This thesis explores the issues that confront the GP community and the wider medical establishment as they struggle to contend with the rapid pace of change brought about by the new technology.  Whilst the banking, retail and business communities have embraced change in order to survive, the NHS and medical practice has yet to catch up.  There needs to be a wide public debate on the issues raised by telemedicine and on how the NHS as an institution can adapt and continue to survive into the next century.