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On Tue, 5 Dec 2006 17:26:10 +0000 "Aaron Trevena" <aaron.trevena@xxxxxxxxx> wrote: > So following the disaster that is Choose and Book, we now have a > centralised patient information system on it's way - which > unfortunately seems to be of no actual use when it comes to caring for > patients... Like any government IT project, it isn't going to arrive any time soon (or on budget). Don't believe what government sources tell you, the word from the sharp end is that no progress has been made on the basic problems of incompatibility. There is no central drug database (the current 6 are mutually incompatible), there is no central prescription spine (of the 4 systems, only 1 is actually ready) . . . Adrian can speak for GP's but I will be very surprised if any of this works the way it is expected. > All the confidential things that you discuss, are prescribed, are > tested for or that your GP's comment will be stored, and linked to you > in an easily identifiable way, and accessable by anybody in the NHS at > all with access to the system, without any control or paper trail. There are controls within this mega database - I will have access to the certain parts of the data you describe but I will not have access to areas that are of no professional use to me. Some of that access must be delegated to highly trained technicians but they do so only under my supervision. In the end, it will make drug treatment safer because I can check that a patient is having regular blood tests for a particular side-effect or drug related biological state without needing to pester a GP. It doesn't happen often but it does matter and does improve overall safety. When I check these things now, most of the time everything is being monitored - just sometimes it has proved worthwhile to ensure that the tests are being done. I'm quite sure you would want me to know about previous medication and medical history before you ask me for advice on prescription treatment. Not all patients can remember what medicines they take. At least 50% of my daily consultations require me to lookup the records on the pharmacy systems. Another 5-10% I cannot help simply because that patient usually gets their scripts dispensed elsewhere and I have no records to check. Drug names are unfamiliar to patients - asking someone what medicines they take can seem as if you'd asked them to calculate pi to 47 decimal places. There will also be an audit trail - electronic - because everything I access is logged according to my own ID. It won't stop another Harold Shipman but then what would? > And this database is already being mined, without anonymising patients > by researchers and private companys for their own benefit. I think you'll find that is for the benefit of system development - there are precious few records on the system right now. > Because if you or a member of your family ever has to deal with > anything embarrising or especially private, from counselling to > prozac, to threadworm or an STD, the Department of Health, faceless > hospital managers, any student at any college or university, and any > private company with an interest can find and identify you. It is not open to private companies - unless they provide an NHS service. Those who have access do not have access to all areas. It's not as scary as you claim, Aaron. > This from the people who brought you ID Cards, Biometric Passports, > The Millenium Done and The Child Support Agency. True - my concern is that the NHS network spine will collapse - regularly. That will cause more trouble and truly endanger lives because it will remove access to essential data that was previously recorded in non-electronic formats. The NHS is a monolith - right or wrong, that's what the politics require. Monolithic systems require system-wide IT implementations. The NHS cannot continue with the current system. There are valid concerns about how the NHS database gets linked to your ID card and the Benefits Agency or HM Revenue and Customs. There are valid concerns about how the NHS records will be used in the legal system or how the inevitable security lapses and system failures will be handled. The NHS database is not, IMNSHO, a valid privacy concern. Like other large databases handled by the state, the problem is not the data in the database it is how that data is cross-referenced with other data. The only alternative to the NHS IT spine is to break up the NHS into county sized independent units and create that wonder of tabloid headlines: a true postcode lottery for all sectors of healthcare. -- Neil Williams ============= http://www.data-freedom.org/ http://www.nosoftwarepatents.com/ http://www.linux.codehelp.co.uk/
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