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06 Jul 2009
The Conservative Party is considering proposals that would allow citizens to store their own medical records using Microsoft HealthVault or Google Health.
The proposals would mean the end of the government's centralised Integrated Care Records Service, also known as the NHS Spine, that is estimated to have cost between £12bn and £20bn and has been continuously stalled by set backs.
The suggestions have been put forward by the Centre for Policy Studies (CPS), but the Conservative Party has commissioned its own research into the IT underpinning the UK health system, and is likely to consider all research before setting out a clear agenda.
The report was written by Liam Maxwell, IT expert at the CPS, which was set up under Margaret Thatcher in the 1970s.
Maxwell believes that there are two options for healthcare IT. Either the government continues with the huge central computer on which all medical records are stored, or individual citizens are allowed to store and analyse their own health records.
The latter would eliminate the need for the NHS database, and be practically cost-free, according to Maxwell, and citizens would benefit because their data would be more secure and private.
"This report starkly highlights the grotesque intrusion by state officials into our everyday lives and the wanton waste of taxpayers' money," said Adam Afriyie, shadow minister for science and innovation.
"We are working on a different view of the government's use of IT, and Maxwell's ideas offer a reason to be hopeful and an alternative path for an incoming government with change in mind."
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Do you agree?
Why not trust local trusts with patient records?
The Conservative proposals not only fail to address a number of fundamental issues such as security, funding, existing NHS standards and integration with other NHS systems but they draw attention away from the real debate at a critical time for the National Programme for IT (NPfIT). Do we really need a centralised patient record system or should responsibility be devolved down to NHS trust level? NHS Trusts already have investments in patient record and appointment booking systems and relationships with / and the trust of local citizens. Why not use the web to enable individual trusts to provide secure access to records for other trusts and patients themselves, rather than duplicating everything centrally? This needn't mean new systems for each and every NHS Trust, far from it! In the time that the NPfIT has been running, web technologies have developed to the point where a web front-end can be quickly and cost-effectively developed and overlaid onto existing systems. Surely making local trusts the guardian of patient records offers the best of both worlds? A trusted and responsible guardian that the public can identify with, without the huge costs and duplications of a centralised system would be a far better use of public funding.
Posted by: Simon Skillen, health practice manager, Adobe UK 10 Jul 2009
Makes a lot of sense to me!
I think the important point being missed is that Google and or Microsoft would be storing the data for the NHS but not controlling it. The interface to access, update and manage the data still needs to be designed and implemented with all the care and proper consideration for Patient, NHS, Law etc. All you are doing is offloading a large part of the cost in providing the processing power, storage, data centers, DR, effective search algorithims etc to companies who already have all this in place. Google and Microsoft Health have already proven themselves effective in the States in a highly regulated market. I can't think of anything the NHS does differently that they have not had to deal with already.
Posted by: Andrew Hunter 09 Jul 2009
Truly off the wall!
Tories show flawed thinking yet again. Apart from a comparatively low level of computer proficiency in the population at large, there are still huge tranches of the population who do not have access to a PC, and others who live in areas that might as well be on the moon. BT service in my own town is far poorer than claimed, with band width throttled by copper substitutes, and VodaFone's vaunted £G coverage has more holes than a swiss cheese. As for the security of Personal Indentifiable Information... have the Tories heard of identity theft? Think of the value of health records. If someone where to pose as a patient with credible knowledge of their "own" state of health, their credibility increases and social engineering becomes even easier for the unscrupulous.
Posted by: Steve Atkinson 08 Jul 2009
NHS spine alternatives
3 cheers! some common sense at last. the grotesque project of the government is just too cumbersome and is likely to leak like a sieve - or the data be left on a train or in a taxi! we must surely be able to look after it ourselves much better than they can in one central database. inidividuals can carry a card or a memory stick with their data so it can be used and updated at hospital, surgery, dentist, etc. Empower the people with their data.
Posted by: Martin Dear 08 Jul 2009
Only option?
Having worked as an IT Trainer for many years I am only too aware of the general incompetence of a large section of the general public when it comes to basic IT literacy. I don't see how this can be our only option - who will take care of the records for a child - the parent? What if that child is under 16 but still wishes to keep an instance of care from their parent? If the parent is still responsible for the childs records does it give them the right to view? Giving the public responsibility for their own care records opens up a myriad of minefields that it will take more cash to rectify than the cost of implementing the spine, and may cost lives when people forget their care records. Can we really justify the cost of scrapping a project we've already spent cash on in favour of something else that will in the long run be more costly?
Posted by: Victoria Lockwood 07 Jul 2009
good intentions, bad thinking
Ok, so spine doesn't work and is obviously destined to fail due to its vast and creeping spec. However home storage would require some form of connections to the nhs simply because they need access to the data. You then have the general incompetence of people - because they don't want to have to care leading to loss of essential data. Using a microsoft or google service is pure recklessness. These ideas are definitely NOT being cooked up by developers - more likely in board rooms with political agendas.
Posted by: john n 06 Jul 2009
Must be April 1st
Another piece of advice from the 'experts' I suspect, much along the lines of the guidance provided by the incumbent 'experts' in the present failing project. Putting any important information in the hands of the chaps from Seattle would be complete insanity. I ask you this: In what other industry would a company be allowed to attain a position of almost complete domination, by producing one of the poorest products on the planet? There has never been a good version of Windows - and yet the majority of computer users on the planet currently have the choice of an old and lousy system, a newer and even more lousy system, and an even newer but unknown system. This is the equivalent of General Motors selling all their cars for the last 20 years with engines which reduce in power from the day you buy the car, and a random function where the cars stop at odd intervals for no apparent reason. And Mr C wants them to look after our health information. I would ask him to just take a peek at any other project these guys have 'helped' with over the years, and have nice lie down in a dark room and think about it.
Posted by: Carlos Barajas 06 Jul 2009