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Re: [LUG] OldTopic: Patients on the NHS Database

 

Adrian Midgley (Gmail) wrote:
> 
> As I understand it this is how one makes a reservation on an aircraft,

Aircraft reservations are typically quite simple transactions. And there
is a reason you can only reserve certain things, and it isn't to do with
what is available on the plane but what was available when the plane
reservation systems were specced.

> You don't though, see above.  It becomes a condition of entry.

Someone has to do it. If you off load the task to a supplier you just
push up their cost to you, the work is conserved.

> On this I can say that I have been involved in that, more than once, and
> it has not worked.

That doesn't mean other approaches will succeed, or that the approach
itself is flawed.

>>> We have the example of the Internet before us, we know how these large
>>> tasks should be attempted.
> 
>> Depends what criteria you place on it. The really large systems on the
>> Internet that handle these kinds of user volumes are often proprietary
>> (think GMail). Or inherently quite simple (DNS).
> 
> I meant The Internet.  Not individual things on it, the whole thing.

It routes packets of data in a fairly unreliable manner.

You already have an internal network which is better than the Internet
as a whole, so your problems should be solved ;)

Over 4% of Internet traffic by data volume is malicious (DDoS) or from
compromised systems, I do hope you aren't suggesting..... One would hope
for less in a medical network.

> Ross Anderson's view on aggregation is one which I share.

I think the view is sometimes it is unavoidable.

But there are security benefits to aggregation, are all the systems you
described working 24x7x365, can they handle substantial load, do they
have off-site live backup systems. If not, they may fail when most
needed - disaster wipes out GP surgery(ies) and surrounding properties,
lots of wounded folk going down fast with contagions that follow natural
disasters, eventually we evacuate the sick to surrounding hospitals:
HadThisDrug("Amoxicillin") - remote server does not respond x n,000.

I guess you can make those all requirements of joining, but in
fulfilling them data will be aggregated, as it will cost effective for
remote backup providers to specialise, so the aggregation will be due to
market forces. Then there is a fire in the Paddington Telephone exchange
and no one can settle credit card transactions for days on end.

Okay I know in such circumstances you just give it to them and hope.

The Iodide distribution guidelines for radiation emergencies note that
for some thyroid patients it may be better not to take the pill, but
asking would delay the distribution process so you give it to everyone
and statistics say you save more than you lose. That isn't the
personalised medicine of the future I was hoping for.



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