Abstract
Value in the British National Health Service have shifted away from patient care towards financial control. However, in the quest for efficiency , huge amounts of NHS money have been wasted on computer system which failed. In this paper, I draw on a case study to explore some of the ethical issues which underlie this kind of waste of resources. Issues include the gap between public pronouncements and personal experience, the chaos of which lies behind the facade of rationality, and the systematic silencing of people, usually women, who question the viability of computer systems which are created for private gain rather than public service.