London NHS paper reveals plans to share patient data

The best case yet against government healthcare?

If the CCTV cameras, terrorism act ... weren't bad enough, we give our medical data to a government run hell hole the NHS, we must be stupid to expect it isn't transferred to every bureaucrat in the country - heck, I'm suprised it isn't being shipped off to Brussels already.

Re: They can't do that can they?

Since they're parts of the knee-jerk government hell bent on curtailing civil liberties and doing it in the name of the war on terror if it can't be squeezed through any other way, wanna bet?

Legislation: easy come, easy go.

data protection act ?. means Jack S***

The data protection act? means jack s*** and from experience I can tell you that the Information Commissioner's office is a total and utter waste of time. Even if someone/a company breaches the Act they will simply say to them "dont do it again that was naughty" and that is IT. Dont waste your breathe making a complaint !

The laptop

Just needs one person to leak the database in a couple of seconds and the entire medical records of Britain are for sale, to anyone who cares to buy.

Even if you an encrypted VPN; one person is sure to have a trojan slurping up everything they type and pulling down all the data. I'm sure a sales person for an insurance company would pay a suitcase full of cash for just a glimpse at this data. I know I would.

Plus you can refer back to the data with advances in medicine and make good bets as to the risk. With the recent case of investment banks having planted criminal employees who use insider trading on takeovers, surely the medical data will be worth Billions in hard cash.

I can see several ways to make vast amounts of money by dropping high risk people, fast. Such as paying a couple of million to someone for a copy :)

In addition

Plus I wouldn't even want to steal it, just a couple of hours to run some simple searches and get the output would be enough for me.

Silly Brits

You have no rights, only what the government feels generous enough to play along with. Get a real constitution and a Bill of Rights. The Clintons tried this crap, but didn't get away with it. It would never hold up in American courts.

Grow up

Few things annoy me more than this type of reflex "Big Brother" response to any attempt by public authorities to share data.

I will give just one example of why it is needed. There have been countless inquiries in the UK about well-publicised cases of the death of vulnerable children after years of systematic abuse (the most famous being the case of Victoria Climbie). In all of these cases, all of the public authorities knew a bit - the police, the hospitals, the social workers - but no-one was putting the data together to spot the pattern. Woudln't any sane person living in a civilsied society expect the authorities to use data in the defence of these children, providing access was only given to suitable responsible professionals?

I could give similar examples in relation to the care of the elderly. By all means bleat about civil liberties and Big Brother as long as you give up your rights to complain about care services in future.

i see a problem with this (well, many in fact....,

but I will start with this one:

regardless of backdoor attacks..... the intended use has a major flaw:- a major reason to have an NHS database is to provide doctors with access to patient records so things like allergies can be detected sooner etc - so that means doctors will be able to pull up a record when a patient comes in the door - sounds reasonable... until the doctor in question happens to be in terrorist - which today (3 July 2007) 12 or so doctors have apparently proven to be. So if they can access medical records, they could easily steal identiies to use to cover their tracks e.g. pull up deceased records. And If the national ID database comes to fruitition and is linked in to the NHS...

Any tool the governement can create to help them, can be hacked and hence, help the enemy instead.

Trouble is abrewing.

That's why i am going to try out munich for a while.

Grow up? Try getting a clue!

Sminky:

Sure, cases such as Victoria Climbie were tragic but they are by far the *exception* rather than the rule.

If someone is possibly at risk, then the groups involved (Social Services et al) could make a request to have that person's data shared, but what this system is proposing is that *everyone's* data be treated in this way as if we are *all* at risk.

Of course what we are really all at risk from is the widespread abuse of our data and it being shared in ways that we don't want and which are *not* to our benefit.

So please don't try the Appeal to Pity fallacy, those "emotional blackmail" arguments simply won't hold water.

unintended consequences

Just love the doctor / terrorist scenario - mind you the apparatchiks won't have their details on the system, for reasons of privacy.

The Victoria Climbie thing is really tiresome - contact point specifically excludes the likes of V. Climbie (see letter at http://www.guardian.co.uk/letters/story/0,,2113021,00.html). IIRC her problem was (i) young social worker thrown in at the deep end (ii) a doctor who didn't keep her in hospital (prob. cut backs) and (iii) a WPC who didn't want to get her hands dirty.

Computers don't solve social problems, they do sums.

The Big Opt Out

The Big Opt Out

http://www.nhsconfidentiality.org/?page_id=3

supplies a template letter to give to your GP, to refuse permission for your data to be added to the NHS 'spine'. Give it a go.

Misnomer

From healthcare to stealthcare.

Babies and bathwater

Graham: how nice to see you again...

You are, of course, completely correct about the risk.

You can't do anything much without risk, unfortunately. Getting out of bed will soon have a Government Health Warning on it, I suspect.

The clinical benefits of the NHS Patient Data Spine will be self-evident, without me having to go into vast detail, I hope.

The problem is going to be delivering those benefits appropriately and safely, and shedloads of work has been done and is still being done on ensuring that the security of personal data is paramount.

Arguably, the discussions that have already taken place on this subject within the CfH project have already watered down the stuff that will be carried on the spine to the point that its usefulness is beginning to be called into question, but the central principle is, believe it or not, that information should be shared, on a "need to know" basis, in a timely fashion in order to provide care to people who need it.

This may come as a bit of a shock, but the NHS does not simply consist of hospitals, surgeries, doctors and nurses. Because not all the problems the NHS treat have first causes that are specifically medical, the NHS works in partnership with Social Services in a wide variety of areas, effectively extending the reach of the NHS from hospitals and doctors' surgeries right into, where appropriate and necessary, people's homes. The two also work with the police, where appropriate and necessary, particularly in areas involving people with mental health issues.

The NHS, Social Services and the Police are all vast organisations with their own problems of inefficiencies and communication problems intrinsic to each, and you can make a convincing argument that, by effectively making each organisation a user of a common dataset that contains information that will help each organisation work with the others AND provide accurate and useful information, the problems and inefficiencies of each in some areas at least will be reduced, possibly even significantly.

Now: access to the data will be from computers directly connected to the NHS Network. Access to the computers will be require the possession of a "chip and pin" card identifying the user. Users will have access only to those systems that they need to be able to see, and within those systems, will have access only to those data that they need. Further, and as you may expect, every access to those data will be logged and trailed, as will every report printed.

Can this be abused? Of course it can. But so can the systems already being used. The new systems are the most security-savvy systems the NHS has ever contemplated (and it is undeniable that there are issues with the ability of the systems to provide timely information to a user who is not, at the precise moment of need, logged on, and with the usability of the systems presently being implemented). The issue is not "do we need to do this?" -- it's "how do we do this right?"

There is no conspiracy here. There are a load of people -- clinicians, social workers etc etc etc -- who want to be able to help vulnerable or sick or needy people better than they presently can. Argue about how, not about if.

ex 2:252/108

My shared health record

'Patient exhibiting symptoms of..........something quite dire. Examined patient, vitals normal except BP elevated to 1......well, quite a large number/90-something.

Performed routine chest, thyroid and lymph palpations. Unremarkable. ENT unremarkable except for patient screaming, "It's my leg!" during exam.

Questioned patient as to recent health history. Patient seemed unresponsive, screaming, "It's my leg!" instead of answering questions.

As exams were unremarkable and patient was unresponsive, RX'd mild analgesic and advised patient to return in 2 days if condition unchanged.

N.B. On patient's exit, noticed significant amount of blood on floor. Spent remainder of consulting hours drafting stiff reprimand to cleaning services manager."

Me? I'm not worried.