NHS records on-line - aid to patient care or invasion of privacy?

Question

The medical records of all UK citizens are set to be made available on-line in a national NHS database. It has cost in the order of 12 billion pounds to set up. There are still worries regarding security and as to who exactly will have access to the records. Will this be a great advance in national health care as its proponents claim, or simply yet another example of the government invading our privacy?

Get more info on this here - http://news.bbc.co.uk/1/hi/health/6454947.stm

Exceptionally annoying - be careful what you wish for.

Ok I've had a hard time choosing best answer on this one, so before I do, here's my opinion.

I do see the merits of having all medical records in a central database, and if the system were perfect, I think it would indeed be a great advance in healthcae in this country. I also like the idea of being able to access my own records on line. I tend to think that the system may be far from perfect, however, so I do worry about security. I also worry about who may have access without the patients knowledge. So, I fear that there may be a serious of risk peoples private medical history becoming available (whether legally or illegally) to certain individuals who have no right to see them. Also if this becomes the case - couldn't it be considered a breach of the hyprcatic oath?

In my view, The only people who should be allowed to see these records without permission are the patients themselves and their GPs.

I would add that those seeking permission should only be able to receive it from the patient in question, if able to do so - and if not, the patients immediate family or GP.

So, I will certainly be opting out until I am satisfied that my details are secure and private. As Heralda said in her answer it should be a matter of personal choice. Your choice, your risk.

Answer 1

It should be a matter of personal chioce. You CAN opt-out, but you have to write to your GP and make sure a copy of your letter is prominent in your file.

Medical records are so intimatly personal they should not, under any circumstances become public knowledge, and until I can be sure that security is tight enough, I won't trust it. If that means I'll suffer the consequences of a wrong decision, so be it. I would have to accept that it was a choice I made when I opted out. It's a risk I'm prepared to take.

I know there's a template for an opt-out letter on the web, but I don't know the address. Sorry

Answer 2

Hi,

12 billion pounds sounds like a small sum compared to what it will actually cost (think of Wembley Stadium) However to the rights/wrongs of having everyone's details on line...

...I now live in Spain, and my medical details, along with everyone else's, are already on line.

From a medical point of view this has a high value. A strange doctor, called in the middle of the night, for example, can identify our health histories instantly. The doctor will know whether I am allergic to any particular medicine and know my medical problems before he sees me. If, for instance, I was unconcious this could save my life.

At the very least it could speed up the examination process.

That's a postive patient benefit. There are fears, I know, from benefit claimants, that the details on the computer system would, or could, be available to the government department that deals with their benefit claims.

This could happen. I don't think it happens here, but in Mr. Blair's Britain...? There are other possible 'investigators'...perhaps employment officials who could examine the frequency of 'self certified' illnesses, or even doctor certified ones and judge on the frequency and validity of these.

These would be people who would have the 'right' to look at your records. personally I don't see anyone having a justified complaint about these groups having access (unless, of course they were illegal claimers of benefit-and I don't have much sympathy there)

However not having the 'right' to look doesn't seem to stop the thousands of 'hackers' getting in to sensitive 'closed' databanks, such as the American government's FBI records, defence records and so on. Even Banks have been 'hacked'.

Perhaps the answer is to pay the 12 billion (or so) to the people who look after the security in Swiss banks, who certainly seem to manage a decent level of security.

On the other hand, would it matter? The present (non-computerised) system in the NHS is far from perfect (how many personal records are 'lost', or 'thrown out in the rubbish for all to find and read')

Far too many as I read in the newspapers or see on TV.

So, you pays your money and takes your choice (as the saying goes) Do you want helpful, efficient access for doctors to help with their care and treatment of your health problems, or do you want possible easier access by any government department to reveal details that may costs you money or employment?

The security issue is probably not important given the present state of insecurity that controls access to everybody's records...

Not much help, I suspect, but this is my view on the subject.

Cheers (and good health)

BobSpain

Answer 3

Hiya,
I was working on part of the original N3 project.
The idea is that everyone has their own medical access cards. You can take this to any GP and they have a "GP access card".
You put your card on a scanner, the GP puts their card on the same scanner and only then do your medical records get accessed.
The idea is that you can go to any GP in the country and your medical info is instantly available. There isn't, as far as i'm aware, any intention for government access to this information.
It's a great idea, shame the cost keeps going up :(

Answer 4

it will be an invasion of privacy and with so many computer boffins around today it could mean someone could find a way of accessing other peoples medical records which is worrying i think the money could of been better used cutting down waiting lists or being used on drugs that certain health authorities say are to expensive to use like a cancer drug that many women could have but the nhs says its just to expensive i think its a waste of money and more importantly i am now worried people could have access to my medical records as nothing on the Internet is secure

Answer 5

This along with the other government data bases is yet another big brother move by the dictatorship that call itself the Labour party. I wouldn't trust any government computer system to be secure.

Answer 6

More public money wasted. I would rather they spent 12 million pounds on cancer care or childrens hospitals.

There is no chance of the system being secure, this is yet another example of the Government erroding our personal rights and privacy.

Answer 7

The concept is excellent.

The doctor you go to see, who may not be your regular doctor, will have access to your records.

The Casualty department will be able to see if you are on any medication that might adversly affect the treatment you are about to get.

A great step forward, should help save lives.

I am all for it.

If they use thin clients, like the one's I sell, the data security is enhanced even further.

Yahoo rules do not permit me to advertise, so I can't tell you which firm I represent.

Answer 8

I very much hope to find your details Spacephantom so I may have an initmate chat with you in person...

Answer 9

it all depends how secure the network is and can be.
no doubnt that a patient medical history on a central database is going to make treating patient properly and so with a better degree of care than is currently or has been in place up til now.
it needs a system where no user can input a simple word or number alone as we all know a site with strong passwords is a little more secure than one with weak passwords and user IDs. that said no electronic system is ever 100% secure. there will always be people who want to try to gain illegal access. so it may be advisable instead of a fixed line to the database to make sure that only certain parties with a set phone number and a set list of user IDs and passwords can access the network. (each phone line in is allocated a limitied number of users at a central server level, each user then has to go to the location of the server and set a strong password, users are assigned a level of access such as read only edit but add only without deleting any data. or the level of full control for system administrators) this should save a fortune in the long term if it can be done properly. think of the anual paper budget for the entire NHS each hospital must get through hundreds of pounds worth of paper and related stationary every week. this soon adds up the billions spent if properly spent could yield a great sytem or a typical government contracted bad to the point of being unfit for purpose one. as yet we really can not tell.

it should be compulsary for every man woman and child to either opt-in to be on the data base or not as they see fit.
no one should have date that is that personal available on a database without prior consent. placeing the data on would in effect be a breach of the data protection act if we as a public are not given the right to choose to opt in or opt out.
i would love to see that go to court.
just my opinion. and to be honest i do not and would never agree for my medical records be electronic on a central database. a personal database such as a personal re-writable DVD now that i could live with. or may be a new personal electronic gadget could be developed (pocket medic) this could hold all your medical history and could be linked to the hospitals system much like a modern flash drive only with a fingerprint reader and a seperate password and ID. (seperate password would be to by pass the fingerprint reader incase you lost a hand in an accident or worse both and the fingerprints were irretrevable for example).
why have a central database anyway. networks are still insecure. you could have each hospital and surgery offline and still use a similer method, everyday a courier under armed guard could arrange to transfer date from surgery to local hospital, then the hospitals distibute to eachother and then finally back to local surgeries. ok medical records would not be up to dat that but safe in the short term from hackers.
the problems with that are several, every hospital in the country would have one or more computers with your medical records on. this presents a problem when a computer is at the end of its useful life. how do you clean the drives.
the only effective way is to disolve the drives in acid. a dangerous and less than eco friendly way to go.
one of the other possibilities is the armed transport could be robbed of the data disks opening up all kinds of problems worse than that of the cyber hacker.
as for the flash drive idea that seems the easiest for everyone. especially if we have the pocket medic built in to phones and PDAs.

sorry to ramble on but that is just my tired opinion on this.

as for the root questions great advance NO, invading privacy YES but not always by the government, if not done right (monitored correctly) the developers could create a back door into the system that would allow them to acces the records of anyone in the database and alter it in anyway they want. which could have deadly effects esecially if a persons dosage of a medicine were altered.
so do YOU want your records on a data base?
no me, as i said give me the "pocket medic" opotion as i call it. better for privacy in my opiniion. though it would need to be made compulsary to carry the device at all times so that if you are in an accident for example your treating first aider can gain access to your records instantly and can see if you have allergies etc that would stop them administering some types of drugs. anyone who qualifies as a first aider or first responder could go with proof they are a qualified first responder and then could be added as a fist resonder which would have a seperate level of access to your data. once a week everyone would be required to take the device to a local centre for the device to be updated say the lobby of your local GP surgery you plug it in and wait for example. now your device is up to date it has the list of first responders.
you are involved in an accident of somesort, a qualified first aider is found and comes to your aid, they find your pocket medic, and log in with a fingerprint, they are presented with a list of your allergies and any known illnesses that may cause you to feint or black out in the street for example. they treat you while waiting for the ambulance paramedic they get read only access to your full medical notes. you are transfered to the hospital where your pocket medic plugs into your bed inturn your bed is hard wired to the hospitals admiting computer where they get to remote admin your records update only.

just a fantasy i'm dreaming where we all take responsibility for our own health and stop complaing that the NhS is not doing this or that. if we all took better care of ourselves and took less risks with our health expecting the nhs to pick up the tab if someone is injured in a bar fight (the agressor (the person who threw the first punch) should be made to pay the medical bill in full. there is so much more i feel i could say on this but i best not.

just my opinion.

Answer 10

Does it really matter? I'm more worried that people can't dip into my bank account.