Leading computing suppliers fear that Treasury interference with the coming NHS IM&T strategy will leave unsolved their main problem - the byzantine procurement procedures imposed on trusts wanting to spend more than a trivial sum on their IT projects.

Bryan Wrighton, managing director of the largest UK supplier, HBO, told HSJ: 'We need the procurement thresholds raised to a more practical level - with the pounds250,000 limit for private finance initiatives being pushed up to pounds1m. NHS head of IT Frank Burns believes he has convinced the Treasury to accept these changes, but I'm concerned that they will beat him down.'

But Mr Wrighton sees light at the end of the tunnel - for the first time in a grim five years - in the form of opportunities for getting IT directly to care givers. Order communications systems are the norm in the US, and Mr Wrighton believes the strategy will make order communications systems a mandatory purchase for all hospital trusts.

Several large hospitals are about to sign contracts for electronic patient record implementations, says Mr Wrighton. He expects Mr Burns' policy to accept off-the-shelf electronic patient record packages, rather than demanding NHS-bespoke. 'Unlike administrative software, the needs of clinical systems do not differ much between the US and Britain, and the industry already has several EPR systems working across the pond.'

Roger Wallhouse of SMS also doubts whether the strategy will address the 'onerous' pricing and contractual conditions that NHS computing suppliers have to overcome. He is pessimistic about new business: 'It will take time for the trusts to start handing out new contracts, especially when their focus is on how to cope with the year 2000 bug. We don't expect much activity, except in a few trusts where year 2000 is well under control.'

Mr Wrighton, too, fears that the millennium will occupy much of IT departments' time.

Both consider Mr Burns has done the best job possible in the time allowed him. But John Cruickshank of healthcare consultants Pareto warned that the industry might react with cynicism to the new strategy's calls on its resources - especially the need to develop new EPR software for primary care groups.