By Nick Heath, 7 July 2009 14:07
COMMENT
Seven years into the project and the Conservatives want to put it under the knife. But, asks Nick Heath, are the Tories right to bail on the NPfIT?
The Conservatives have come up with a new vision of how to fix the problems plaguing Labour's £12.7bn revamp of NHS IT - put it under the private sector knife.
Under the proposals reported in The Times yesterday, the Conservatives suggest an alternative to the Labour government's plan to create a central Summary Care Record for every patient within the NHS, a scheme currently running at least four years behind schedule according to the Public Accounts Committee.
Instead, patients would be given the option of storing their medical records with private companies, which would then make the records available to patients and health staff via online services such as Google Health and Microsoft HealthVault.
Such a scheme raises big questions over security, and heightens the risk that by passing on patient details to private companies the NHS loses control of how citizens' personal information is kept confidential.
How will these companies manage to strike the tricky balance between easy access for millions of patients and healthcare staff and stopping unauthorised users snooping on records?
The government's National Programme for IT (NPfIT) has struggled to make its revamped vision of healthcare IT a reality - but the question is whether the commercial offerings as envisaged by the Conservatives can offer a better approach, particularly when dealing with access to information that can save a patient's life. Few patients would be willing to put up with an outage on their medical records in the way that they accept their email is sometimes unavailable, for example.
The Conservatives healthcare IT plan also prompts questions over whether scrapping the NPfIT would really benefit the country's bottom line. With £3.5bn already spent on different projects under the National Programme for IT the politicians need to do their sums carefully before wielding the scalpel.
The cost of going back to square one seven years into the NPfIT and transferring vast amounts of patient information out of the NHS systems and into the private sector could put a hefty dent in the saving provided by going down the commercial route.
Hospitals have also already suffered long waits for suppliers to deploy new patient administration systems capable of handling summary care records and won't welcome further delays while other systems are tailored to the UK market and staff are trained to use another new IT set-up.
The plans to create a single electronic medical record are undeniably in a critical condition, with the NHS CIO Christine Connelly giving suppliers six months to speed up delivery of key IT systems.
But we should think carefully before switching off the life support and committing the NHS' already stretched resources to nursing what could end up being another terminal case.
Comments
There are 5 comments. Join the discussion
1. anonymous
At Zaptag, a UK based company, we are already providing this service for patients to be able to manage their own health records online. We have integrated with GP and private practice systems in order get patients their key medical information from their GP / specialist so that they can then share this information with their other health providers or in the case of an emergency have this available to emergency personnel. Surely the Goverment (and future governments) should be looking at existing solutions in the UK. Both Google and Microsoft only have offerings for the US yet. They have yet to provide such solutions in Europe.
2. Philip Needham
The NHS system will be obsolete the day it gets switched on (if ever!!). Use of third party systems makes real sense, and the necessary checks and balances will be externalised, and therefore could be more transparent to us poor unhealthy citizens. The govt could then fine the third parties for breaches of security, instead of having to take the rap itself. As with the "Perils of Pauline", with one leap, she (the govt) is free!!
3. anonymous
Just why does anyone feel there is a need to have everyones records on a huge data base. I worked as a nurse for 22 years for the N.H.S,and there are working in the establishment many very incompetant people. Also i feel too many already have access to our private information. Too much emphasis is placed on computer technology, and still not enough on good record keeping. The vast majority on records need only be accessed locally by GPs, community nurses. For the minority who do require help from further afield we have the telephone. All aspects of our lives are becoming available to so many people making it so easy for any unscrupulous person to obtain otherwise private and confidential material. In all aspects of our lives we need to stop and take a long hard look at our society,and get it back on track again.
4. Dave Brown
I don't believe it, the Conservatives have caught the ID scheme bug - lets give all our sensitive details to private companies like Google and Microsoft - "you can trust us guv!".
Have they learnt NOTHING from the Governments floundering around trying to get us to accept compulsory ID cards?
It is just NOT going to happen.
5. Simon Skillen
The Conservative proposals not only fail to address a number of fundamental issues such as security, funding, existing NHS standards and integration with other NHS systems but they draw attention away from the real debate at a critical time for the National Programme for IT (NPfIT). Do we really need a centralised patient record system or should responsibility be devolved down to NHS trust level? NHS Trusts already have investments in patient record and appointment booking systems and relationships with / and the trust of local citizens. Why not use the web to enable individual trusts to provide secure access to records for other trusts and patients themselves, rather than duplicating everything centrally? This needn't mean new systems for each and every NHS Trust, far from it! In the time that the NPfIT has been running, web technologies have developed to the point where a web front-end can be quickly and cost-effectively developed and overlaid onto existing systems.
Surely making local trusts the guardian of patient records offers the best of both worlds? A trusted and responsible guardian that the public can identify with, without the huge costs and duplications of a centralised system would be a far better use of public funding.