, Limewire and Grokster. 

These days it’s streaming services. You can find almost any song from any genre. The industry is much happier with this arrangement since some of your monthly fee will go to the record companies and some even gets to the artists. 

The cost is reasonable for the service from Spotify, Google, Apple and Amazon but starts to mount up if you subscribe to them all. It’s hard to choose the best and asking Cortana, Siri and Alexa does not help. They’re all a little biased. 

Change is a constant. New approaches and technologies supersede old ones. The new ones are better, cheaper or faster and often all three. Records, reel to reel, cassette, MP3 then streaming ... each had advantages over its predecessor. As these advantages become apparent the new extinguishes the old. Only steampunks can be bothered with records.

The market advances through the process of creative destruction as first defined by Joseph Schumpeter in the 1940s. New companies profit and grow while the old whither and die.

The North Coast Primary Health Network is catching the next wave with its own internal IT structure. It is moving its computer systems to the “cloud”. This should offer improvements in accessibility, safety and efficiency. There will also be significant savings in hardware and maintenance costs. 

Many patients are already in the cloud and are disappointed when their doctors are not. There are literally tens of thousands of medical apps for mobile phones. Patients may enquire which ones their GP recommends. It is a daunting task to evaluate them. The NCPHN in conjunction with HealthCare Software is making the Australian Digital Health guide available on request to North Coast GPs to help address this issue.

The NCPHN is also pursuing Innovations in service delivery. Through commissioning it can extract maximum value from its contractors while avoiding the associated costs of long term relationships.  

In August it was announced that North Coast GP Training had won the contract for medical education delivery across the PHN footprint. On page 19 the new CEO, Sharyn White, outlines the framework for the next 9 months. NCGPT’s relationship with the existing medical education groups is unclear as their membership and areas of interest fall outside the contract’s restrictions. 

Previous NCGPT CEO, John Langill, is leaving the organisation and the area. On page 5 he reflects on what made the NCGPT a successful organisation and wishes Sharyn well for the future. 

Also leaving is the Hastings Macleay General Practice Network. On page 30 the last chairman of the Board, John Vaughan, pays tribute to the work done by the GPs and staff through the good times and the bad of the organisation’s 25 years existence.

New approaches and technologies are constantly being trialled and the successful ones eventually replace the old. 

Eleanor Rigby was the “B” side. Thinking back it was probably the much cheerier Yellow Submarine on the flip side that attracted this nine-year-old. That was a much better vessel for a magical mystery tour.

Image:Beatles-yellow-submarine-characters; Anathea Utley; CC by 2.0