UK govt promises to sink billions into electronic health records for England The UK's National Health Service (NHS) has committed to implementing electronic health records for all hospitals and community practices by 2025, backed by £2 billion (c $2.4 billion) in funding. The investment from one of the world's largest healthcare providers follows Oracle founder Larry Ellison's promise to create " …
-> Javid said: "The plan shows how we will effectively create a single, life-long digital health and care record for everyone giving patients a chance to easily access their own data with these records in place universally by 2024.
And neatly wrapping up everyone's health records for sale to the highest bidder/biggest donor to the Tories.
I'm fascinated that every time someone uses the term 'the Tories' it's part of some unsubstantiated fearmongering.
In this instance, 'dismantle the NHS'.
I seem to recall NHS funding growing significantly over the past few years, with no cuts in budget at any point. That's a curious way to dismantle something.
The Conservative Party manifesto thoroughly supports the NHS.
The actions of the current Government have been to throw vast sums of money at the NHS.
There's an entirely new tax (the NI uplift) that's explicitly to fund the NHS.
Meanwhile, the one clear shift towards privatisation of the NHS - the disastrous PFI initiative - was heavily embraced by the last Labour Government.
Still, it could be worse. We could live in Scotland.
The Lansley reforms brought in by the Health and social care act 2012 broke the NHS into 3000 organisations with their own boards that had to compete with each other and private providers to provide NHS branded services.
these organisations have their own boards of directors getting paid £100k+ each and have no economies of scale or power when negotiating with suppliers.
if you look NHS-wide, this has driven up costs and down quality and support, according to a study released yesterday, this has also correlated with an increase in avoidable deaths
Basically, the NHS is broken and the Torries did it.
If the people running the NHS dealt with the absenteeism, the bureaucracy and the incompetence then there wouldn't be 'shortfalls' in the NHS.
Look how easily the army organised and established testing once it was taken off the incapable NHS.
I support nationalised healthcare, but I don't support nurses prioritising tiktok video recording over patient care. Meanwhile NHS funding does keep going up, and up, and up, and.. wait, where exactly are the GPs?
The NHS were responsible for COVID vaccinations in the UK not the Army. I didn't see single person in uniform when I got my three jabs and if you're going to tell me that they were all the Army in civvies then God help us if Putin invades.
As for "I support nationalised healthcare..". You clearly don't.
As far as I can tell, Covid testing was never actually the responsibility of the NHS; billions of pounds were instead shovelled to Deloitte to run test and trace, setting up and expanding subcontract private labs instead of ramping up capacity in existing NHS labs, but without requiring the testing data to be shared with the NHS. And of course the 'trace' element was subcontracted to Serco and G4S instead of putting it in the hands of the existing experienced public health contact tracers, with further sub-contracting, price gouging and MUC fraud rampant.
Where the army was brought in to assist with testing, I imagine that it was because the Deloitte partners were too busy counting the taxpayer cash rolling in to their already inflated bank accounts to worry about the shit job that was being done in the name of the NHS...
The hero-worship of the NHS is part of the problem. It's clearly utterly dysfunctional and top-heavy - see recent reports about the way in which management has incresased dramatically over the past few years whereas front-line staff have increased by a much smaller amount. Then there's the obsession with EDI (loads of NHS roles at high salaries been advertised for that in the past few years). Meanwhile large parts of the population can't get an appointment with a GP for weeks or months, then may end up on an even longer waiting list to see a specialist.
It all needs breaking up and a different model adopting. What exactly that would be is the question, but plenty of European examples to look at, which achieve better outcomes for patients than the NHS does. Unfortunately any suggestion of that is immediately treated as heresy by the NHS-worshippers who seem to see the even more dysfunctional US healthcare system as the only alternative.
Top-heavy, yes. Utterly dysfunctional, seems pretty harsh; look at the covid vaccine rollout, which despite ministers regularly attempting to take the credit for, was left to the NHS to organise.
Folks can't get a GP appointment because despite repeated promises to recruit more GPs, numbers continue to go down while the population goes up, yet sectors of the media seem intent on painting them as work-shy. https://www.pulsetoday.co.uk/analysis/cover-feature/whats-the-next-big-recruitment-plan
I suspect that a lot of the problems in the NHS are the result of successive health ministers' desire to be seen to 'reform' the NHS, with yet more internal markets and dogmatic 'competitive forces', each of which just serves to add yet another layer of bureaucracy and management overhead, instead of focusing on clinical needs.
It's not just the numbers of GPs - a high proportion work part time, right from early in their careers (no doubt related to it becoming a heavily feminised profession). The partial answer to that could be that the government pays all training costs, but in return they have to work full time for X number of years, or pay back a proportion of those costs.
I don't regard the clotshot rollout as in any way something for the NHS to be proud of - the obsession with giving people a dubious "vaccine" (which most didn't need even if it worked as the NHS originally claimed, which it doesn't) led to nearly everything else being sidelined and people dying from conditions which would have been treatable if addressed earlier. Rather than relentlessly hassling me and many others to get injected with the gunk (and flatly refusing to stop the letters and texts despite repeated requests) they could have put the effort into something worthwhile.
"Abandoned NHS IT system has cost £10bn so far
This article is more than 8 years old
Bill for abortive plan, described as 'the biggest IT failure ever seen', was originally estimated to be £6.4bn"
https://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn
So eight Bill would be a snip.
Those are rookie numbers! The pros can do "GBP 37 billion last we checked - and still going up": https://committees.parliament.uk/committee/127/public-accounts-committee/news/150988/unimaginable-cost-of-test-trace-failed-to-deliver-central-promise-of-averting-another-lockdown
100M tests at manufacturing cost of, let's say £2 each = £200M. Where's the other 36.8Bn gone? Even if you were to try to claim that those tests cost £20 each, that's still £35 billion quid unaccounted for.
Of course, this doesn't include the costs of "the app", which may have run into a couple of hundred thousand (a rounding error in this case), or staff costs. Did test-and-trace employee a million people at £35,000 each, for example?
To quote, "Do me a lemon, that's a poor IQ for a glass of water"
All that money went somewhere, and it wasn't on costs.
£2 each? PCR tests were nearer £200 each.
100 million tests? They handed out over 1.7 billion 'rapid' tests.
You don't need a very high cost-per-test (which has to include distribution costs) for 1.7bn tests to start eating into £37bn.
It's ok, I entirely accept that there was terrible waste during the pandemic period. The furlough scheme (and its associated fraud), the economic damage caused by unnecessary lockdowns, the selfish behaviour of the public sector, the horrifically bad modelling by SAGE causing poor decisions and unnecessary costs.
I just get fed up with people bleating on about £37bn without acknowledging where the bulk of that money actually went.
the selfish behaviour of the public sector
To what are you referring ?
the horrifically bad modelling by SAGE causing poor decisions and unnecessary costs
Is it bad modelling, or poor decision making by those making the decisions ?
AIUI SAGE did the best they could given a lot of unknowns - and I am confident given the scientific background of those involved that their advice would have been carefully expressed in terms of "if x,y,z then the result is likely to be foo" - with added caveats that "we're not exactly sure what x is at the moment, nor y, now z". I strongly suspect that once conveyed to non-scientific people it will have been interpreted as "foo will happen".
While there is plenty of experience from previous pandemics, covid has had significant differences which means you can't simply plug numbers into an existing model, wind the handle, and get sensible numbers out.
Well you can buy a PCR Fit to Fly for £49 retail inc the certification service so that reflects the actual real cost.
As T&T were doing in bulk and in-house, if their costs were anything more than this you need to be asking about procurement again.
Well you can buy a PCR Fit to Fly for £49 retail inc the certification service so that reflects the actual real cost.
PCR is an automated process, the costs are in the sample handling and staff costs. Very definitely something where economy of scale make savings (how many tests per hour do you reckon the average lab assistant would be capable of opening and pipetting into an inlet nozzle?)
Tests that retail at £49 are almost certainly going to be VATable at 20%, so the actual cost there is £39.20. Distribution and packaging costs probably account for another couple of quid, then you have a healthy profit margin for the sellers. The actual cost of producing, sterilising, collecting, processing and analysing one is probably under £20. In a hospital environment, where they have their own on-site lab, the actual cost may be significantly lower. Having been subject to both a rapid-flow, and PCR test at the same time, in a hospital setting, I can assure you that the sample collection and dispatch is identical for both, so the only differences are in the amount of time it takes to process the sample (the PCR reaction takes time to amplify DNA) and the complexity of the sample preparation for analysis, and I suspect this involves the sum total of taking the swab, swirling it around in some buffer, and then pipetting it into a machine. The paperwork is probably more time consuming.
There's a reason I didn't put the government COVID app on my phone, not least of which is that several early versions of it were rejected by the platform's app store over privacy concerns. I got around the need to use this to scan barcodes everywhere by making the sensible decision not to go into crowded public places during a pandemic unless I really had to.
I'm told the NHS "official" app is better than the government's one, but how long before this is replaced by something "NHS" branded but wholly owned and operated by private interests (with lots of suspicious links to the Tory Party?), and with no link to, or oversight from, the NHS at all. You know, just like "NHS Track and Trace".
With the current government's fetish for derogating human rights, and willingness to weaken data protection laws, I have absolutely zero confidence that this won't be used to gather private and personal data and sell it to the highest bidder. Given their track record, this is essentially a foregone conclusion.
On the flip side, I can see the benefits of a unified electronic medical record. However, the subject MUST have complete control over how this is gathered, where it is stored, and what it is used for. There must be proper, legally enforceable oversight, and any transfers to organisations outside of the UK must be an opt-in process, with a basis in necessity. I can't actually think of any necessary cases where my medical data needs to leave the UK, except possibly for emergency treatment when overseas.
There may need to be exceptions to consent, for example in emergencies when the subject can't consent, but in these cases, there needs to be proper data governance, with the principles of limitation (only the data that is needed for the purpose), auditing (a log being kept of who, what, and when, stored with the main record), and assurance of destruction when no longer required (e.g. when discharged from that overseas hospital). There must be absolutely no scope for data collection, storage, and sale of this data.
I have no confidence in the current government to ensure any of these things. In fact, I can envision them licking their chops hungrily at the thought of just how they will spend the cash they get from selling us out.
This is what should be the plan's foremost, nay singular objective. Which means it will be badly implemented, fail to unify anything much at all, and go many billions over budget. If it's delivered at all.
What it will do is provide Palantir et al. another foot in the back door to snoop and slurp all our juicy health data. Any public health and individual user benefits with be a serendipitous side effect.
Our Trust implemented an EPR many years ago. The clinical coders (deal with patients being coded correctly and therefore the Trust gets paid accordingly), reckoned it generated more paperwork than the old system...
Some areas are already linking together to get faster regional record updates. e.g. Great North Care Record.
We have a lot of invested time and energy in EPR's PAS's Path systems, let alone Specalist Clinical systems (that I work with)
Its got to better to link these up rather than chucking out the lot and starting again with some new system.
Interfaces are what makes the systems work, not puting in the new shiny shiny every 5 years.
"The most significant risk to this new vision of digital health and care is the lack of capacity among the health and care workforce," Mistry said
To the vision maybe. The most significant risk to the security of the data is that, given the govt's record of performance in application development, there'll almost inevitably be one or more stupid bugs in the software that allow the data to be exfiltrated or corrupted by 'bad actors'. And they will try, as it's some of the most sensitive information around.
> The most significant risk to the security of the data is that, given the govt's record of performance in application development, there'll almost inevitably be one or more stupid bugs in the software that allow the data to be exfiltrated or corrupted by 'bad actors'. <
Who needs bugs when, like the equivalent Northern Ireland (NIECR) system, they'll share the data within the NHS in an unlawful manner first before thinking about sharing/selling/leaking it to commercial orgs? "Let's have a Data Sharing Agreement to govern (legalise) the sharing but we won't actually get most of the organisations involved to see/sign/agree to the DSA and we'll leave out most of the important things from the DSA like defining any lawful basis or conditions".
BSO in NI have recently admitted to the ICO case officer investigating my complaint that "There clearly has been a misunderstanding collectively on our part on the legal basis applicable for use by ECR since the project was initiated". So BSO, the central body managing/running the IT system sharing almost 2 million peoples' health data since 2013 didn't know the lawful basis was that was allegedly in place between 500+ organisations to lawfully share that data!
ICO imposed a deadline on BSO to provide documentation to back up some of their "claims" regarding lawful basis/law condition/prove which orgs signed the Data Sharing Agreement/etc but it is now *three months past* the ICO specified deadline with no sign yet of BSO providing the requested documents. Of course ICO does not want to go down the route of issuing an Information Notice to BSO to compel them to provide the requested info, they want to take the "softer" approach.
Welcome to the ICO's world of (lack of) data protection law enforcement!
Just to be pedantic, it's not the government that does the development.
The fundamental problem is that managing a big project like this is a serious job - but various factors mean that the civil service (or rather, the various bodies that are part of it) lack the expertise needed to do it well.
The reality is that, especially after various "periods of austerity", "periods of 'pay freeze'", and so on - most CSs (Civil Servants) can easily earn more, often a lot more, by leaving for the private sector, especially so for specialist skills like IT project management. Yeah, there are other benefits, but they only go so far - and no, the pension isn't as gold plated as some would have you believe The end result is that often the CS project teams responsible for managing the projects are at least partly staffed by contractors, and between the resident staff inexperience and contractors short-term-ism and (potentially) an eye on future work, the teams are not able to adequately control the project.
In this environment, the usual big outfits, who can pay far more, will work the system to their advantage. In a situation where everyone has the same end goals (delivery of a good, efficient system at a sensible price), anyone spotting issues or omissions with a specification would speak up as soon as they saw it. But the way many of these projects happen, there are those involved who will see such issues/omissions as an opportunity to "add value" for themselves later by charging for a specification change later when the "does exactly what the spec said, but the spec was wrong" software doesn't work properly. And these contractors know that they have us over a barrel - they can effectively pick a number out of the air (or some bodily orifice if you prefer) for each change knowing that we can't shop around for someone who'll do it cheaper.
If the departments were allowed to pay what's needed, they could have the in-house expertise to get the spec right in the first place, and to nail down the contractors when they try it on. But they aren't - the treasury imposes restrictions regardless fo the harm it might do to the country as a whole. Read many of the reports on what went wrong with gov IT projects, and the root cause is usually down to inadequate up-front planning and definition by understaffed teams without the right people - followed up by "the usual suspects" taking advantage of that.
Oh yes, I nearly forgot the penchant for politicians to glibly announce something to the media and then expect a previously unaware CS department to implement it to a politically imposed deadline rather than a practical one.
Disclosure: I'm a CS. When I last asked I was told that around 1 in 5 posts in our organisation were currently vacant, and it shows. There are teams that simply do not have the manpower to do the tasks that they are being asked to do, and we struggle to get people of the right experience - I'll admit it, I don't really have the experience/knowledge for my current post, but it had been vacant for a year before I applied !
You know what, this is stuff thrown at the top of the pyramid. Nothing changes at the sharp end.
After 35yrs in NHS as a clinician, nothing ever reached us unless we did it ourselves.
Ok you need infrastructure, but we were told 'you will have X in three years', 10 yrs later, still waiting
So we did our own 'diy' stuff which worked for us; 21 years later still using our 'diy' software and word from NHS Digital, "2yrs and it will be with you"
Sorry, we've moved on and NHS IT has not (for us).
In short, all cr&p until it turns up and works
You were doing so well until the typo in the last sentence, did you mean:
"turns up and doesn't work"
Never mind, this money will achieve it's primary purpose i.e. line the pockets of government friends that the contracts will be given to and lubricate the ministers transition into a cushy job when they finally leave politics.
Quote (William Burroughs): "The paranoid is a person who knows a little of what is going on."
Tories + Palantir + Oracle = ($billions of taxpayer money) + (more shopping bags full of cash) + (even less privacy)
Only the "shopping bags full of cash" will be anonymised!!
Color me surprised!
*Citation required*
I'm not going to claim that there aren't dodgy politicians in every political party. However, the Venn diagram of dodgy politicians and Labour and the Tories would be a circle to represent the dodgy ones, a circle slightly overlapping this to represent the Labour party, and a circle contained within the first representing the current lot of Tories. The even-slightly-reputable ones (and I hesitate to refer to the likes of Ken Clarke as reputable) were pushed out at the last election.
Do any readers know if there are bookies out there willing to take a bet that on December 31st 2025 this will (a) not be finished, or even close, (b) be running years late, (c) have been hacked, and (d) will be way, way, way, way over budget?
The American companies seeking to purchase our data and parts of the NHS for peanuts will have to get their small print sorted, or they may be burned as badly as UK citizens and the UK economy have been by the clown cabal. Will any of them trust a contract signed by Glorious Leader? The EU were fool enough to and they came to regret it.
"At the moment, 86 percent of NHS trusts have a form of electronic patient record in place. The government wants that figure to reach 90 per cent by the end of next year, he said."
I'm more than 86% certain that those forms are not compatibile, or exportable, or useful. The problem with healthcare is that data is not what cares for people. Data also needs to be integrated into an agreed system of care. NHS (nor any other "system" for that matter) does not have this. Even more so as these are changing times with little leadership and much profit to be made sucking out resources from the financing.
The dream which is modelled on "what will" has no basis, no input from the people actually doing the work.
Pretty much anyone actually providing care will be rolling their eyes wondering just how long this thing will take until the next thing comes along and wastes valuable financial resources that could make a diffrence by actually paying and employing more people.
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