back to article Cameron: We'll turn NHS patients into real-time drugs lab rats

Prime minister David Cameron said his government is launching a consultation on changing the NHS constitution so that the "default setting" is for patients' data to be used for research unless the patient opts out. In a speech to the Global Health Policy Summit in London, he said that the UK is going to be the "world leader" …

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  1. Mike Brown

    parasites

    the tories really are scum huh? this is a money move, and nothing else.

    1. ukgnome

      Re: parasites

      I'm presuming that question is entirely rhetorical

      Sigh, only 3 more years of the blue meanies and then who knows what knobbers will be in parliament.

      Maybe the comentards of El reg should form a political party. We only disagree slightly less with each other.

      1. Anonymous Coward
        Anonymous Coward

        Re: parasites

        Hear, hear!

        I say, the House of Lords should be populated with Mac owners, but only if they're running Debian.

        The Commons should be run by (mostly x86) wielding BSD fans.

        That should improve the stability of the country.

        Win-tards - well, they're who we're replacing, right?

        /ducks, runs, hides until the war is over.

    2. HMB
      Alert

      Re: parasites

      I totally agree with you.

      The way I see it, the public purse will have more money and drugs companies will have more data available to them about possible problems.

      What bastards!

      I sincerely hope that if I have an adverse reaction to a drug that no one else knows about it so they can keep using it on other people. I know, I'm not a nice person.

      1. Mike Brown

        Re: parasites

        "public purse will have more money and drugs companies will have more data available to them"

        great! but its not his data to sell. and what happens when it leaks? and ends up on the pirate bay?

        this is a horrible way to drum up money with no effort. he is selling the medical records of his citizens, to big biz. deplorable.

        1. Anonymous Coward
          Anonymous Coward

          Re: parasites

          And why not.

          BigBiz long ago bought the politicians, now it is their turn to sell us to BigBiz.

      2. Tim of the Win
        Thumb Up

        Re: parasites

        And I completely agree with you. I'm surprised this data isn't available wholesale already. We're always hearing stories about X or Y drug might cause Z. If the boffins have access to the data for all the patients taking that drug we should be able to spot/dismiss these things sooner.

        1. Glenn Booth

          Re: parasites

          >> If the boffins have access to the data for all the patients taking that drug we should be able to spot/dismiss these things sooner.

          You think that they'll give that data back to us? Not a chance.

          That's not how it works. More likely they'll use it to formulate a new drug with different side effects, which they will then patent and sell for more than the old drug, all the while denying that there is anything wrong with the old drug.

          Big Pharma are not charities. Just because our data the might help them build a new drug, don't expect a payback.

    3. Anonymous Coward
      Facepalm

      Re: parasites

      If the TOrY'S realy had there way then everybody who does not vote will be automaticaly opted in too of voted tory.

      Piss's me off that society has a situation were to have you opted in by deafault were it is in your interest then the default is to have you opted out and when it is a situation were by default you would want to be opted out by default then they have a default of opted in. Can even bet that to opt out you have cant do that at your doctors but have to deal with some other department that or two or three.

      1. Anonymous Coward
        Anonymous Coward

        @ PXG : What's wrong with you?

        Give a monkey a typewriter and some LSD and they will produce something that is more comprehensible than your comment.

        I think you must have lost your way and been unable find the place where they were giving out brains.

  2. g e

    Classy.

    Can't imagine that Pfizer, GSK or chums haven't given DC some 'encouragement' here, can you?

    I wonder how many nice, cheap data processing centres they have in Bangalore or similar. :o/

    I await my cheque from Big Pharma with less-than-baited breath

  3. Blofeld's Cat
    WTF?

    Orderly!

    Would you bring the straitjacket and restraints to cubicle three please. Mr Cameron's has got out of bed again.

    He just keeps muttering "world leader" again and again. The poor man clearly has delusions of adequacy.

    We should never have allowed him to watch the Olympics.

  4. James 51

    I thought that doctors were suppose to fill in reports about incidents of allergic reactions and adverse affects already.

    1. Anonymous Coward
      Anonymous Coward

      @James51

      They are supposed to, but they often don't. And few believe anything useful is done with the collected data anyway.

  5. Admiral Grace Hopper
    Black Helicopters

    Next stop

    Soylent Green.

    1. LarsG
      Meh

      Re: Next stop

      Classic, 'we're eating.... People!'

  6. Arnold Lieberman
    Joke

    Yeah, those evil researchers

    All big drug companies are pure money-grabbing evil, giving us nothing back. Burn the lot! I want drugs that have never been tested on any sentient beings or other life forms. What's that you say? Cancer? Give me organic carrots!

    1. Anonymous Coward
      Anonymous Coward

      Re: Yeah, those evil researchers

      We could always just test drugs on you. That would avoid testing on sentient beings.

      1. Arnold Lieberman
        FAIL

        Re: Yeah, those evil researchers

        Oh well, looks like you win that argument with your persuasive rhetoric!

    2. James 51
      FAIL

      Re: Yeah, those evil researchers

      It's only a matter of time before this information is abused in some way. Blackmail when it reveals you have a socially embrassing condition. Insurance companies driving up your premiums if they figured out you were alergic to cheap drugs for a particular condition.

    3. Elmer Phud

      Re: Yeah, those evil researchers

      An old one but --- would you ever buy a dog shampoo that's not been tested on animals?

    4. ed2020
      Thumb Down

      Re: Yeah, those evil researchers

      All big drug companies are pure money-grabbing evil, giving us nothing back.

      They sell us things back. I can think of no examples of things being given back.

  7. Anonymous Coward
    Anonymous Coward

    Adverse Reaction Reports

    I wish that some of the adverse reaction reports were filed along with the adverse reaction to misstreatment reports. For example

    1) One daughter left bed almost bound by the reaction to one long term treatment with the GP unable to trace the problem. It took about 45 secopnds with a private appointment to read the complete notes (provided by her parents) for the private doctor to diagnose the rectification actions.

    2) Between four a five years wrong treatment for my wife when a simple blood test would and later did find the cause of her problem.

    3) If Simvastin works for you great, alternatively if you like the feeling that your blood has been replaced and that battery acid is fueling what is left of your muscles go ahead and take the stuff.

    4) Twenty years and still counting to get receive a printed report of a diagnosis for daughter in (1)'s under lying condition.

    3) Side effects of withdrawing treatment leading to attempted suiciide three times for daughter in (1), perhaps they might learn if we let them try the change a fourth time?

    5) Other daughter took a similar length of time (19 years) to get partial diagnosis of her still ongoing and only partially controlled problems.

    On second thoughts the NHS will probably not like to let that schedule into the public arean?

    Anonymous for obvious reasons and the above list is a brief extract.

    1. Aaron Em

      Socialist medicine, whee!

      Let's have some of that in the United States, why don't we? I can't wait for my choices to range from shitty, incompetent doctors on the one end, to incompetent, shitty doctors on the other! Thank God we have the indigent and the shiftless, and those who buy votes from them en masse, to show us the way --

  8. Anonymous Coward
    FAIL

    Oh dear

    Cameron

    Usually

    Not

    Thinking

    1. Anonymous Coward
      Anonymous Coward

      Re: Oh dear

      Tories

      Will

      Always

      Turn

      Sinister.

  9. wowfood

    governmentt

    I'd rather see a group of pre-school children in charge of the country, they'd bicker less and make far fewer childish decisions.

    This is why I vote green party. I agree with some of their stances, but I know they'll never get a majority vote, so I have a right to bitch when somebody else I dislike more gets into office.

    1. Anonymous Coward
      Anonymous Coward

      Re: governmentt

      Your green vote gave more power to the tories!

    2. Aaron Em

      That you vote

      makes you part of the problem.

      1. Ploughmans Lunch
        Pint

        Re: That you vote

        Exactly, if we all vote blank that would send a message right up 'em

        1. Mr Young
          Thumb Up

          Re: That you vote

          Aye - a 'none of the above' box on the form would do just nicely. I'm quite sure it would also increase voter turnout.

        2. Aaron Em
          Mushroom

          Re: That you vote

          Why not? Rather that than perpetuate the apparent legitimacy of mob rule, or "democracy", or "crowdsourced government" as I gather the kiddies are calling it these days.

  10. System 10 from Navarone
    FAIL

    Yes Mr Cameron, except...

    ...there won't be an NHS will there, because you're hell bent on dismantling it, aren't you.

    Currently the vast amount of very valuable and useful data collected is largely all under the one NHS roof and data systems and formats are *fairly* compatible, and access to the data is (relatively) well controlled. Once the NHS is a random mixture of private companies, third sector organisations, charities, trusts, international businesses, etc, who's going to be looking after all our personal data then, eh?

    1. Arnold Lieberman

      Re: Yes Mr Cameron, except...

      Call me naive, but I should imagine someone would come up with some sort of standardised data access method. Profound, I know, but it might just be possible.

      As for dismantling the NHS, doesn't sound like a bad idea. As long as treatment is free at the point of use and of good quality, who cares! Do you refuse to use your GP because he/she is a privately run business? Do you even know that GPs are not part of the NHS?

      1. Anonymous Coward
        Anonymous Coward

        Re: Yes Mr Cameron, except...

        As for dismantling the NHS, doesn't sound like a bad idea. As long as treatment is free at the point of use and of good quality, who cares!

        Yes because a dismantled NHS rebuilt from Private companies is going to stay free to use for how long? The NHS has it's problems, sure, but I think people forget just how lucky we are.

        As an example, having grown tired of getting addicted to prescription painkillers (I don't blame the GP, we were both told Tramadol was 'non-addictive'!) I discussed the matter with the doc and moved myself onto a more, ahem, natural product.

        Now, if I'm skint, I have to go without pain relief. Not at all pleasant, especially when it looks like it may be a full month before I can purchase another stash (yes, sadly I'm that broke at the moment). I've spent most of my life in pain, so whilst not nice, an extra month's not going to kill me. But it did make me think, what if all healthcare came with the proviso that you've got to be able to afford it (or at least, an insurance policy?).

        Bearing in mind I actually had to consider whether I could afford to continue my life insurance this month, how would I (and others in a similar position) cope if the only way you could get (non-emergency) medical care was to pay for it (with money you don't have).

        From my point of view, that's a shit state of affairs. Yes the NHS may be slow and sometimes inadequate, but at least there's some provision there. I made the choice to switch to a more privately sourced form of analgesia and knew what I was getting into, but would I do the same for all my healthcare (or may family's)? Fuck no.

        The problem we have is that funding to the NHS will slowly decline as the private sector takes over (especially whilst the Tories are in power) and we'll end up with a new NHS called BUPA. If you want to sit back and watch it happen, it's your perogative, but having seen a little of the other side of the fence I intend to do what I can to fight it (which at the moment is probably limited to arm-chair complaining!)

        1. This post has been deleted by its author

      2. System 10 from Navarone
        Stop

        Re: Yes Mr Cameron, except...

        "Call me naive, but I should imagine someone would come up with some sort of standardised data access method. Profound, I know, but it might just be possible."

        OK, you're naive.

        It might just be possible if we had an integrated *national* health service, but what we're going to end up with is a free market of 1000's of competing organisations. Who do you think this 'somebody' is who will standardise things across that lot? The politicians?!? Private enterprise?!?

        Yep, naive.

  11. Richard 81

    If... then... else

    If access to this data was properly controlled, then great. It could be extremely useful for any number of non-evil groups.

    If, however, it is handed out to any Tom, Dick or Harry, or simply leaked by mismanagement, then abuse is going to be a serious concern. As mentioned by someone earlier, insurance companies would love to get their greasy mitts on this kind of dirt.

    ...actually, now I think about it, poor data quality may make this database largely useless anyway. Data from clinical trials are often really difficult to interpret since doctors don't care/don't have time to worry about consistent data entry.

  12. Steven Jones

    By heavens there are some cynics on this forum. I believe no less than Ben Goldacre, no friend of big-pharma has been advocating the use of (anonymised) data by researchers. Researchers does not necessarily mean drug companies - it also covers those looking for the most effective treatment regimes.

    Also, the idiot byline about "turn NHS patients into real-time drugs lab rats" is ridiculous. Nobody is suggesting patients will be entered into clinical trials without their knowledge (or forced into such). As always, clinical trials are subject to review by ethics committees.

    The writer of this headline needs to grow up and not make tabloid misrepresentations. There is a discussion for grown-ups about the ethics of using individual health records, anonymised or not. However, to characterise this as patients being turned into lab rats is just plain dishonest.

    1. Robert Carnegie Silver badge

      Agreed

      This is actually a good idea. But it's the evil, evil Tories who hate the NHS that are doing it, so I also agree that it's probably a cover for doing something horrible like cutting off treatment unless you pay to go private.

      I think we deserve this government to teach us a lesson, but I wish there was a God to punsih them for the stuff that they break.

      1. Anonymous Coward
        Anonymous Coward

        Re: Agreed@ Robert Carniegie

        "I think we deserve this government to teach us a lesson, but I wish there was a God to punsih them for the stuff that they break."

        The government to teach you a lesson was a recent one, run by a war mongering traitor, who's blind halfwit sidekick spent this country into a financial black hole of Grecian proportions, in the biggest act of inter-generational theft this country has ever seen, whilst blowing the biggest financial sector bubble in history, accompanied by weak regulation.

        So far the famed spending "cuts" have been negative, in aggregate terms. For the hard of thinking, that is to say that public spending has increased, as has government borrowing, and taxing, which I presume is what you actually want?

        1. JohnMurray

          Re: Agreed@ Robert Carniegie

          The financial black hole you speak of is solely made-up of private debt.

          The real black hole is that of the PFI scandal...started by a previous conservative administration, and estimated to be worth some 300 billion to the companies involved...and wrapped-up in long-term contracts with penal penalty clauses...to their shame, labour continued it.

          If you want real scandal, of astronomical criminality, you should look to the banking and other financial institutions. Really scandalous....and quite literally....some dozens of trillions of whatever currency....locked into everything worth nothing....

          1. Anonymous Coward
            Anonymous Coward

            Re: Agreed@ Robert Carniegie

            "The financial black hole you speak of is solely made-up of private debt."

            Sadly not. In very rough terms we're talking about £6trillion of debt facing the UK, of which £1trn is straight public sector debt, £2trn is unfunded public sector obligations (primarily gold plated pensions promises), £2trn is finance sector bailouts and QE, and £1trn private sector debt such as mortgages and credit cards.

            Nominally that looks like 50/50, but most of the financial bailout is notional, insofar as the money was magicked up, and what we will eventually be on the hook for is the difference between what was magicked up and what we get repaid. A not-reasonable guess would put that at around £0.3trn, but this won't be clear for a year or two. The reality is that PFI is a pimple on all of this debt, as an additional circa £0.3trn as you state, with about 90% of that signed up by that incompetent Scottish knob that the Labour party put in charge of the money.

            The general willingness to do down our biggest export earning sector, our biggest tax payer, and one of our biggest employers is quite remarkable. I'd agree that there has been epic crime and incompetence here - but looking at the vast, unpayable debts run up by virtually every Western government (excluding financial bailouts), don't you think that it isn't just the banks at fault?

            1. Rampant Spaniel

              Re: Agreed@ Robert Carniegie

              It is largely the voting public who are at fault, directly and indirectly. We live in a society where we are rarely obliged to accept fault and will dive on any oppertunity to avoid responsibility like a fat kid on the last slice of pie.

              Irrespective of your political leanings, consider society as a whole, exactly how successful do you think a candidate for PM or POTUS would be if they stood up and said

              1- You ALL have to pay more tax (in some cases up from nothing)

              2- There will be a reduction in most government services, armed forces and social spending

              3- We will pass legislation that makes companies more responsible for their conduct and the sustainability of their methods, which would result in a decrease in growth (at least to some degree, its possible to argue it would reduce boom and bust) which will impact investments and pensions.

              Individually, some may agree, collectively the person who gets in will be the one that promises some wonderful way of postponing dealing with it coupled with a few token spending cuts in the albatross cuddling agency and huge tax breaks for the companies and rich folks who paid for his campaign.

              1. Anonymous Coward
                Anonymous Coward

                Re: Agreed@ Rampant Spaniel

                Hold one one moment there! At the last UK general election, the parties were falling over each other to claim to be harder on cutting spending than the others, and promising to raise taxes.

                Unfortunately, once we'd got a government, they then spent eighteen months TALKING about the need for cuts and higher taxes, but delivering nothing in respect of either. By the time the cretinous halfwits had got round to starting, the iron was no longer hot, in that the public had got bored of the talk, and no longer believed it. And it quickly became apparent that Parliament lacked the spine, the vision, and enthusiasm to actually start slashing spending. So for everything they did do in terms of cuts and changes the knob ends then committed to raising spending in other areas. So they introduced huge tuition fee increases, and then that useless, idiot knob end Cameron decides to increase the foreign aid budget by the same amount he's cut from UK higher education. We have a defence review that was a work of monumental imbecility, but half the cash savings from that were thrown away on grandstanding in Libya.

                Most of the public understand that the public finances are in a mess; regardless of who they voted for (!) they were promised cuts and tax rises, but in practical terms Parliament has as usual failed to deliver. And a key part of that is because of the UK's national religion of the NHS as free at point of issue, so that they've not cut the health budget in any worthwhile degree, and they've not looked at charging and co-funding options (added to which some NHS staff have sort to penalise those who have tried to co-fund treatments - private sector healthcare being some sort of pariah, unless of course it's a highly profitably GP practice reaming out the healthcare budget).

                If we want to sort out the public finances, then there's some simple if brutal changes that can deliver:

                1) Shut down 90% of BIS, DECC, and DEFRA

                2) Stop 90% of foreign aid - disaster relief being the 10%

                3) National construction corporation to employ the unemployed: Welfare for work, or no welfare. Use this resource to build the infrastructure that we currently can't afford to do.

                4) Modest charges at point of use for the NHS for those able to pay

                5) Eliminate gold plated public sector pensions, and slash the liabilities (by whatever means necessary)

                6) Remove payroll taxes and red tape

                7) Stop paying the EU for nothing

                8) Stop immigration. Overall immigrants have been a good thing for the UK (and in the last 10,000 years, we're all immigrants), but our services and infrastructure can't support the existing population properly, added to which if you've got an unemployment problem, so letting in two or three hundrand thousand additional people a year isn't helping.

                9) Examine a means of penal taxation for companies who offshore British jobs. Not sure if we could do this fairly, but worth looking at, given that our biggest export appears to be jobs.

                1. Rampant Spaniel

                  Ledswinger for pm

                  I vaguely remember the last election (the US doesn't really cover foreign things unless it's related to an upcoming invasion), for me it really highlighted the problem. There were shouts about who would cut and tax, but upon closer inspection some of the cuts turned out to be slower growth (although there have been cuts, usually in the wrong places i.e. less police and nurses, why cant we just get rid of mep's? and all msp's and welsh assembly members should double up as mp's) and as for tax increases, wasn't Dave recently wittering about lowering the top tax bracket? I remember theem going to great pains to state that they could reduce the deficit in a manner which we wouldn't really notice. None of them turned round and said, taxes are going up 10%.

                  I would add another to your list, placing more people back into taxation / reducing benefit levels. In the US, nearly half of everyone pays no federal tax. Thats truly staggering. Even if they only paid a small amount each it should help.

                  Also restricting what you can spend benefits on. The US actually gets a few things right, their WIC program (for mums and kids) actually gives out vouchers for specific things, they cannot be used at Gala bingo. Some benefits like 'food stamps' also called SNAP can be dispensed onto a debit card that cannot be used for booze or fags. I love wine but if I had to resort to the public purse I would not expect to be able to spend it on mad dog 2020.

                  Another good idea they have is unemployment payments are related to how much you paid in tax and limited in duration so if you get canned you can actually afford to carry on living and you are encouraged to find work. Exceptions on duration are made like during the current crisis. The US gets plenty wrong but having lived in both the UK and US I do like a few of their ideas and a few of ours.

                  Overall I'd be happy to see your idea's implemented. You'd probably be voted out in about 10 seconds, but thats the nature of the beast. Politicians have to walk a fine line between appeasing the companies that own them and us lot who vote for them. Thats why we continue borrowing. As it stands here, our property taxes are going up (in reality the 'allowance' is decreasing rather than a rate change) but shock horror all the rich folks with mc mansions on agricultural land still dont pay a fair rate because the local slime squad know who pays for their reelection campaigns.

                  1. Anonymous Coward
                    Anonymous Coward

                    Re: Ledswinger for pm

                    Yay! I'd sort the mess out, and be happy to be voted out. Wouldn't even take a full term of Parliament. And I'd scrap MP's excessive holidays, make the turds work for their living. Which would give me more time to pass or repeal legislation (But even that could be simplified - I'd start off with the Repeal of Ten years of Tony Blair's Shitheaded Legislation Act, 2012).

                    Getting voted in is the problem. But even so, it might be the wrong career for me: Watching the British women's hockey team the other night, I came to the conclusion that of my various grave errors of judgement over the years, the biggest was not choosing to become a sports physio.

    2. Rampant Spaniel

      Very well put. When our 2nd kid was born stateside we were asked if we would donate any unused blood samples and access to anonymous records for research and we consented (no such requests for kid 1 in the UK despite being in a teaching hospital?). In principal I agree with the idea of allowing researchers access to data but there has to be some level of control.

      I can't help but feel a little paranoid here, but business and government have proven time and time again that personal gain is more important than following rules. I cannot think of two groups of people I trust less. Should that get in the way of something that might help everyone in the long run?

      There are diseases we need cures for, diseases that can be cured if we apply ourselves. A little more time working on cancer and a little less working on the next stealth uav or whatever might be a good idea.

      As for the nhs, try living in the states, the nhs is phenominal. It delivers mostly excellent quality service for a very low cost and everyone gets treated for nearly everything. Perfect they are not but the Beveridge and Bismark systems are leagues ahead of the states in efficency and coverage.

    3. Ken Hagan Gold badge

      @Steven Jones

      Quite right. The basic idea is a good one, even though it will almost certainly be screwed up beyond all belief in the implementation. (Big pharma should be paying big bucks for access to millions of records. I bet, however, that they'll pay next to nothing once the monkeys that pass for contract lawyers in the civil service have finished.)

      As usual, the way to see this is to imagine the uproar if somebody was sitting on millions of health records that *could* be used for any number of studies but sadly they've decided that "we" aren't offering anough cash so they aren't going to release them. Such a person would last about 5 seconds in the court of public opinion. We can all see the potential benefits to exploiting the records that are created as a by-product of the NHS doing its job. It's just a question of not screwing up.

  13. Irongut Silver badge

    National DNA database?

    How exactly would this idea create a national DNA database? My doctor does not have my DNA and has no reason to ask for a sample so my DNA is not in my medical records. I'm guessing that will be the same for most of the population.

    It would be nice if for once the anti groups would make a sensible argument so they don't get laughed at and ignored as nut jobs.

    1. Anonymous Coward
      Anonymous Coward

      Re: National DNA database?

      You seem to be a very trusting person. Do you really have no concerns? If not, you have not thought about the situation and the possibilities.

    2. JohnMurray

      Re: National DNA database?

      Easy to implement though....let's check your blood Mr Irongut....and let's have a sputum sample, not to mention urine (pee here)

      Got it yet ?

      All the police need is a hair sample...your doc' gets more than that.

    3. cyberdyne2012

      Re: National DNA database?

      All children have blood samples taken at birth to do standard tests. This has been used to build huge illegal DNA databases in Ireland, Australia and New Zealand. The governments now claim they've been 'destroyed'. In the case of Ireland only samples over 10 years old have been destroyed.

      "A DUBLIN hospital has built a database containing the DNA of almost every person born in the country since 1984 without their knowledge in an apparent breach of data protection laws."

      http://www.tjmcintyre.com/2009/12/temple-street-hospital-holding-de-facto.html

      (Article from the Times is behind a paywall so here's the journalists personal site)

  14. Arnold Lieberman
    FAIL

    Oh Danny Boy(le)

    Looks like he isn't the only one brainwashed into thinking of the NHS as some sort of sacrosanct organisation. I'd rather have a health service that really is the best in the world, not just in the fertile imagination of some socialist who has never actually had to deal with it.

    If it is so bloody great, why are our cancer survival rates so abysmal compared to other countries?

    http://fullfact.org/blog/NHS_reforms_Department_of_Health_Andrew_Lansley_internatioanl_comparisons_disease_mortality-2690

    1. System 10 from Navarone
      WTF?

      Re: Oh Danny Boy(le)

      It is not 'so bloody great', it is the *concept* that is 'so bloody great'.

      The effort should be going in to making the implementation the best in the world, not wrecking it and building something worse from a blueprint where Party Dogma is the chief designer

      1. Anonymous Coward
        Stop

        Re: Oh Danny Boy(le)

        "it is the *concept* that is 'so bloody great'."

        I see nothing great in a concept where we've started to beggar our educational and science sectors in order to pay ever increasing amounts to keep health care free at point of delivery, when the country is (by historical standards) richer than it has ever been. Back in 1947 the starting point was rather different, and the model was at that time a very good and progressive move, but now it an expensive albatross, with standards of care that are very patchy indeed.

        Perhaps we need to copy Germany's approach. Very social democratic and inclusive, but also fairly effective in medical and cost terms, combining public and private health insurance funds, and using individual charges to deter excessive demands. No reason at all why working people shouldn't pay thirty quid a visit to see their GP, for example That'd raise £2bn a year if only a quarter of patients are working. Instead of this, the clowns come up with pathetic nuisance schemes like charging for hospital car parking, that raise bu99er all in revenues, but inconvenience both staff and service users.

        The tragedy of the NHS is that the peasants of this country think nothing of spending £40 on a takeaway meal, sixty quid on a pair of trainers, seventy quid on a tank of petrol, and yet they won't see that it isn't a sustainable model for them to see a very highly qualified professional for free, to be referred on to clinical experts using expensive faciltiies, and still there's neither charge nor limit.

        1. Ken Hagan Gold badge

          Re: Oh Danny Boy(le)

          "I see nothing great in a concept where we've started to beggar our educational and science sectors in order to pay ever increasing amounts to keep health care free at point of delivery, when the country is (by historical standards) richer than it has ever been."

          The concept is "healthcare that is free at the point of delivery and allocated according to the greatest need". Nothing in the concept specifies the size of the pool of cash or the metric used to determine "need". Just because the last 70 years worth of political giants have let the newspapers answer both of these questions does not mean we can't do better.

          1. Anonymous Coward
            Anonymous Coward

            Re: Oh Danny Boy(le)@Ken Hagan

            Possibly right, but the idea of "according to greatest need" doesn't work. Despite the resources being poured in, poor & thick people have worse health, and the NHS isn't doing much to sort that out by medical interventions.

            Which suggests that public health should be a much greater priority to reduce the demand for clinical services. But PH is a very, very poor relation in the NHS, with woeful funding and management, despite some committed people (PH tends to be quite a vocational thing, even within the wider context of healthcare as a vocation).

            And if we put the resources in, where does that start leading us? Everybody knows what they should and shouldn't consume, but they do it anyway, so this isn't about communication or information. There's already a widespread ban on smoking, with proposals to extend this into private cars and even people's homes. Having got as near as they can to a total ban, the public health jihadis next target is alcohol, with widespread enthusiasm for minimum pricing, extant public drinking bans and the like. How do you think that is going to develop? What then? A "fat tax", or a complete ban on unhealthy food? Mandatory exercise? Force feeding broccoli to the plebs?

            I don't like the way that things might go, because I don't believe the state should tell people in such specirfic and personal detail what they must or cannot do. But if people want to have freedom of choice in areas that negatively impact their health, then let's charge them a minimum to use the service. Not "at cost" or anything, but for those who can afford it, an extra contribution for GP visits, inpatient stays, physio services, etc

        2. JohnMurray

          Re: Oh Danny Boy(le)

          Free ?

          I pay some 42 quid a week in NI....my employer pays similar....

          Nothing's free....it's free at the point of service....and costs a lot elsewhere.

          My local hospital has two MRI scanners, which cost some 1.5 million each, and more for the buildings.

          Along with several other invasive and non-invasive imaging suites....take the cost of drugs to the NHS (antibiotics from a quid a course, to inhalers at 74 quid each, to an annual treatment for HIV+ patients running to several thousand a year) into account as well...

        3. Anonymous Coward
          Anonymous Coward

          Re: Oh Danny Boy(le)

          The tragedy of this country is that the rich are getting richer and the poor are getting poorer.

      2. Arnold Lieberman

        Re: Oh Danny Boy(le)

        It is not 'so bloody great', it is the *concept* that is 'so bloody great'.

        If I may, erm, agree with that statement. The concept is fine but it is the current structure that is wrong. Like with software design, sometimes you have to start with a new codebase cos you can't keep cobbling new features onto an old design, so with the NHS. Keep the ideas but redesign the mechanism of delivery. Bring in private operators (objects) under a standard API (service agreement), then let them get on with managing their own processes. If they do not perform adequately, remove management and reboot. Take metrics from patients (outcome and satisfaction) and build that into the contract.

      3. John A Blackley

        Re: Oh Danny Boy(le)

        I think they tried that with communism - another "bloody great" concept.

    2. Anonymous Coward
      Anonymous Coward

      Re: Oh Danny Boy(le)

      So should we move to the americans system of private healthcare for those who can afford it?

      Well done, your ill conceived idea will doom the majority of us to having NO health care at all.

      W O W!

      1. Anonymous Coward
        Anonymous Coward

        Re: Oh Danny Boy(le)

        Where did anyone say anything about moving to the American system, pray tell? Fine if you disagree with what was said, but don't start making up arguments that never happened.

        Jeez, some people...

        The "NHS" as it is stinks for the most part. There are some brilliant doctors and nurses, as there will always be regardless of the structure. HOWEVER, and this is the point you should try to comprehend RATER THAN MAKING UP SOME STRAW-MAN ARGUMENT... It is the lack of focus on patients that is the problem. I have seen enough incompetence and cover-ups to inform me that things are not right, the sort of problems that would never be allowed to develop in a customer-focussed free market.

        I have seen my grandfather battle for over 10 years against doctors covering up for other doctors over the terrible treatment my grandmother received. In the end he won his court case but it consumed the rest of his life.

        I have also seen my father being fed pills to stop him from being sick even though he had throat cancer and therefore couldn't swallow anything. Of course, I could never speak to the doctor directly as he did his rounds when patients were not allowed in and the nurses were far too busy to talk. In the end, he only got decent treatment when he went into a hospice. A non NHS, charitable institution where the staff actually cared.

        My mother, at the age of 72, volunteers at the local hospital as a "feeding buddy" cos the nurses are too busy to look after their patients. That's not a reflection on them personally by the way, but it is a reflection on a system which is too preoccupied to do what is necessary for the patients.

        How many of the sneering leftie commentards have been into a hospital in the last new years to see what's really going on?

        There's a lot that can be done, whether it is in terms of procurement of services or supplies or providing patient care, and much is happening for disabled people who are given their own budgets by social services (obviously managed by a parent/guardian) in order to procure services. So now you find the old monolithic institutions are being replaced by much smaller businesses, mostly people who are willing to share their lives with someone in need. This is both better for the client as they get to stay in a family environment and cheaper for the council as they are paying £40/night instead of £hundreds. This is a system that has nothing to do with the NHS yet still provides what the clients need.

        1. Intractable Potsherd Silver badge

          Re: Oh Danny Boy(le)

          I don't know if I count as a "sneering leftie commentard", but I have been in two different hospitals as a patient several times for different complaints over the last few years, and dealt with my GP and outpatient services for those and other conditions. I am also an ex-nurse, and I am currently extremely closely involved with the provision of medical law and ethics education to medical students, practitioners, and management . I therefore feel that I am qualified to comment here.*

          Overall, my experience of the NHS is that it is still very, very good, but there are areas that are slipping. In terms of diagnosis and basic treatment, I have nothing to complain about. One recent condition was diagnosed as being something completely different from what was being looked for, and the change from one specialist to another was quick and seamless. It is possible that, under a better system the time from diagnosis to surgery (four months) would have been less, but it was not life-threatening, merely (very) uncomfortable and had some impact on my lifestyle for a while. The most recent hospitalisation in January (as far as I can remember - I was very ill on admission) must have cost thousands of pounds in tests while the doctors stabilised me and tried to work out what the problem was.

          The down-side is that levels of communication between staff and patient, and especially with my wife, were extremely poor. As an ex-nurse, I find the amount of time that anyone qualified to speak knowledgeably about my conditions either to me or my nearest relative extremely poor. During the last admission I literally had to say to a doctor (the chances of speaking to a nurse were laughably small - absolutely disgraceful, since that is the primary function of a nurse in my opinion) "Please come and tell us what exactly is happening". They had been great at telling me what tests they were doing, and what results they had got, but not at pulling the story together. Disappointingly, the junior doctor who did come to do the job told a different story than the consultant gave me two days later, and I still don't know if I have had a particular intervention done or not!

          The major problems in the NHS are: 1) creeping managerialism, with too many people coming from commercial enterprises and having no clue what the basic ethos of the NHS is, and how to maintain it. For instance, I know of one Trust Chief Exec who feels that all clinical ethics problems are management issues, and therefore that Trust has a Clinical Ethics Committee made up entirely of managers! 2) Poor standards of training for nurses. There was nothing wrong with the old apprenticeship method of training that was phased out on the 1980s, but the RCN insisted that nurses need to be more "professional" to compete with doctors. This was an utter disaster, and leads directly to cases where people are dying in hospital due to dehydration, and (to use a case posted here) people with throat cancer are given oral medications. We need an urgent return to nurses being trained on the wards as members of the team (though who would train them properly now we are infested by nurses trained in universities?) 3) Contracting out leading to a lack of team spirit. When I was on the wards, everyone, from the cleaner to the ward manager, was on the same team and did what was necessary. This is no longer the case, and it impacts badly on the patient.

          I could go on, but the NHS is still worth fighting for. Treatment free at the point of care is vital in a civilisation, and the information that is locked in the NHS should be freed somehow in order to improve care (indeed, Beveridge expected that there would be no need for a huge NHS after a while because the information generated would lead to better preventive healthcare). If that makes me a "sneering leftie commentard", I'm proud of it!

          *I do not discount the possibility that all of these things affect the way I have been treated, and so accept the possibility of observer bias.

          1. Anonymous Coward
            Anonymous Coward

            Re: Oh Danny Boy(le)@Intractable Potsherd

            A thoughtful and useful contribution, thank you. I think you're on the money with the comments about nurses and training. But our local general hospital is dreadful in all respects - in the view of my wife who works for the NHS and is a (properly) trained nurse and midwife. And that's not just nursing, but medical care. Indifferent, lazy, uncaring nursing staff sitting on their fat arses gassing to each other, whilst ignoring thirsty elderly patients, the background sound of drip alarms that are just ignored, foreign doctors who are barely competent in medicine (eg consultants failing to refer to other consultants whose specialism was more relevant, and could barely speak English). Fabric and cleanliness wise it's medicre as well.

            I just don't see that "free at point of delivery" reflects modern times, and this unfortunate historical hangover has now ceased to be part of a solution, and become a problem in its own right. Clean water is more important than medical care, but that's not free, nor is food. Why this mystical, even religious belief in "free" healthcare?

            1. Intractable Potsherd Silver badge

              Re: Oh Danny Boy(le)@Intractable Potsherd

              Thanks, Ledswinger - I appreciate the reply. I doubt anyone will read this now, but for completeness:

              Free healthcare means that no-one ever has to think about whether they can afford to get treatment for what is wrong with them. The situation is bad enough with people not taking adequate time off work to get well due to losing money (or job).

              I really, genuinely, believe that it is the mark of a truly civilised country that anyone can roll up at a surgery without ever having to think about the cost.

      2. Aaron Em
        Thumb Down

        Re: Oh Danny Boy(le)

        "NO health care at all"

        Right, because emergency departments in the United States turn away anyone who can't pay in cash, up front, for any treatment they might possibly require.

    3. Nick G
      Mushroom

      Re: Oh Danny Boy(le)

      Did you even read all of that article?

      The very last paragraph states:

      "All of the reports above are extremely detailed and extensive, with data covering a wide range of diseases and health issues, in which the UK's performance is variable – from very good to very bad. Focusing solely on the negative outcomes may therefore be a bit of a selective analysis."

    4. Anonymous Coward
      FAIL

      Re: Oh Danny Boy(le)

      Your link does not suggest that the NHS cancer survival rates are absymal. It says that the rates are worse than some of our neighbours, carries the caveat that the data set is incomplete and concludes with the line that "UK's performance is variable – from very good to very bad.".

      A better link for survival rates than your suggestion is - http://www.nhs.uk/news/2010/12december/pages/cancer-survival-rates-compared.aspx

    5. Anonymous Coward
      Anonymous Coward

      Re: Oh Danny Boy(le)

      I was under the impression it was largely down to misdiagnosis by the people Lansley wants to put in charge of the budget.

  15. Anonymous Coward
    Anonymous Coward

    Needs reasonable controls

    It needs reasonable controls to stop very small sample sets being made available whcih could be cross-referenced to guess identities. And more importantly make sure no procedures are caried out as a feedback loop wihout a LOT of checks. However I don't see how the privacy hysteria is warranted.

    What they need to do is stop our local hospital giving out my details to med students so they can ask me to participate in studies every few months - very annoying and much more privacy invading than the above.

  16. Triggerfish

    To depressed to think of a witty title

    David Cameron the MArk Zuckenberg of our civil liberties.

    I thought the last lot were bastards.

    I actually think conceptually this is a good idea.

    Realistically I know we are going to get shafted someway.

    1. Anonymous Coward
      Anonymous Coward

      Too retarded to even spell your shitty title correctly

      Idiot.

      1. Triggerfish

        Re: Too retarded to even spell your shitty title correctly

        Nah mate I worry about spelling for business and things like that.

        But typing quickly at work for a forum?

        Well I frankly cba to worry about my spelling in the hope of not offending an anon coward. :)

        1. Triggerfish

          Re: Too retarded to even spell your shitty title correctly

          But I'll agree the title was shit.

  17. Mark 65 Silver badge

    Given Government of all levels capabilities with regards data retention and privacy I'm not exactly filled with confidence.

  18. John A Blackley

    Too late

    to be the 'world leader' on this one, Mr. Cameron. The United States has already started collecting patient data (through Health Information Exchanges) on an 'opt out if you don't want your health information splattered all over the world' basis. That patient data - suitably 'anonymised' except for medication details, allergy details and treatment notes - will be passed to the pharmas for their delectation.

    So imagine you've got a vomiting kid with a temp of 103 and you take it to the emergency room. Your one chance to 'opt out' of the above comes when they hand you a two-sheet 'consent to treat form' which, on the very bottom of the second sheet, contains (in pretty dense language) your chance to opt out. Gonna take ten minutes to read the whole thing before they even look at your kid or are you simply going to sign it?

    A scam of the first order.

    1. Ken Hagan Gold badge
      Coat

      Re: a vomitting kid with a temp of 103

      Only a complete idiot would design the system so that you had to exercise your opt-out at the point of treatment. Oh wait...

      1. JohnMurray

        Re: a vomitting kid with a temp of 103

        You actually have to inform your GP that you do not wish your details entered onto the NHS database.

        Not really a problem....nobody will treat you based only upon your data....even if your data says "blood group A+" they will not treat you based on that...they always check...

  19. sheila

    As usual Scotland is ahead of the game...

    As detailed here: http://www.home-education.biz/forum/56529-post2.html

    For more on Big Brother Scotland see here: http://www.home-education.biz/forum/general-discussion/12948-big-brother-scotland.html

  20. David 45
    FAIL

    A hacker's paradise

    And, of course the government can always be trusted to keep all our personal data secure from hackers and other prying eyes.

  21. Anonymous Coward
    Anonymous Coward

    A big dump of inaccurate data

    Patient (non)compliance will screw up attempts at data harvesting-- after my mother died we found six months worth of statins in a carrier bag under the stairs, She'd been told to stop taking the statins because the erythromycin she was prescribed took interacted with them. But they'd forgotten to tell her that when she ran out of antibiotic she should restart the statin. So the statins piled up to fill a tesco bag, and she never took more than a couple of days worth of antibiotics before also hiding those in a drawer. Her last year was an uphill struggle, trying to get her to take a range of medications on schedule every day: without someone standing over her, she'd take meds randomly or not at all, and believe she'd taken them properly. I did wonder how long she'd been doing random medication before we discovered the situation. Extend that to millions of elderly patients and see how much clinically useful data you get.....

  22. Alan Firminger

    I don't have any problem with my data anonymised and sold to private companies to find better treatments.

    I would give it away for the benefit to humanity.

    Realize that the anon bit blocks the release of DNA, because DNA is identity.

    And Mr Cameron is wrong in his hope that it would boost British drug development. The worlds companies would buy the data and do the work where it is cheaper, like India or China.

  23. Anonymous Coward
    Anonymous Coward

    re cameron comments

    The labour party would do this and more. Not that I'm defending the tories you understand.

    The 'research' alluded to consists of hyping me too drugs to doctors and supressing negative results. Big pharmas marketing budget is bigger than the 'research' budget. Most medical (actual real ground breaking) research is done in the public sector and then given away...

  24. Anonymous Coward
    Anonymous Coward

    forgot

    gross invasion of privacy.

  25. SJRulez

    Opt in... Not f**kin opt out

    Seems every time the gov has an idea it has to be imposed first and then you have to decide you don't want it otherwise they know people wont go for it!

    Whats the betting Cameron has either got friends in the drug industry or is probably about to buy large shares and stocks prior to leaving office.....

  26. Wilseus
    Mushroom

    Predictable

    Before I even clicked on this link I predicted that many of the comments on here would consist of hysterical nonsense. I was right.

    1. System 10 from Navarone

      Re: Predictable

      "Before I even clicked on this link I predicted that many of the comments on here would consist of hysterical nonsense. I was right."

      Mr Cameron! What are you doing here unaccompanied?!

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