If private detectives hack people’s phones and provide transcripts of their messages to News of the World reporters, it should only take us a moment to see the enormous prize offered to journalists and inquiry agents when everyone’s medical records in England are uploaded to a centralised database that will be accessed by hundred of thousands of NHS workers.
On the whole, the public seems blissfully unaware of the risks, but GPs see it all too well and are acting together in London to make it easier for patients to opt out from the NHS “Spine”, which the British Medical Association says is being rolled out far too hastily.
The threat of the database being breached is very real indeed. In January I reported onthe failure of Scotland’s Crown Office to prosecute Dr Andrew Jamieson who, out of curiosity, accessed and read the medical files of Gordon Brown, Alex Salmond, Jack McConnell and TV and sports celebrities that were held on a similar database. There was evidence to suggest that court case would prove so embarrassing for the victims, whose medical records would be produced in evidence, that charges against the doctor brought a year ago were dropped.
In terms of security there is not much to choose between the Emergency Care Summary system in Scotland and Summary Care Record, which is being introduced in England and will make an outline of a person’s medical history available to hundreds of thousands of NHS staff.
To most people, the Spine seems logical in the digital age, but the Scottish case offers an example of what Professor Ross Anderson of Cambridge has been predicting while at the same time steadily insisting that there are ways of making patients’ information available as well as maintaining their privacy. He was among those to welcome the action by the London GPs to hinder the roll out to six million patients in the capital on the grounds that most people don’t understand the implications of the database run by BT and Oracle.
A letter is being sent to GPs from the London-wide group local medical committees that warns about the very short period that primary care trusts and the NHS are giving patients to make this critical decision on their records, which, by the way, cannot be viewed when a patient falls ill in Scotland or abroad. According to Computer Weekly, “The organisation is also encouraging GPs to “be more proactive and contact patients directly, or via patient participation groups, or via the practice website and text system if you have them.”
Patients who do not opt out will have their records uploaded but the records of those who do will be kept solely at their doctor’s surgery, where far fewer people will be able to access them. It seems an obvious choice to those who care about their privacy and worry about the eventual linking up of all government records which might give access to various agencies unconcerned with patient health.
It is difficult to find a doctor who is in favour of the system. “It is important that opting-out is made easier,” said John May from the BMA’s patient liaison group to Politics.co.uk. “At the moment there’s no opt-out form in the patient information packs being sent to patients across the country. They either have to take the time out of their day to go and see their GP, or phone a call centre, or download a form from the internet and post it in.” Dr Grant Ingrams, chair of the GP IT committee added, “The summary care record roll-out is now happening too hastily.”
Another doctor said the action by London Medical Committees represents a “complete lack of confidence in the Summary Care Record and fundamental confusion and reservation about the ethics of transferring records on to the SCR without the confirmed explicit consent of each patient”.
The GPS are circulating a poster to London practices that asks: “Do you want your medical records to stay confidential to this practice, or to be uploaded to the NHS central record system, the NHS “spine”?
Meanwhile, if you want to the opt out the form is at the end of the document entitled “What happens if I choose not to have a summary care record (SCR)?”. If you have any questions about the opt-out, you can phone the NHS care records service information line on 0845 603 8510.
• The BBC has revealed that the government is trying to fix a quick deal with suppliers for its controversial £12.7bn NHS IT programme ahead of the next general election and in order to tie the hands of the next government. Mike O’Brien has confirmed to BBC Radio 4’s File on Four programme – in a broadcast this evening – that his officials aim to sign new deals by the end of March. This story appears in the latest Computer Weekly which says that the memorandum of understand would commit the NHS to spending about £3bn.
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