THIS week (in my free time, naturally) I have mostly been internet shopping. I ve had several birthdays this month and not all that much time to do the present-buying thing, so the world wide web has come in very handy. I know I probably sound a bit over-

THIS week (in my free time, naturally) I have mostly been internet shopping.

I've had several birthdays this month and not all that much time to do the present-buying thing, so the world wide web has come in very handy.

I know I probably sound a bit over-enthusiastic, but sometimes it amazes me how easy the internet makes things.

You sit there at your computer in your joggers, drinking tea and dunking digestive biscuits (I'm not painting all that glamorous a picture of myself, I know) and then a couple of days later, lo and behold, whatever you've ordered arrives at your front door.

Just like that!

The internet and email have, beyond doubt, broadened our horizons and made it possible to shop, read, research and communicate with anyone in the world while sitting, standing or walking almost anywhere.

Which is, for the most part, a good thing.

Who can argue with increased flexibility?

Well, medical secretaries at Lister Hospital have a case to put..

Thanks to the wonders of technology and the desperate need for East and North Hertfordshire NHS Trust to save some cash, it has been decided to "outsource" (translation: get someone else to do it for less money) some of the secretaries' typing work.

Under this new system, routine letters will be dictated using special software, and will be sent electronically for typing to a team of specialist transcribers, who are likely to be based overseas.

The typed letters will then be sent back to the hospital.

Back in the UK, as a result of this, some of Lister Hospital's medical secretaries will be made redundant.

The Trust hopes that most of these will be voluntary.

It is thought that adopting this system will make a much-needed saving of £1million.

The Trust is also adamant that all the new workers will be graduates, fully trained in medical transcription and that there will be stringent quality control measures to minimise mistakes.

In one way, you can't argue with a public body saving £1million, and if the work is done well, it seems fair enough.

Neither is the idea of technology changing the system for typing up routine letters a new one.

It was not so long ago that medical secretaries sat in on consultations, so the poor patient had to endure a non-medical member of staff scribbling away while they chatted to the doctor - hardly great for patient confidentiality.

The advent of the Dictaphone meant notes could be made and given to a secretary afterwards, so the patients got a bit more privacy.

Technological evolution and changes to working practice happen, not just in Lister but all over the country, all over the world.

I guess in a way we can't fight it and if it saves money we also can't moan too much.

But we must also not forget that behind the technological gloss, there are people who stand to lose their jobs.

Even if the redundancies at Lister are voluntary, the whole process is going to be very stressful for all those concerned.

We can't stand in the way of progress or improvements but we must not forget the human cost.