"'Legitimate Relationships' stop anyone who is not directly connected to that patient accessing clinical data, and flagged records in the Patient Demographic Service stop demographic details of sensitive patients falling into the wrong hands."

Medical Training Application Service.

That's all I'm saying.

"f someone with access to the spine was blackmailed/bribed or otherwise persuaded to share their access, *all* records would be compromised, audited or not."

That's what legitimate relationships cover.

Also flagged record, data envelopes, etc.

No system is secure, finding the patient's surgery is not a big deal, and even easier if you know what "clinic" they've been to recently *picks up a copy of the Sun*.

My point is, there is MANY safeguards in place to prevent widescale abuse, congrats, you've busted the system and told the papers Gorden Brown has a heart condition, it gets trailed back to you and you spend the next 5 years in jail and go broke due to "proceeds of crime", that's a pretty good deterrant. Who's going to find out if you copy the records out from a piece of paper?

I'm not worried about a nosey health worker accessing my health record - the sad person needs help. The "spine" system provides detection tools so that's great then?

If the data is distributed it makes it very much more difficult to get at (who actually needs it, anyway?) and, be assured, I trust 20k Drs to much more readily flag a data mining operation than I do a bunch of civil servants who could be involved in a revolving door process with "industry".

Actually, you are right Egor. It is about "trust" and the blighters in charge don't have mine. On the basis of recent revelations they won’t be getting it anytime soon, either. They've very publicly shown they don't deserve it and can't handle it, even if not voluntarily given.

Lucy is right: the spine will give fraudulent access to your personal details a country-wide scope where now its limited to an individual surgery. That's a worry given the sieve-like security of so many government databases from the PNC to HMRC's data pile.

However, there's worse that can happen than that. Much worse.

My chief worry is that once everybody's data is in the system, the government will start changing the rules. I can visualise the access creep now as they progressively change the rules so that they can:

- match medical records with disability claims

- combine them with the DNA database

- combine them with DVLA records

- combine them with the ID/passport database

- sell them to insurance companies to recoup NHS costs

At my local charnel house, patient records are part-computerised and part hardcopy. The bloodletters who deign to see me once in a while display the computer skills of a two-year-old iguana (perhaps the real reason why they won't put patient records on 'the spine').

The real computer whizzes in this outpost of Nightingale Medicine, Inc. are the receptionists and admin. assistants (after all, until they were forced off unemployment, they had little else to do between Richard and Judy and I'm A Nonentity, Get Me Exposure Here.) Now, if you want to know what's wrong with your brother Willie's willy, meet said receptionist or admin. ass. in the pub on Friday night. A couple of Stellas will get you what you want to know.

and there is still time to persuade the other 41%.

A related issue, post 9/11 is if someone claiming to be from the security services arrived at your doctor's surgery and said they required your records for security purposes, and to avoid a terrorist incident, or some such similar insinuation. What would your doctor's response be? The correct response is F**k off and don't come back without a court order. The deplorable response is Here they are, and by the way, s/he is well acquainted with X, Y, and Z.

It's good to see some physicians can recall the Hippocratic Oath.

If you go to our web site www.thebigoptout.com there is suitable a letter to opt out of SPINE, that is available for download. Just fill it in ans sign it then give to Reception at your GP Surgery. It has been written by 2 doctors who advise The Big Opt Out.

You can sign a letter on behalf of any children under 16 too.

Helen Wilkinson-Makey

Co-Founder

The Big Opt Out

I am a nurse (hence, have to remain anonymous).

We have to use a computer system for patient records (no, not the "Spine"). On 95% of the shifts I work, we have bank or agency staff. Probably more than 50% of these do not have a login. Management have instructed that these must "borrow" one -- no, I'm not kidding. Also, computers are frequently unattended while a person is logged in.

Yes, there are audit trails which, in theory, will record who has accessed any information. No, it does not work -- could have been anyone accessing that record.

And no, my own details will not go onto the "Spine". Social services looking at my medical records? You must be kidding.

they gone ahead and done this is Scotland anyway?

AFAIK, very few people opted out as they WERE NOT told they could.....

I don't normally post anonymously on here, but this will be an exception.

I am a doctor and I have told my GP that my records are not to be sent onto the Spine.

I just don't trust the government to hold that much information about myself.

My medical data is between myself and my doctor and a very select group of people to whom I decide to disclose it.

NOT for Gordon Brown's eyes.

..what the survey result would be if they ran it again this week? A bit more than 59%, possibly... :-)

"There *is* a strong case for being able to share data electronically, at least on a case-by-case basis. The present system is archaic, slow and potentially lethal."

Possibly, but shouldn't it be my choice.

There are several things I would NEVER have discussed with a GP if I had known at the time that his notes would eventually be uploaded to a central database. It's a complete breach of confidentiality.

I find it fucking outrageous that the government is now laying claim to MY medical records and suggesting I have no choice.

Incidentally if there is a group out there who have funding and want a subject for a test case - I'm your man

Posting anonymously about my girl friend, who is a nurse at a major London hospital, whose experiences echo the previous anonymous nurse's post.

Indeed, all patient information is already entered on a computer system (local to the hospital, I believe). Computer security is bypassed on an almost continuous basis due to factors such as agency staff (of which there are enormous numbers) without their own logins (or trackable guest logins), borrowed logins due to forgotten passwords or delayed userid/password setup, or simply because the system security is so horrible to use that they haven't got time or can't be bothered - if you make something too difficult for people to use then they won't; if it's security then they'll bypass it.

Now almost every dept in the NHS probably has at least one agency staffer. So how easy do you think it is for an unscrupulous person to get a job with access to confidential data? And what do you think the chances of tracing that person would be, given the above situation? If they used a fake ID (perhaps built from the handy data on that copy of that nice HMRC CD they bought from ebay or downloaded!)

Also, physical security is similarly lax, for much the same reasons: security doors that should be accessible only by ID swipe badge are wedged open, again for reasons such as agency staff haven't got the access badges, locks faulty (for weeks at a time), or can't be bothered with them. On the one occasion I visited the dept to meet my girl-friend after work, I was able to walk through the wedged open security doors into the "secure" area, and was able to wait in the empty managers office, where I had immediate physical access to the PC and hospital network and systems (the manager being busy helping out with clinical matters due to the chronic staff shortages).

Obviously, some medical information is critial for the successful treatment of emergency medical situations. Maybe not my life history, but medical information of a sort in case I require treatment and cannot speak for myself.

On that basis, I carry with me a duly signed, legally-binding, business card sized, advanced medical document listing preferneces and current meds. I also have a living will (which is registered at the GP and local hospital). I carry a copy of said living will with me when I travel. My wife does the same.

I am not a lawyer. I am not a doctor. I am a First Aider, but prefer to hide behind the IT Bod banner. I have had a think about what level of medical treatment I want and what, if anything, I don't want. I've done my homework.

If people were prepared to do the research, document their choices, make the results of this research freely available on their person - would there be much reason for the "spine"?