Earl Howe

From Nhs It Info


Written answers (19 Dec 2006)


"Asked Her Majesty's Government: What plans are in place, or under discussion, to make electronic patient records accessible in prisons."

House of Lords Debate (21 Jun 2007)


"[Lord Warner] will be relieved to know that I am not going to make a strident attack on Connecting for Health. Indeed, I support its aims, for the most part enthusiastically. However, in April this year, the Public Accounts Committee in another place published a report on the current state of play. The largest single element of Connecting for Health—the Care Records Service—is running about two years behind schedule. The suppliers to the programme are struggling to deliver. Not only that, but the department has failed to win hearts and minds in the NHS, especially on the question of whether the system will be fit for purpose. Four years after the programme started, there is still huge uncertainty about its cost across the wider NHS and considerable woolliness about the value of the benefits that it will eventually provide. . . Records held by a GP and made available to the local hospital present little or no difficulty, but when records are placed on a national spine there is a real problem of accountability for the security of the data. Who exactly is accountable? But there is a wider issue here. There are many who believe—I am one—that in a major respect this massive IT programme was not soundly conceived. None of us, I am sure, would argue that holding patient records in electronic format in a GP practice or at PCT level is a bad concept; far from it. But exactly what cost-benefit analysis was done to validate the central vision of a nationally accessible patient database? The answer to that, so it appears, is practically none. The underlying thought was, in truth, a pretty loose one: that it would be handy to have someone's medical records freely available in an emergency at any hospital in the country. The evidence to support that idea was nil. The overwhelming majority of patients access NHS care within their local community. If you have a heart attack or you are in a car crash miles from home, there are established clinical protocols that should make access to your medical records almost irrelevant. It is telling that in Wales the Assembly has opted for a much less ambitious and much less costly IT solution. The original estimate for a Welsh equivalent of the Care Records Service was £1.5 billion. That option was rejected in favour of a system costing a mere £3 million. For that sum of money, the Welsh NHS will get a single patient record system available to GPs, local acute trusts and doctors performing out-of-hours duties. In other words, the vast majority of situations for the vast majority of patients will be covered. I am told that doctors in Wales are more than content with this approach. That is the key difference between Wales and England, where stakeholders feel resentful about not being more involved in the procurement process and, above all, lack a sense of ownership of a system that they are being asked to operate. How do the Government propose to remedy this, given that only one-quarter of GPs now say that they support the programme? In 2004, the figure was well over 50 per cent. . ."

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