By John Carvel
social affairs editor
November 21, 2006
About 50% of family doctors are threatening to defy government
instructions to automatically put patient records on a new national
database because of fears that they will not be safe, a Guardian poll
reveals today. It shows that GPs are expressing grave doubts about
access to the "Spine" - an electronic warehouse being built to store
information on about 50 million patients - and how information on it
could be vulnerable to hackers, bribery and blackmail.
The survey reveals that four out of five doctors think the
confidentiality of their patients' medical records will be at risk if
the government proceeds with plans to load them on to the new database.
More than 60% of family doctors in England also said they feared records
would be vulnerable to hackers and unauthorised access by public
officials from outside the NHS and social care.
Ministers have committed a large slice of the NHS's 12bn IT upgrade to
developing the Spine. They acted on the assumption that doctors would
provide the information without asking their patients' permission first.
The new system has been constructed to upload information from GPs'
computer systems automatically, without giving patients a say. But the
poll found 51% of GPs are unwilling to allow this uploading without
getting each patient's specific consent. Only 13% say they are willing
to proceed without consent and the rest are unsure or lack enough
information to comment.
The poll was conducted by Medix, a healthcare online research
organisation that has been used previously by the government to test
medical opinion. It found most doctors think a national electronic
record will bring clinical benefits for patients. About 51% of GPs and
65% of hospital doctors said it would enable doctors and nurses "to make
better decisions by having easy access to a complete up-to-date record
of clinical information". But the doctors were not convinced about the
security of the records.
They saw a big threat to patient confidentiality, with 79% of GPs and
55% of hospital doctors disagreeing with the claim of Richard Granger,
the NHS IT chief, that the new system will be more secure than current
Asked to identify the three most important concerns about
confidentiality, 62% of GPs and 56% of hospital doctors said they were
worried about "outsiders hacking into the system"; 62% of GPs and 51% of
hospital doctors similarly feared "access by public officials outside
health or social care". Other big fears included "bribery or blackmail
of people with access to the records" and concern about "clinicians not
adhering to the rules".
Nearly half the doctors who saw clinical benefits from a national record
thought the confidentiality risks worth taking. But only 11% of GPs and
18% of hospital doctors were prepared to upload details without the
The British Medical Association said: "We share the concerns of the GPs
responding to the poll. We are worried patients are not going to have
all the information they need to know what is going on with their
records. That is why we are in favour of a system that seeks their
Connecting for Health, the agency responsible for the NHS's 12bn IT
investment, said the poll showed most doctors recognised the benefits to
patients of the national programme for IT and agreed that introducing
electronic care records would help clinicians make better decisions.
A spokesman said: "The law constrains how a national database must
operate, but it does not prevent the creation of such a database, nor
does it prevent the merger of existing databases for efficiency and
safety reasons, as is being done to create the central summary clinical
record. The Department of Health believes that this will be of great
benefit to a great majority of people, improving healthcare and
preventing unnecessary deaths."
Ministers are preparing a public information campaign to persuade
patients of the medical benefits of a national electronic patient
record. About 50 NHS primary care trusts have volunteered to trial the
electronic record by uploading a summary of key medical information
about patients, but excluding sensitive medical histories. Ministers
have shortlisted six PCTs for the trials.
Local information campaigns will tell patients they can deny NHS staff
access to their medical details, but doing so may damage their chances
of getting the best treatment. However, once the record is stored on the
Spine, there will be no way of deleting it.
Medix said the sample of 1,026 GPs, consultants and other doctors was
fully representative of the profession. The survey was commissioned by
the Guardian and four magazines and websites with an interest in NHS IT.
It was conducted online this month, about a week after a Guardian
inquiry found a lack of safeguards against access to medical records on
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