National UK patient database a non-starter with doctors

Nov 20 2007

A scheme by the British government to put the medical records of 50 million National Health (NHS) patients on a national electronic database, is in danger of being boycotted by as many as two-thirds of family doctors.

In a climate rife with suspicion that sensitive personal data could be stolen by hackers and blackmailers, a poll has found that 59% of GPs in England are unwilling to upload any record without the patient's specific consent.

The poll of more than 1,000 doctors was carried out by Medix, which is a healthcare research organisation previously used by the Department of Health to test medical opinion.

The poll revealed that three-quarters of family doctors thought medical records would become less secure when put on a database ultimately for use by NHS and social services staff throughout England.

Half thought the records would be vulnerable to hackers and unauthorised access by officials outside the NHS, while a quarter voiced concern over the risk of bribery or blackmail by people with access to the records.

Twenty one percent also had doubts that social services staff would honour confidentiality rules.

The poll found GPs are increasingly concerned about the department's plan to automatically upload the records of everyone who does not register an objection.

A campaign last year forced government ministers to concede that patients should have the right to stop their medical files being passed from the GP to an NHS data warehouse known as the Spine but anyone not exercising this veto would be assumed to have given "implied consent".

A Medix poll a year ago before the government's concession found that 38% of GPs said they would not put clinical records on the database without getting a patient's specific consent, and 13% said they were unlikely to do so.

However recent polls suggest these proportions rose to 43% refusing to upload without specific consent and 16% unlikely to do so; another 30% were unsure or unable to comment, leaving only 11% who thought they were likely to comply with the government's proposal.

The high level of skepticism follows months of campaigning by NHS agencies to persuade doctors that the "summary care record" scheme would save lives.

In trials in Bolton less than 1% of patients opted out and the first 50,000 summary records were transferred to the database, including details of medications and allergies.

The move has made the information available to doctors providing out-of-hours care and eventually security clearance will be needed for tens of thousands of NHS staff to access to millions of patients' files.

Many doctors believe patients' confidential records will undoubtedly be at risk and say the security of a national scheme cannot be trusted.

The summary care record is a part of a £12.4bn programme to modernise the NHS's IT systems but the poll found many family doctors and hospital doctors do not think the programme is an appropriate use of NHS resources.

The majority of doctors favour an independent review carried out before any more money is earmarked.

The British Medical Association (BMA) suggests the government will not regain the confidence of the public or the profession unless it can demonstrate that its systems are safe.