The Earl of Northesk

From Nhs It Info


House of Lords debate (7 Dec 2006)

". . . a top-down system driven by centralised control and targeting—the Government's current proposal—is antipathetic both philosophically and practically to the concept of giving patients more control of their health and treatment. Nowhere is this dichotomy more apparent than in the Government's approach to the issue of confidentiality of patient data. . . this database will be accessible, albeit at variable levels of authority, by not only the 300,000 or so NHS staff who have been issued PIN-coded smart cards so far but also by non-medical authorities provided that their requests for access are judged to be in the public interest. It should be borne in mind that summary care records will comprise data that would fall within the category of "sensitive" as defined in the Data Protection Act, not least because at last month's annual meeting of the Care Records Development Board the decision was taken in principle that there should be a "single holistic record" of patient care, encompassing not only health records but social care information. In effect, it does not stretch credibility to suppose that the spine represents the health and social care records arm of the national identity register. . . According to the Sealed Envelopes Risk Assessment Project report commissioned by the CfH, the security and confidentiality of patient data would be best achieved by a "sealed envelope" design, with data held locally rather than uploaded to the spine. Moreover, as evidenced by the YouGov poll on ID cards in last week's Daily Telegraph, there is growing public discomfort with the accuracy, reliability and confidentiality of centralised databases. By any measure, the trend of public sentiment in this area is towards a more patient-centred approach. It is therefore regrettable that, notwithstanding the soothing rhetoric to be found in some of the policy development literature, the Government seem to be lapsing back into an almost Stalinist mindset, an enforced centralised diktat delivered with all the subtlety of the playground bully. . . For my part, I would heartily recommend that anyone who shares those concerns should visit The Government really do have to make up their minds whether the avowed determination to make the NHS more patient-centred is actually delivered or just so much hot air. A good start would be to allow patients the right to opt out of the spine."

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