Today is National "Overspend on Government IT Projects" day. Did you notice?
Health Secretary Jeremy Hunt confirmed this week that Whitehall had slapped a further £240m on the pile of taxpayer cash needed for his grand plan to store and process medical records digitally. That means the government has now set aside £500m – which is expected to be matched by local health and care trusts to make up a …
Thursday 5th September 2013 12:56 GMT David Roberts
Who foots the bill?
Loads of words about "You should contact your GP practice".
How many people are reading these words?
Probably not the majority of active patients, as these will include a significant number of over 60s who are not Internet savvy.
Circulation of national newspapers is no longer very high.
Unless the Govmint runs a full saturation national TV and radio advertisement campaign to inform people that they have to make a choice and contact their surgery to opt out then most people will not even know that this is going on and that they have a choice.
The GPs aren't going to pay out £K to mailshot everyone.
They have enough financial problems already.
Thursday 5th September 2013 16:11 GMT typeo
Re: Who foots the bill?
I seem to remember receiving an extensive mailing about this, though I guess this was from a regional health authority rather than a UK wide campaign if others haven't seen one.
I know of cases where records have been lost or sent to another practice when the patient hasn't even moved so I will be amazed if this system goes to plan or doesn't need even more cash thrown at it.
Friday 6th September 2013 08:16 GMT Anonymous Coward
Re: Who foots the bill?
"The GPs aren't going to pay out £K to mailshot everyone. They have enough financial problems already."
The biggest financial problem GP's have is how to count the loot that they themselves take out of the system, with average salaries over £100k for a four day week, plus whatever they can get renting practice buildings back to the NHS, and milking incentives for additional services or performance. And the vast, vast majority don't dirty their hands or interrupt their golf by seeing patients out of surgery hours (or charge yet more to do so).
Try that in IT: Ask your boss for a six figure salary. But only doing IT work four days, the other day "updating your professional knowledge". No late nights, no weekends. A free hand to work privately in any capacity and for any employer you choose. Provide your own and your junior colleague's offices and rent them to your employer at a nice margin. And your competence and employability only to be judged only by your peers running the same arrangements.
Friday 6th September 2013 12:54 GMT Anonymous Coward
Re: Who foots the bill?
GP practices are private practices operating under an NHS contract. Some of those GP's are partners in the practice and so have a say in how much they get paid, and how many hours they work. The other GP's at the practice (usually juniors, locums etc) are under contract and have to work the hours required for the pay offered. The reason they don't do out of hour work is much the same as why a lot of workers don't - management don't want to pay the overtime.
Hospitals are government funded, but only the the extent that they exist. They don't get anything to cover the cost of treating patients: They have to bill the GP practice for that, and that is where things can get quite interesting.
So if you want to earn £100k for 4 days a week working in IT, you'd best start your own business and bring in enough money to cover it - just like those who are doing so already do (but not me, unfortunately - I am yet another wage slave).
Thursday 5th September 2013 13:20 GMT Anonymous Coward
Primary purpose of the NHS
I wish the primary purpose of the NHS was at the forefront of government thinking. You know, to help mend people who are ill.
It pisses me off no end to read that 'we' can find £500m to spend on SI's, who'll doubtless once again demonstrate that neither they nor the government able to deliver such an ambition, whilst 'we' have to fight tooth-and-nail the likes of the NHS's NICE who will 'cost effectively' rule out patient treatments using modern drugs on the basis of affordably versus efficacy at the drop of a hat.
Thursday 5th September 2013 13:26 GMT John Smith 19
US Study. Zip code, gender & DOB identified 87% of *all* people in database.
Including the Governor of the state that put out its "annonymized" medical records to allow data pimping.
Which is where the core data came from.
To even start to do this properly you start by disordering the starting records if you're deriving some kind of unique number from them, otherwise you need a truly random number generator to assign code numbers.
And as I'm no expert I wouldn't trust even that
I wonder how the Minister would feel if someone managed to de-annonymize his records for example?
Thursday 5th September 2013 14:06 GMT Anonymous Coward
Thursday 5th September 2013 16:47 GMT CABVolunteer
UK postcodes not good enough
Local authorities are supposed to use Super Output Areas(SOAs and LSOAs) for statistical analysis simply because postcodes are too small to allow anonymity. Clearly, one department of the government doesn't pay attention to what other departments have done, but then El Reg readers would be more surprised if it happened......
Friday 6th September 2013 08:35 GMT Anonymous Coward
Re: US Study. Zip code, gender & DOB identified 87% of *all* people in database.
"I wonder how the Minister would feel if someone managed to de-annonymize his records for example?"
The curious thing is why use the postcode at all? If you're in a new house you often don't have one for months, and for up to a year after you do, third party systems don't recognise the one you get allocated. On its own It isn't accurate enough to address things by, but is accurate enough to perhaps identify you by. And then we come to the problemette of who owns the postcode, who controls it, and what organisations have to pay to use it.
Cheif Idiot Cameron is determined to privatise the Post Office (not necessarily a bad idea) but allowing the private company to have the intellectual property of the postcode address file (PAF), which is an exceedingly bad idea. Taxpayers have already paid for the creation of the PAF infrastructure as a national asset, but Cameron thinks it would be a good idea to give it away. He's been told this is a bad idea by senior colleagues, and the gormless fool has ignored them. How's that going to work out? There will be inadequate controls to stop the privatised PO from changing and messing with the PAF at their own convenience, and I'm sure that an organisation as obsessively self focused and user unfriendly as the PO will immediately look to hike charges to use PAF. Maybe the regulator will step in? You think? Unfortunately not, the postal regulator is part of OFCOM, the owrld's most ineffectual and useless regulator - the same people who allowed them to introduce complex, inconvenient and user-hostile charges for parcels based on a combination of what shape it is, what size it is, and what weight it is (which is why Amazon's packaging suddenly became a lot crapper than it was).
I'm sure that the newly prvatised PO, running by Cameron's rich City mates will manage to make an expensive mess of all services that currently use postcodes, from health to commercial logistics, from mapping to third party parcels servicves.
Friday 6th September 2013 12:33 GMT Anonymous Coward
Re: US Study. Zip code, gender & DOB identified 87% of *all* people in database.
@John Smith 19
Anonymised medical records would not include date of birth. In fact we consider a post code to be identifiable data, too (that is the full postcode - removing the last 3 characters works to anonymise the data, as does using the Electoral ward).
There are actually rules and legislation covering this, and most trusts take these seriously. The data breaches come from those who consider themselves exceptions to the rules and wind up leaving unencrypted patient details on thumb drives on trains as a result... the problem there is we can't encrypt people's brains... (yet!)
Thursday 5th September 2013 14:30 GMT Anonymous Coward
Thursday 5th September 2013 15:24 GMT Kelly Fiveash
Thursday 5th September 2013 15:25 GMT Anonymous Coward
Re: Not "sick Brits"
Actually, NHS funding for Scotland, Northern Ireland and England/Wales comes out of central UK taxation (source NHS funding and expenditure - Standard Note: SN/SG/724) and the £121bn is allocated as:
Northern Ireland receives 34.9% ( £42.2bn ) with average annual 'per head' spend of £2,105
Scotland receives 33.6% ( £40.7bn ), per head spend of £2,025
England & Wales 31.6% ( £38.1bn ) with a per head spend of £1,900.
The proportion of central UK taxation collected per country (based on population) is, for Northern Ireland 2.9%, Scotland it is 8.4% and for England & Wales it is 88.7%, the overwhelming majority of contribution.
Thursday 5th September 2013 15:50 GMT Gav
Re: Not "sick Brits"
Who said anything about funding? This is about policy and IT systems. This proposed system is only going to be implemented in England.
And the figures you are quoting are totally false. From the document you quote:
England; £99,249bn (83%)
Wales; £6.065bn (5%)
Scotland; £10,821bn (9%)
Northern Ireland; £3,790bn (3%)
Thursday 5th September 2013 15:07 GMT Dr_N
Thursday 5th September 2013 16:33 GMT Maharg
I am in support of this idea.
I moved to a new area recently, I went to register with the local GP and was told it could take up to 4 weeks for all my records to be updated, in the mean time I had a load of forms to fill in regarding my personal information, including disabilities and ethic origin, me and my families medical history, my lifestyle (how much I drink, smoke, if I have given birth, exercise etc).
Fine, Ok, no problem, I see the need for that, but if my information is going to be sent from the last GP I had (which I had moved to that area only a year ago anyway) why do I need to fill it in again just for what is a change of address? I was told it was so the doctor would have an updated record, so I asked why I cannot wait until my information is sent and then update what is needed? In the end it transpires that GPs don’t use the same kind of forms, therefore the information requested from one GP surgery may not be the same as from another, so when they get the information they will compare it to what I have filled in and take anything extra and leave the rest.
Now for those of you not familiar with the Data Protection Act, medical records are required to be kept for a minimum of 10 years… after you die.
And since I am not dead, and have a Forces background (moved around a lot) off the top of my head, 4 different hospitals (an asthma attack (a broken leg, a dislocated elbow, and one instance of losing a fight with a car on a zebra crossing) 8 GP offices and 8 dentists and the British Army have all accessed and may have my medical information on file in one form or another.
That’s 21 different instances.
Each time there has had to either been a request for my information or I have had to fill it in myself.
In one case of having to go to the hospital during an asthma attack, unlucky at 2am on a Saturday they could not give me an inhaler since they did not have my records, even though I showed them the empty one I had been trying to use for the last hour, in the end I was given oxygen, told to sit in a corner and by the time a doctor was ready to see me after seeing all the Friday night casualties so he could do an assessment before giving me an inhaler it was 4 hours later, I had gone outside and asked the smokers if one had one I could have a couple of puffs on 3 and a half hours ago. And was just waiting so I would have one to take home.
While I know this doesn’t apply to everyone, and lots of people will have had the same GP surgery since they were born, in this case, while I do have issues with the likes of Google having my information, standardised information that can be accessed and shared between GPs and doctors seems like a good idea to me, as long as it is done properly and securely.
On a side note I realise that’s a bit of an essay so I understand if you just take the title line and be done with it.
And Mr Jeremy Hunt is still a word that rhymes with his last name and begins with C
Thursday 5th September 2013 16:59 GMT Circadian
Re: I am in support of this idea.
The problem is "as long as it is done properly and securely". Do you seriously believe that there is any chance of that happening?
The set-up is already proposing handing your data over for "research purposes". I wonder how many safeguards are in place to make sure that it's not insurance companies doing actuarial research (even if not actual de-anonymisation research)?
Thursday 5th September 2013 17:19 GMT Jim O'Reilly
Reinventing the wheel
My local medical group in the US (just 100 doctors) has quietly extended their IT system to provide electronic prescriptions direct to the local pharmacies. I suspect they paid a little bit less than $1.5 Billion for the service.
Why does the British government persist in setting up massive central software schemes when they could do this much more efficiently on a distributed local system. Heck, they could buy the US system, run it on local hospital servers, and probably have a billion dollars left over for medical care.
And what's more, it would be much more flexible, since the US system has a good many more insurance and other services to manage, so it would be easily a superset of the UK needs.
Thursday 5th September 2013 18:47 GMT OllyL
Where's all this cash going...
So like Jim O'Reilly by the sounds of it, I'm a Brit living in the states. Having just moved from one major metropolitan city to another, I simply went to my existing doctor & dentist, requested a copy of my records; moved, found a new doctor & dentist & handed them over. All my prescriptions transferred automagically via CVS (like Boots) and are transferable to Walmart/Walgreens/the ghetto pharmacy round the corner with a simple click of a mouse. I can even get at my medical records online with minimal fuss & get 'suggestions' on medications etc...from the portal based on my last few health checkups. I can't for the life of me see where 250million is going when my local doctors pharmacy (in a not so wonderful area of metropolitan Detroit) can manage to electronically send my prescriptions etc...to any number of pharmacies in/around the city and approve refills online when their revenue is likely well under a couple of million dollars annually
Thursday 5th September 2013 22:20 GMT Anonymous Coward
The NHS of the future the ICO biggest customer
The issue is trusting that the NHS can keep the data secure.
I don't mind my medical data being kept electronically if they can guarantee NO data Leakage. which is not possible.
I definitely don't want data shared with private companies even if "all" identifying data has been removed as this has been proved in the past to be insufficient to prevent determined researchers from identifying individuals.
Why don't I trust the NHS and data security, apart from well documented data breaches, I have my own example. I purchased a PC from ebay and a quick run of recouva on the HDD and I had documents including patient medical information from a GP surgery in seaside town in the north west. (has a tower)
Friday 6th September 2013 08:46 GMT Anonymous Coward
Re: The NHS of the future the ICO biggest customer
"The issue is trusting that the NHS can keep the data secure."
They don't at the moment, to judge by the findings of Leveson. So all the bleating from some posters about the risk to our privacy rather ignores the fact that should somebody actually want to have access to your records, they would probably be able to blag them. In fact, if you went and asked to verify your medical records (as a poster above mentions) how would your GP know or verify that you were in fact you? I go the the GP less than once every five years, so they'd have no idea who I was. I suspect with a bit of front any of you lot of a suitably similar age and ethnicity could (knowing my name, address and DOB) go and "check that my records were accurate". And in the unlikely event that a journo wanted to know my health history, a few backhanders would overcome the inhibitions of junior staff.
So why the big deal about electronic reords?
Friday 6th September 2013 08:05 GMT oldcodger
Does nobody care about accuracy?
Once again, every one who has commented assumes that the data that will be shared from their GP will be their own correct data.
I will state again : there are NO checks to ensure that the data is correct, or even that it your data!
My wife and I went through a saga with our data records, where we found that the data entry person in the practice had appended other patients details onto our records, and left out very pertinent allergy information from my wife's record.
If you have a day to spare, ask your GP surgery to let you check your records, you will be surprised!
Tuesday 10th September 2013 18:00 GMT Matt Hawkins