By Nick Heath, 10 August 2009 17:46
NEWS
The Conservative Party has today revealed its plans to reform what it calls Labour's "shambolic" and "costly" plans for healthcare technology in England.
The plans are designed to end the repeated delays to a core part of the £12.7bn National Programme for IT, called the Summary Care Record project, which will create a single electronic medical record for patients throughout England stored on a central database know as the Spine. The introduction of Patient Administration Systems at hospitals that will eventually handle the electronic care records have been delayed by technical and usability problems, and systems will now not be in place until 2014.
Launching the review shadow health minister, Stephen O'Brien, said in a statement: "Labour's handling of NHS IT has been shambolic. Their top-down, bureaucratic plans have been hugely disruptive to the NHS and have been plagued with delays and cost overruns."
"The proposals we are setting out today... will make sure the NHS has the technology it needs to deliver world-class healthcare for patients," he added.
The Conservatives propose abandoning the idea of a single medical record for each patient in England, in favour of separate electronic medical records for each hospital and GP surgery, based on common data formats to allow records to be shared when needed.
However, it is the Tories' proposal that patient medical records could be manually or automatically copied onto online health portals, such as private sector offerings including Microsoft HealthVault or Google Health, to be accessed and updated by patients online, that have drawn criticism.
Dr Grant Ingrams, chairman of the British Medical Association joint GP IT Committee, said it would suffer from the same issues that make the idea of a centralised Summary Care Record (SCR) unworkable: "It is basically what the SCR would be except you would be giving this information to private companies.
"Getting the national legal and IT compatibility requirements between existing NHS records and private sector databases is not going to be a straightforward thing to do."
Ingrams warned it could take years to make private systems compatible, pointing out that it took two years longer than expected to get the EMIS patient administration system used by GPs to be compatible with the central summary care record.
Giving patients and multiple doctors the ability to update the records would also create uncertainty over the accuracy of the information in the record, he said.
"Creating a multi-contribute detailed care record across the whole health economy is an unworkable idea - you are adding confusion to the system," he told silicon.com.
Stewart Room, partner in privacy and information for lawyers Field Fisher Waterhouse, said that the private sector has less regulation in place to keep data secure compared to the public sector, which saw additional data handling security measures introduced in the wake of HM Revenue and Customs loss of 25 million people's details in 2007.
"Since the HMRC losses it has been demonstrated that both the public and private sectors are equally bad at looking after data," he said.
"But at the moment the strength of regulatory oversight for a public sector body is stronger than within the private sector. It raises the question of how you would ensure effective oversight of security at private sector companies."
One example of the disparity between the public and private sector can be seen in the Coroners and Justice Bill, currently going through parliament. Under the Bill, the privacy watchdog, the Information Commissioner, will gain the power to carry out unannounced spot checks on data handling at public sector bodies, while private sector companies will be exempt under the current version of the legislation, Room said.
Private sector offerings will have to prove themselves before they can be introduced, according to the Tory review.
"Further investigation is required into the use and role of personal health databases in the NHS such as HealthSpace, HealthVault, Google Health and any other commercial or NHS-funded solutions that may emerge. These products, if deployed, must prove their readiness for deployment in the NHS before they are considered," it said.
As well as considering the use of private sector software, the Conservative review recommends allowing local health trusts to choose from a wider range of IT suppliers to give them a greater range of choice over the computer systems they install.
To do this, the review recommends halting and renegotiating contracts with the NHS' two remaining keys suppliers, BT and CSC, who are overseeing the implementation of new patients administration systems at hospitals across England. It says that this would "save further inefficiencies with regard to cost and delivery".
But Anthony Miller, managing partner at analyst house TechMarketView, warned that doing this could incur hefty compensation payouts on the multibillion pound contracts with BT and CSC.
"It sounds a nonsensical approach with all the compensation payments that would be due.
"They could not make the contracts any cheaper - when they were struck years ago they managed to screw the lowest possible price and that led to the suppliers not being able to make any money."
Miller said unfavourable terms within NHS deals had fuelled Accenture and Fujitsu's decision to abandon their position as local service providers and the multimillion pound write-off by BT on its NPfIT contract.
Comments
There are 3 comments. Join the discussion
1. Steve Horsfield
"But at the moment the strength of regulatory oversight for a public sector body is stronger than within the private sector. It raises the question of how you would ensure effective oversight of security at private sector companies."
Where the responsibility for holding the data is statutory, which may apply to certain aspects of health information, data ownership remains with the statutory body. I cannot see the Information Commissioner settling for, 'You can't inspect my procedures, because I've sub-contracted them to MicroSoft.'
2. Gayna Hart
The NHS Spine, the central IT database that is set to contain patient data, has already been created. To abandon it now would be a waste of considerable time and effort. It is already enabling services that are driving major improvements to the NHS, such as Choose and Book; a national electronic referral service which gives patients a choice of place, date and time for their first outpatient appointment in a hospital or clinic.
Rather than recommending to “rip and replace”, a more sensible approach would be to align this foundation to the PCTs requirements. Throwing money at a replacement would not help the NHS. Instead they need to promote the use of integration to absorb and update existing systems, which will reduce costs while improving services. A lack of consultation with these end users nearly scuppered the NPfIT before; we need to learn from the mistakes rather than repeat them.
3. anonymous
I am using an online personal health record provided by Zaptag in the UK and they already get access to your NHS records. Surely the government should be supporting organisations in the UK that are already doing this than be looking at Google or Microsoft who will probably end up costing the tax payer the same amount.