Archive for June 8th, 2008

Last week I wrote an entry entitled Repetition bemoaning the number of times of that I had to enter exactly the same information, on different forms, about the same woman when booking her. I was musing upon the fact that in our electronic age there was not a computer programme, which would allow me with one press of a button to print off all the necessary paperwork. One of the comments I received about the post was from Helen at TheBigOptOut.Org concerning confidentiality and the information about data protection that I give my women. I will admit that initially I was defensive; I felt that I was giving them all the information there was to know, well as much as I knew anyway. Now I know that not only was I sketching a very incomplete outline for them but I also had no idea what was happening to anyone’s, including my own, medical details. I should really have been more savvy, after all it’s not the first time that a government body has allowed personal details to be passed on to other companies. I’m thinking here of DVLA and the way our details, which we have to submit if we wish to be driving legally, are sold to private firms. £15 million is what DVLA have apparently made from allowing car clampers, solicitors etc. to have access to our personal details. Following an outcry about this back in 2005 the government promised to tighten DVLA’s information release practices, however Liberal Democrat M.P Norman Baker obtained figures recently from the Department of Transport and commented that “It’s quite clear that the Government has failed to live up to its promise to stop the inappropriate release of information.”

The situation at present is that all our medical records, hospital and G.P are, if they’re not already they soon will be, being stored electronically. Is that a problem? Well, if you don’t want anyone employed within the NHS to have some degree of access to them, yes it is. You know that receptionist at your G.P’s surgery, the one who lives in the next road, well she will have access to some of your personal information. I’m using the future tense here, in many practices this is already happening, and in some of the practices I have contact with anyone who is able to logon can read ALL about you. I have to admit that this does not overly concern me, after all they are sworn to secrecy when they sign their contracts, it’s not pleasant knowing that someone you see at the school gates may know all your medical complaints but it’s exactly the same when you bump into your G.P at the supermarket, and he rarely sniggers at you whilst whispering to his wife!

So, what does concern me? It’s the way we have no control over who else, what unnamed individuals or companies may be allowed access to, or indeed sent, our medical details. Dr Foster, you have heard of this information giver, well apparently they receive all their info “from data provided by individual trusts and doctors, as well as from the Department of Health.” (BMJ 2002), and what’s more it is given to them in identifiable form. Incidentally, whilst trawling around Dr Foster I found this interesting little contribution from The National Audit Office concerning the “joint venture between the Information Centre and a private sector company Dr Foster LLP” . Staggering to read the monetary details between the Department of Health and The NHS Information Centre’s deal with Dr F  “The Information Centre paid £12 million in cash for a 50 per cent share of the joint venture. This price included an acknowledged strategic premium of between £2.5 million and £4 million, and was higher than their financial advisers’ indicative valuation of the share. The Department also spent more than £1.7 million on professional fees, £50,000 of which was paid to Dr Foster Ltd for advice about the establishment of the Information Centre and a possible relationship with the private sector. The report also raises concerns about the Department’s decision to pay Dr Foster Ltd for advice when it had already entered discussions about a partnership”. Nice money if you can find some government body willing to pay it.

So, now we know how the government sells our details what is there we can do about it? Apparently we can opt-out, well we could if we knew how. The organisation I linked to at the beginning,  The Big Opt Out, have a page which advises on the pro’s and con’s of opting out, and also how to go about it. Remember, it is up to you to make the move, consent is implied.

What do Doctors think about this? NHS Blog Doctor wrote about the issue back in March, he seems to have very little confidence in the Spine’s ability to maintain patient confidentiality  “The British government promised that there would be strict confidentiality of all private medical records uploaded to the NHS Spine. The government lied”.  Dr Rant is far more directive in his approach ” OPT OUT NOW” is his advise. Dr Paul Thornton, in written evidence to The House of Commons Select Committee on Health says “There is a direct conflict between the sharing of information, even among health care professionals, and the protection of patient privacy. Patients divulge information to individuals, perhaps to teams, rarely to institutions and certainly not to the entirety of the National Health Service. The risk to privacy increases in proportion to the number of users of a database.” And boy are there going to be a awful lot of users. (This written evidence is brilliant, well worth reading). According to the Guardian two-thirds of G.P’s are going to boycott the scheme, hardly confidence giving.

The computer world itself is questioning the security of a national database. Martyn Hart, chairman of The National Outsourcing Association, said in Computerworld  “The only place you can make that kind of arrangement work is where there is strict control and governance, like in the army. Not in a health organisation.”

There is no stopping the governments plans for amalgamating all our health records…but….I finish with his from the Guardian article:-

“After a Guardian campaign last year ministers conceded that patients would have the right to stop their medical files being passed from the GP to an NHS data warehouse known as the Spine.

But they said everyone not exercising this veto would be assumed to have given “implied consent”.”

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