Patients' medical records go online without consent

Patients’ confidential medical records are being placed on the controversial NHS database (NPfIT) without their knowledge, doctors’ leaders have warned.

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June.

Those who do not wish to have their details on the £11 billion computer system are supposed to be able to opt out by informing health authorities.

But doctors have accused the Government of rushing the project through, meaning that patients have had their details uploaded to the database before they have had a chance to object.

The scheme, one of the largest of its kind in the world, will eventually hold the private records of more than 50 million patients.

But it has been dogged by accusations that the private information held on it will not be safe from hackers.

The British Medical Association claims that records have been placed on the system without patients’ knowledge or consent.

It follows allegations that the Government wanted to complete the project before the Conservatives had a chance to cancel it.

In a letter to ministers published today, the BMA urges the Government to suspend the scheme.

Hamish Meldrum, its chairman, writes: "The breakneck speed with which this programme is being implemented is of huge concern.

"Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it.

"If the process continues to be rushed, not only will the rights of patients be damaged, but the limited confidence of the public and the medical profession

in NHS IT will be further eroded."

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June. By the end of next

year, the NHS hopes to have more than 50 million uploaded.

The "summary" records contain basic medical information including illnesses, vaccination history, and could include medication patients have been given. Ages

and addresses are also included.

Patients are supposed to be notified by letter at least 12 weeks before their details go live on the system and given the chance to opt out.

The BMA says that letters have gone to the wrong addresses and that many patients have been unsure what they mean.

Doctors point out that there has been no national advertising programme to explain the scheme, as has been the case with other government initiatives.

The BMA also criticises the fact that the information packs do not include the form which allows patients to opt out. It can only be obtained via the internet or by calling a helpline.

Katherine Murphy, of the Patients Association, said: "The Health Service should not put in place bureaucratic obstacles to patient choice because they are worried about what patients might choose to do."

Norman Lamb, the Liberal Democrat health spokesman, said: "The Government needs to end its obsession with massive central databases. The NHS IT scheme has been a disastrous waste of money and the national programme should be abandoned."

From:

http://www.telegraph.co.uk/Patients-medical-records-go-online-without-consent

Health Direct was warning of labour's duplicity, for example on Dec 16, 2009's post- Your medical confidentiality under threat again

Despite labour's promises to the contrary- their track record on snooping databases is appalling.

Having launched the Identity and Passport Service last week- which 96% of the population doesn't want, the labour govt are still going ahead with their health database.

Health Direct strongly recommends that you use the opt-out letter which was developed by with TheBigOptOut at http://www.nhsconfidentiality.org/optoutletter

and send it of NOW!

Labour's scramble to launch £11bn IT spending spree

Labour was accused of rushing through huge contracts before the election to safeguard the party's "nanny state pet projects".

The NHS computer scheme has cost £12.7bn; Home Secretary Alan Johnson with the aborted compulsory National ID card; the MOD computer system is £180m over budget.

Labour was accused yesterday of rushing through £11bn of spending before the general election in a "scorched earth" policy to prevent its pet projects being scrapped by an incoming Conservative government.

Despite the looming squeeze on public spending, ministers are trying to push through several massive computer contracts before ballot day, which is widely expected on 6 May. The "break clauses" in some deals may make them very expensive to cancel, locking in the new government.

Tory frontbenchers believe that, if they win power, they would discover "poison pills", making it harder for them to announce the immediate spending cuts they have promised. As well as contracts that are difficult to scrap, the Conservatives fear that Whitehall budgets have been drawn up to protect flagship Labour projects such as housing and children's services, so that any attempt to find small-scale savings would inflict maximum political damage.

Labour insists it has every right to carry on governing and argues that the new information technology (IT) contracts will provide value for money. Cabinet Office rules say that decisions on matters of policy and "other issues such as large and/or contentious procurement contracts, on which a new government might be expected to want the opportunity to take a different view from the present government, should be postponed until after the election, provided that such postponement would not be detrimental to the national interest or wasteful of public money". 

However, the guidelines do not kick in until the election is called – which Gordon Brown is not expected to do for three weeks. Although the Tories would call an immediate halt to all IT contracts if they won power, The Independent understands that last-ditch actions planned by the labour Government this month include:

*approving local supplier contracts for the controversial £12.7bn NHS electronic patient records scheme, the largest computer project in the UK, which the Tories would dismantle;
*signing a £1bn logistics software contract for the Ministry of Defence;
*speeding up a £600m contract to run new personal pension accounts due to start in 2012;
*completing an £800m agreement for communications equipment and services at the Serious Organised Crime Agency;
*starting to print the 30 million forms for the 2011 census, even though the Tories have said they would scale back the £482m project.

Labour denies acting irresponsibly and says an incoming government would be able to cancel the personal pensions contract at a cost of only £25m this autumn. But one minister admitted privately: "We are pushing hard on what we can get through by the end of March and asking civil servants to prioritise that, rather than medium- and long-term projects which could not be completed by the election."

However, some senior civil servants are frustrated that Labour and Tory frontbenchers will engage in frank talks with them about the spending cuts that will inevitably be needed to close this year's £178bn gap in the public finances. They say politicians fear their intentions would leak before the election.

Francis Maude, the shadow Cabinet Office Minister who heads an implementation unit planning the early work of a Tory government, said: "Labour's actions resemble a dying administration making reckless and irresponsible spending commitments to wreck the finances for any incoming government."

He added: "Once again we see Gordon Brown putting the Labour Party ahead of the country. Labour is unable to ditch its obsession with partisan dividing lines. The choice at the election will be clear: a responsible united government under David Cameron or a reckless irresponsible government under Gordon Brown who are only going to make things worse."

About £4bn is believed to have been spent already on the long-delayed NHS scheme for patient records to be available to any GP or hospital in England. The Tories want a local rather than a centralised scheme but fear the contracts would cost billions to unravel.

Labour insists the NHS contracts are being revised to save taxpayers £600m. The Health Minister, Mike O'Brien, said: "What we want to do is make sure we get these savings. I am certainly not going to get into a situation where because we are approaching a general election some day soon, the whole of government stops and we cannot make any contracts with suppliers of key NHS equipment. That would be complete nonsense."

But Stephen O'Brien, the shadow Health Minister, said: "At best it is a last-ditch attempt to tackle a deficit of Labour's own making. At worst it is an underhand effort to tie the hands of the next government."

From:

http://www.independent.co.uk/news/uk/politics/labours-scramble-to-launch-16311bn-spree-1917781.html

Labour's computer blunders cost £26bn- and rising

Labour ministers blamed for 'stupendous incompetence' after taxpayers are left with huge bills for bungled IT projects.

A series of botched IT projects has left taxpayers with a bill of more than £26bn for computer systems that have suffered severe delays, run millions of pounds over budget or have been cancelled altogether.

An investigation by The Independent has found that the total cost of Labour's 10 most notorious IT failures is equivalent to more than half of the budget for Britain's schools last year. Parliament's spending watchdog has described the projects as "fundamentally flawed" and blamed ministers for "stupendous incompetence" in managing them.

Further evidence has emerged over the failings of Labour's most costly programme, the mammoth £12.7bn IT scheme to revolutionise the NHS. 

Following Health Direct's post last week- Labours' only success- wasting taxpayers money, the Independent has repeated that just 160 health organisations out of about 9,000 are using electronic patient records delivered under the scheme. 

The vast majority of those were GP practices. New figures have also revealed that millions of pounds have been paid out in legal fees. The taxpayer has footed a £39.2m bill for "legal and commercial support" for the National Programme for IT (NPfIT).

Alan Milburn, the former health secretary, said in 2001 that everyone would have access to their health records online by 2005, but it is understood that the Department for Health is still "years away" from fulfilling the pledge.

Government departments right across Whitehall have been guilty of overseeing embarrassing IT failures. A project that was meant to save the Department for Transport (DfT) about £57m eventually cost £81m, and workers at the Driver and Vehicle Licensing Agency (DVLA) were forced to brush up on their language skills when computer systems gave them messages in German.

Another ill-fated IT scheme, designed to allocate subsidies to farms, cost the Department for Environment, Food and Rural Affairs about £350m and left British farmers more than £1bn out of pocket. Last year the Public Accounts Committee (PAC) warned that the system was already "at risk of becoming obsolete". 

In 2004, the Department for Justice gave the go-ahead for the National Offender Management Information System (C-Nomis) to be rolled out to prisons and the probation service in an attempt to make sharing information about offenders easier. But in 2007, when the estimated cost doubled to more than £600m and senior officials questioned the validity of the project, it was abandoned – after £155m had been wasted.

The MoD's Defence Information Infrastructure project is currently running more than £180m over budget and 18 months late, and is now set to cost £7.1bn. Last year, Edward Leigh, chairman of the PAC, said: "No proper pilot for this highly complex programme was carried out, and entirely inadequate research led to a major miscalculation of the condition of the Department's buildings in which the new system would be installed."

Other botched IT projects include the identity cards scheme; the Libra system for modernising magistrates' courts; an attempt to move the Government's GCHQ computer systems into a new building which ended up costing more than £300m; the Benefit Processing Replacement Programme; and the Foreign and Commonwealth Office's Prism system.

IT experts blamed ministers for being too easily wooed by suppliers. Insiders said a lack of expertise within the Government about the technology industry meant they were willing to believe claims made by major IT firms before contracts were awarded.

Several projects are now under renewed threat of being cut back or abandoned altogether as Alistair Darling, the Chancellor, has targeted them as an area of government spending that can be reined in as he attempts to tackle Britain's record £175bn deficit.

Tony Collins, an expert on the Government's IT failures, said Labour had displayed an "irrational exuberance" for IT projects that has often led them to throw good money after bad at failing schemes. "There are too few people in the hierarchy of Labour who understand IT enough to understand that it is not a talisman – there is nothing magical about it."

David Cameron, the Tory leader, has signalled a move away from big IT projects, suggesting he will use technology to increase the transparency of government. "It is easy to make these noises out of office," said Mr Collins. "Once you've got civil servants giving you a host of reasons why you should not be more open, I fear the Tories will sink into the same depths of secrecy that Labour has found itself in."

Botched projects: The cost of failure
£12.7bn National Programme for IT (NHS)

It was meant to revolutionise the way the health service worked. But far from heralding a new age of efficiency, the National Programme for IT is now widely perceived as the greatest government IT white elephant of history. 

As well as the huge costs involved, suppliers have walked away, projects are running years behind schedule, while medical professionals have complained that they were never consulted on what they wanted the new system to achieve.

£7.1bn Defence Information Infrastructure (DII)
It seemed like a good idea at the time. In 2005, the Ministry of Defence decided to offer a contract to a consortium of suppliers to replace the hundreds of different computer systems being used by the military with a single system that would be used by the army, navy and air force, as well as the MoD itself. It was to be used by 300,000 people across 2,000 sites. 

However, it is running more than £180m over budget and 18 months late. A parliamentary inquiry also warned that forces' reliance on older systems put them at risk of a security breach.

£5bn National Identity Scheme
Originally budgeted at £3bn, the labour Government’s plan for new identity cards, containing biometric data and linked to a central database, soon came under heavy criticism from civil liberty campaigners. As the costs spiralled, so the Home Office began to water down the aims of the scheme to assuage the critics.

In July 2009, Alan Johnson announced that the cards would no longer be compulsory, while moves to force all airport workers to use the cards were also abandoned. However thousands are still being wasted trying to get students to sign up as an alcohol proof card.

£400m Libra system (for magistrates' courts)
An attempt to bring records used by magistrates courts into the digital age backfired when trying to introduce one universal IT system to all courts descended into a costly mess. Fujitsu originally bid £146m to deliver the Libra system in 1998. However, the project proved more complicated than anticipated, and costs have now been put at more than £400m.

£350m Single Payment Scheme system (SPS)
The Single Payment Scheme system was designed in 2003 to be a sophisticated way of giving farmers their subsidies, by mapping their land and working out their level of payment. But failures with the IT systems being used mean that farmers were left short-changed. 

In 2006, around £1.28bn of the £1.5bn subsidies destined for British farmers still had not been given out. 

The Rural Payments Agency overseeing the project was ordered to make 23 major changes to the system. Despite the £350m spent on the technology, the Public Accounts Committee warned last year that it was already “at risk of becoming obsolete”.

£300m GCHQ "box move" of technology
When the Government’s intelligence organisation, GCHQ, decided to move its complex computer systems into a new building in 1997, the projected £41m cost was so small that officials believed it could be absorbed within existing budgets. 

That was until the Curse of the Government IT Project struck. Costs of the so-called “box move” soon began to rise out of control. In 2003, the National Audit Office (NAO) put the costs at more than £300m. Edward Leigh, Tory chairman of the Commons Public Accounts Committee, called the original budget “staggeringly inaccurate”.

Now part of the "old office" housing super computers in Cheltenham has been retained in parallel to the new "doughnut".

£155m National Offender Management Information System (C-Nomis)
In an attempt to make sharing information about offenders easier, the Department for Justice gave the go-ahead for the National Offender Management Information System (C-Nomis) to be rolled out to prisons and the probation service. As the estimated cost doubled to more than £600m and senior officials questioned the whole point of the project, it was abandoned in 2007, with £155m already spent.

£106m Benefit Processing Replacement Programme
In June 2006, the Department for Work and Pensions confidently assured Parliament that new funding for its Benefit Processing Replacement Programme (BPRP) had been approved. So it came as a surprise to many when it emerged just three months later that the project had been quietly scrapped. Little information has emerged on why BPRP was abandoned, but the Government has admitted that £106m had already been spent on it before it pulled the plug.

£88.5m Prism IT project
Undeterred by past failures, the Foreign and Commonwealth Office (FCO) thought it would be a good idea in 2002 to order a new computer system for their 200 offices around the globe. The result was the Prism IT project, seemingly a bargain at just £54m. 

However, delays and costs have risen, while the contractor was even forced to temporarily halt the scheme in 2005 while an investigation took place into its various problems. The system has not proved a hit with staff. 

One wrote in 2004: “In all the FCO’s long history of ineptly implemented IT initiatives, Prism is the most badly designed, ill-considered one of the lot.”

£81m Shared Services Centre
To officials at the Department for Transport, the Shared Services Centre seemed to good to be true: not only would it integrate the human resources and financial services of the department and its various agencies, it would even save the taxpayer £57m. 

Unfortunately, those hopes were dashed as the scheme became another example of an IT project going horribly wrong. Workers at the Driver and Vehicle Licensing Agency (DVLA) were forced to brush up on their language skills as computer systems gave them messages in German. It will now cost £81m, a failure in management that the Public Accounts Committee described as a display of “stupendous incompetence”.

TOTAL: £26.3bn

From:

http://www.independent.co.uk/news/uk/politics/labours-computer-blunders-cost-16326bn-1871967.html

Labours' only success- wasting taxpayers money

Health Direct is appalled at the expensive IT project that is the NPfIT white elephant- and the money that is being wasted in our names.

On Jan 5th 2010 in the House of Lords Lord Warner (Labour) asked how many (a) acute trusts, (b) mental health trusts, (c) general practitioners, and (d) community services, are using an electronic summary patient record under the NHS National Programme for IT.

Baroness Thornton (Baronesses in Waiting, HM Household; Labour) replied:
As at 16 December 2009, two acute trusts, one mental health trust, 152 general practitioner practices, and additionally three out of hours providers and two walk in centres were using electronic summary care records delivered under the national programme for information technology. No community trusts were doing so.

http://www.publications.parliament.uk/pa/ld200910/ldhansrd/text/100105w0012.htm#10010561002177

What a waste of taxpayers money- a grand total of 160 health organisations were using the £12 billion scheme.

http://www.theyworkforyou.com/wrans/?id=2010-01-05a.64.3&s=speaker%3A12896#g64.4
Hansard source (Citation: HC Deb, 5 January 2010, c64W)

According to Wikipedia, Dorothea Glenys Thornton, Baroness Thornton (born 16 October 1952), known as Glenys Thornton, is a Labour and Co-operative member of the House of Lords.

A graduate of the London School of Economics, Thornton was Political Secretary of the Royal Arsenal Co-operative Society from 1981, joining the public affairs team of the Co-operative Wholesale Society upon their merger in 1985 and working there until 1992. 

She was General Secretary of the Fabian Society from 1993 to 1996. In 1998 she was made a Life peer as Baroness Thornton, of Manningham in the County of West Yorkshire by Tony Bliar. She chaired the Social Enterprise Coalition until January 2008, when she was appointed a junior minister of the House of Lords.

She lives in Belsize Park, London, and is married to internet safety expert John Carr. They have two children, George and Ruby.

Baroness Thornton is no stranger to wasting taxpayers money:
She was reported to be claiming £22,000 a year in expenses by saying that her mother's bungalow in Yorkshire is her main home, amounting to around £130,000 since 2002.
http://en.wikipedia.org/wiki/Baroness_Thornton

GPs to get new IT in drive to prevent 10,000 cancer deaths

GPs are to start predicting whether a patient has the early symptoms of cancer using a computer program that calculates risk, under plans to prevent the 10,000 unnecessary deaths a year caused by late diagnosis.

The new approach by the NHS means that doctors will tell patients their percentage chance of having cancer, based on factors like their age, weight and symptoms such as bleeding or sudden weight loss.

Professor Mike Richards, the government's cancer tsar, who unveiled the move in an interview with the Guardian, said that within five years every GP in England should be using the software as part of a new drive to reduce the huge toll of avoidable cancer deaths.

Computer-assisted cancer risk assessment will help GPs estimate whether a patient's symptoms could indicate the presence of a cancer and decide whether they needed to refer them for urgent tests in hospital, Richards said.

The computer would assess a patient's age, weight and symptoms – such as rectal bleeding and constant fatigue – and if the risk were above a certain level, the person would be referred to hospital for urgent exploratory tests within two weeks.

Cancer is the UK's biggest killer after heart disease and strokes. Every year 293,000 people are diagnosed with cancer, and about 155,000 die of it. GPs are vital because they spot the signs of cancer in 90% of patients, with screening picking up the other 10%. But a typical GP sees only eight or nine cases of cancer a year.

Britain is far worse than many European countries at diagnosing cancer early, when it is more likely to be treatable and the patient has a much better chance of surviving. That is partly because some patients who develop symptoms delay seeking help, but also because GPs sometimes fail to correctly identify signs of cancer.

Support technology is needed because of that poor record, the difficulty of diagnosing cancer and the sheer number of other ailments that GPs have to know about, Richards said.

There are more than 200 forms of cancer, and many of their symptoms are the same as for a range of other, often less serious, conditions. Computers could help doctors get it right more often when deciding whether to investigate a patient further, discharge them or refer them to hospital.

"This is helping GPs because none of us can retain this sort of information [about cancer symptoms] and having to retain it for bowel cancer, lung cancer and ovarian cancer, as well as for heart disease, it would take a remarkable human brain to be able to do that, so why not get computers to support it?" said Richards.

"The benefit of this will be that GPs will know who should be investigated and who shouldn't. It will also help patients to know that whether they are being reassured, or referred, or getting a test, that is the right thing to do."

Richards said the system would mean "better decision-making by GPs, leading also to earlier diagnosis of cancer patients".

Professor Steve Field, chairman of the Royal College of General Practitioners, welcomed the move. "The future of medicine will be that GPs will be using more and more computer-aided diagnostic tools for more and more conditions, and ultimately in years to come genetic information will be part of that," he said.

"GPs will welcome this because it will make their diagnoses quicker and better. Over time this will save lives."

Family doctors rather than computers will continue to make the key judgments, even after software has become routine in surgeries, Richards emphasised.

"The GP will always have the final say. If he wants to refer a patient to hospital, he will always have the right to do so," he said.

England is understood to be the first country in the world to move to introduce such technology, according to the Department of Health. A number of GP practices across the country will take part in a pilot programme to assess the effectiveness of assisted cancer risk assessment, starting in the spring.

GPs have recently begun using similar software to help them assess a patient's risk of developing cardiovascular disease. It analyses blood pressure, family history, cholesterol, smoking history and current symptoms before producing an odds ratio.

The plan to extend the approach to cancer is underpinned by a series of recent DH-funded research studies by Dr Willie Hamilton, an Exeter GP and expert in cancer diagnosis at Bristol University. Richards said the tests had shown, for example, that a man aged over 40 who develops diarrhoea has less than a 1% chance of that indicating bowel cancer, but two visits to the GP with the same symptom produce a 1.5% risk. This rises to 3.4% if there is a combination of diarrhoea and rectal bleeding and 6.8% if he visits his GP twice with rectal bleeding.

Sarah Woolnough, head of policy at Cancer Research UK, said: "We welcome any initiative that encourages the earlier diagnosis of cancer. Late diagnosis is the reason behind thousands of avoidable cancer deaths every year so it has to be a huge priority to make every effort to diagnose cancer earlier. We need to think imaginatively and innovatively about how we encourage earlier diagnosis, so initiatives like this are very promising for the future."

From:
http://www.guardian.co.uk/society/2009/dec/29/cancer-diagnosis-computer-programme

Health Direct questions the sanity of this new spin.

Firstly, labour has an appalling track record on IT projects- the failed NHS records £12 billion NPfIT project is a prime example.

Secondly, this scheme undermines GPs, doctors and health professionals in general. If this new technology really does work- there will be a logic to save money by sacking them all.

Is this yet another example of hope over adversity. Having utterly failed UK patients with some of the worst cancer rates in europe over the past 13 years- is this a dying labour spin clutching at a straw?

Government departments waste £4m on website redesigns

Labour government departments have spent £4 million of public money revamping their existing websites over the past two and a half years.

Much of the money has gone to external consultants and contractors.

In total, £3.96 million has been spent on redesigns and upgrades since June 2007. The figure does not include the estimated £220 million annual cost of running the government sites.

David Davies, Conservative MP for Monmouth who asked for the information in a string of parliamentary questions, said: "Dfid ministers should be giving financial support to the poorest people in the world not the wealthiest web designers.

"The money spent on a web upgrade could have paid the wages of 100 nurses in one of the poorest African nations for a year, but for Labour ministers, internet propaganda is far more important.

The Central Office of Information (COI) is conducting a study, to be published in June, into whether government websites offer value for money. The investigation was prompted by a National Audit Office report that said over one quarter of government organisations did not even know the running cost of their own websites, making it impossible to assess whether they provide value for money.

The NAO also found that one in six government bodies had no data about how their websites were being used.

Matthew Elliot, the campaign director for The TaxPayers' Alliance, said: "This astonishing £4 million figure shows departments must concentrate on content rather than the appearance of government websites. Many of these sites look a lot better than they actually are."

What departments said they spent on redesigns since June 2007:

Department for International Development £970,419
Department for Business, Enterprise and Regulatory Reform £528,912
Department of Health £513,000
Intellectual Property Office £355,000
Electoral Commission £283,744
Department for Environment, Food and Rural Affairs £181,000
Ministry of Defence £150,000
Electoral Commission voter information site £140,600
Serious Fraud Office £113,309
Office of Rail Regulation £107,169
Department for Innovation, Universities and Skills £105,167
British Army £75,000
Crown Prosecution Service £60,085
Attorney General's Office £59,184
Revenue and Customs Prosecution Office £58,741
Office of Government Commerce £54,000
Bona Vacantia £42,598
UKTI Defence and Security Organisation £42,000
National School of Government £27,683
National Measurement Office £20,649
Government Actuary Department £19,461
Scotland Office £12,880
Disposal Services Authority £12,000
Wales Office £10,500
NI Organised Crime Office £6,825
Forensic Science NI £6,187
NI Youth Justice Agency £4,802
Treasury Pre-Budget £4,578
TOTAL £3,965,493

From:

http://www.telegraph.co.uk/Government-departments-spend-4m-on-website-redesigns

Your medical confidentiality under threat again

Despite labour's promises to the contrary- their track record on snooping databases is appalling.

Having launched the Identity and Passport Service last week- which 96% of the population doesn't want, the labour govt are still going ahead with their health database.

The Department of Health has declared it will push ahead with a mass roll-out of its controversial Summary Care Record (SCR) - uploading parts of your medical record and personal details to a centralised system that is ultimately intended to hold your complete medical history.

So far, only London and the East of England have been mentioned but other regions may be targeted too.

A University College London report found scant evidence for any of the claimed benefits in SCR pilot areas but it appears the Department of Health still wants to ride roughshod over patient consent and medicalconfidentiality.

Having outraged medics and patients with its 'implied consent' model - where it is assumed you have consented to having your sensitive information uploaded if you do not respond to a single notification
letter - the Department has adopted a bizarre approach it calls 'consent to view'.

Under this scheme, you will still only be sent a single letter. If you do not respond, your details will still be uploaded onto the system where they will be accessible to all sorts of non-clinical staff including administrators, bean-counters and bureaucrats, without your knowledge or consent. 

Once on the system, you will not be able to have your details taken off - but you will have to give permission for your OWN doctor to view your record!

It is clear that 'consent to view' will not protect medical confidentiality. And the roll-out may be coming to you, sooner than you think.

Please be on the alert and, if you haven't done so already, think about opting out now. You can always opt in later, if the government can prove its system works. 

Health Direct strongly recommends using the opt-out letter that was developed by with TheBigOptOut at http://www.nhsconfidentiality.org/optoutletter

Turmoil over NHS records scheme as labour cuts NPfIT to save cash

The world’s biggest civilian IT project was thrown into turmoil yesterday after Alistair Darling, the labour chancellor, implied that it was going to be scrapped.

The chancellor told the BBC’s Andrew Marr Show the £12.7bn NHS IT programme – already running years late – was “something that I think we don’t need to go ahead with just now”.

Treasury officials rushed to explain that the government was looking for “significant savings” of up to perhaps £600m over the medium term by cutting back some features that are less important for patients.

A senior health department official, meanwhile, said bluntly span that “the chancellor mis-spoke” in saying the project to create an electronic medical record would be scrapped.

Details of which elements would go were not clear on Sunday night. But the government would face compensation claims of many hundreds of millions of pounds if it cancelled the programme. Fujitsu, an IT provider, is already in mediation with the health department over its £700m compensation claim after it was fired last year.

Ahead of Wednesday’s pre-Budget report, Gordon Brown will on Monday announce that the government has found another £3bn of “efficiency savings” – in practice, many of them cuts – since the Budget.

In a change of rhetoric, Mr Brown is expected to argue these savings are an “element of our efforts to reduce the [£175bn] deficit”, not just a means of protecting frontline services.

Some 123 quangos will go – including the Foreign Office advisory committee on wine purchasing – with the courts inspectorate merged into an existing inspectorate and several health bodies merged with NICE, the National Institute for Curbing Expenditure.

Full details of quango mergers and abolitions will not be spelt out until next year’s Budget, but they are expected to save an estimated £500m.

Central government’s use of consultants will be halved and the marketing budget cut by 25 per cent, saving £650m. Better use of text messaging and online services should save £665m – for example by reducing missed hospital appointments – according to government estimates.

Many of the proposals, which the prime minister will present as “streamlining government”, mirror those from the Tories, who have promised to slash the use of consultants to cut council tax. They also propose reducing by 24,000 the 80,000 civil servants employed in policymaking, inspection and regulation, and grant assessment over the next Parliament.

The FDA, the top civil servants union, condemned the planned cut in civil service numbers as “crude electioneering” and “irresponsible” just months ahead of a general election.

Mr Darling’s apparent scrapping of the NHS electronic record programme excited both the Conservatives and the Liberal Democrats, the latter calling for it to be “abandoned in its entirety” and Andrew Lansley, the Tory health spokesman, describing it as “another government IT procurement disaster”.

From:

http://www.ft.com/cms/s/0/71d29630-e2a5-11de-b028-00144feab49a.html?nclick_check=1

Website for patient waiting times virtually useless

Patients are being given out of date information by a flagship government scheme designed to reduce waiting times for hospital treatment.

The new website www.isdscotland.org/ — unveiled by Malcolm Chisholm, the health minister, was meant to allow patients to choose a clinic with the shortest waiting time but contains information that is up to nine months old.

The leader of Scotland’s GPs condemned the figures as “virtually useless” and patients’ groups described the initiative as “flawed”.

The database should provide the latest waiting times for first outpatient appointments at 3,030 clinics across Scotland. Until now the information had been available only to GPs.

Speaking at the website’s launch, Chisholm said: “This database is good news for patients and will support patient choice.”

However, detailed examination of the information has revealed that waiting times for more than 260 clinics are at least three months out of date.

The figures for outpatient clinics across Fife were last updated at the beginning of July. In Lanarkshire and Glasgow waiting times for more than 100 clinics dated back to February. Two clinics in Lanarkshire even listed waiting times for January. And most hospital waiting times were for early October.

Dr David Love, joint chairman of the British Medical Association’s Scottish GP’s committee, said information dating back several months was “virtually useless”.

He said: “It is a good idea and could be quite useful if patients do their homework before coming to the GP, but the whole thing hinges on the information being accurate. If it is not, it could create more work.”

Margaret Davidson, chief executive of the Scotland Patients’ Association, added: “This website is flawed. The figures have to be up to date for them to be any use.

“Questions also have to be asked as to whether patients will be treated at the hospitals they choose. I don’t think they will.”

Dr Ian Johnston, a member of the local GPs’ committee in East Lothian and a family doctor in Musselburgh, said waiting times should be no more than six weeks old if they were to be of any use. “There is no point in having something on a website that was done in February,” he added.

The launch of the website has been used by opposition politicians to highlight long waiting times of up to 2½ years. According to the target set by the executive, by the end of 2005 nobody should have to wait more than six months for a first outpatient appointment.

A spokeswoman for the executive said the Information and Statistics Division (ISD) of the NHS was responsible for the website. She added that most of the waiting times were up to date.

The ISD admitted that it had decided to launch the website even though some data was many months old. A spokesman said the out-of-date waiting times were the result of old data collection systems which were being modernised.

From;

http://www.timesonline.co.uk/tol/news/uk/scotland/article1006886.ece

Health department spent £585m on consultants

The Department of Health has spent £585m – the cost of building a district general hospital – on management, legal and financial consultants over the past four years.

The half-a-billion pound bill “is a huge amount of money”, Kevin Barron, chairman of the Commons health select committee, said. The committee has been pressing the department to disclose the sum and Mr Barron said now that it was public “we will be returning to the issue”.

Spending on management consultancy by the NHS itself is not included in the total – an amount that the Management Consultancies Association estimates to have run to about £300m last year, although that figure is likely to include the department’s own spending.

The Conservatives are promising to slash Whitehall’s expenditure on consultants if they win the general election, with the cash earmarked to help introduce a council tax freeze. They are also promising to cut the cost of Whitehall itself by 30 per cent over a Parliament.

However, the level of spending on consultancy services “shows that, at least in part, the department does not have the capacity and staffing to do the work it needs to do,” warned Alan Maynard, professor of health economics at York university, and an adviser to the select committee.

Under pressure from the committee, the department has agreed to start publishing the NHS’s own spending on consultancy, having originally argued that to do so would amount to “micromanaging” the NHS.

The figures for the department’s consultancy expenditure for the past four years show that since 2005/06 it has spent £133m, £205m, £132m and £125m last year – a total of £585m.

A breakdown has been provided for last year only. Then, £93m was spent on general consultancy, about £23m on financial and commercial advice and some £8m on legal consultants. Just over £19m of the total was spent on Connecting for Health, the NHS’s £12bn IT programme.

The spending is spread over more than 120 consultants and advisers. The top three earners were Ernst & Young at £12m, McKinsey at £9m and QI Consulting at £7.1m. The top five, who include PA Consulting and KPMG, accounted for 30 per cent of the total.

Expenditure over the past four years is marginally distorted by the £205m spent in 2006/07 when the department bought in private sector “turnround teams” to sort out the NHS’s then £1bn deficit.

“That was an important thing to do,” Mr Barron said, “and Patricia Hewitt’s determination to sort that out was one of the bravest decisions a secretary of state has taken for a long time”.

But even allowing for that, spending is running at about £130m a year “and we do have real concerns about the ongoing cost of all this,” Mr Barron added.

The MCA argues that its estimate of total spending by the NHS amounts to less than 0.3 per cent of the NHS’s total budget. It is currently agreeing a concordat with the department aimed at ensuring that the NHS gets value for money from consultancy contracts.

From:

http://www.ft.com/cms/s/0/36e48e44-c715-11de-bb6f-00144feab49a.html

Labour blows more money on websites as patients urged to rate GPs online

Patients will be able to praise or criticise their doctor on a health website- but the nanny state will not allow us to actually name the person.

Patients are being encouraged to rate their GP surgeries on a new NHS website designed to drive up standards in primary care.

At www.nhs.uk, patients will be able to post comments ranging from how they were treated to whether it was easy to book an appointment.

But mentioning staff by name will not be allowed, say health officials.

The website will compare the 8,269 GP practices in England only.

The health minister Mike O'Brien said the website was part of plans to modernise the health service.

He said: "As we open up real choice in primary care, it is vital we equip patients with enough information to make the right choice for them. This new tool allows every single GP practice in the country to see the patient's view on what they are doing well and what needs to be improved.

"It will help drive up quality across the board, and is another step in ensuring we have a modern NHS which reflects the needs of the patient," he added.

There are 23 million visits to GP practices and related services every month.

In September, ministers announced they wanted to abolish GP boundaries, allowing patients to register with a practice of their choice.

Yet another similar site to compare the performance of hospitals is already up and running.

From:

http://news.bbc.co.uk/1/hi/health/8306041.stm

Doctors told to break confidentiality of patients with knife injuries by nanny state

Doctors are being told to report patients who come to them with knife injuries to the police and disregard their confidentiality under new guidelines.

The doctor’s regulatory body, the General Medical Council (GMC), says even cases involving children with apparently accidental cuts should be reported. Currently, medics are only required to pass on to police details of patients with gunshot wounds.

Dr Henrietta Campbell, who chaired the GMC’s working group on confidentiality, which issued the guidelines, said: “Confidentiality is central to trust between patients and doctors, but it is still an area of ethics which challenges doctors more than any other.

“We are not asking doctors to force patients to speak to the police, but we are asking them to pass on information which will help the police protect patients, the public and staff from risks of serious harm."

“There are occasions when disclosure of certain information may be justified, even if the patient refuses to consent.”

The guidelines will also say that patients with inherited conditions who want to keep their condition secret can be overruled. “Doctors should explain to a patient if their family might be at risk of inheriting a condition,” Dr Campbell added. “However, if a person refuses, it is the doctor’s responsibility to protect those who may be at risk.”

Doctors will also be advised to pass on patient details to other bodies, such as telling the Driver and Vehicle Licensing Agency if a patient is not fit to drive, or passing on information relating to benefit claims.
 

From:

http://www.timesonline.co.uk/tol/news/uk/crime/article6851092.ece

Child vetting database will cost £200 million and create 1,450 jobs in Labour marginal

The total cost of the child vetting scheme is expected to soar close to £200 million – and will lead to the creation of around 1,450 jobs in a key Labour marginal constituency.

Public bodies such as the NHS and the Prison Service will be forced to spend millions of pounds registering their employees on the scheme at a time when their budgets have already been squeezed.

Almost all of the NHS’s 1.3 million employees will have to join at a cost of around £83m. The Local Government Association has already warned about the increased cost to councils and their staff.

Labour Ministers will have to sanction a huge spending increase as the Criminal Records Bureau employs 582 staff who dealt with 3.9 million cases last year, or 6,700 cases per employee.

By contrast, the Independent Safeguarding Authority (ISA) has 250 staff whose case load will soar to 45,200 cases per employee as they reach the target of monitoring one in four adults. If, as expected, the ISA processed the work at the same rate as the Criminal Records Bureau it will require 1,686 employees, up 1,430. The staff bill will rise to £43 million.

It will provide a timely jobs boost for Darlington, where the ISA is based, which is a key election battle ground. Alan Milburn, the former Labour Cabinet minister and local MP is standing down at the election in a seat which until 1992 was Conservative held.

James Dawkins, Research Associate at the TaxPayers’ Alliance, said: “The Criminal Records Bureau already struggles, at huge cost, to do its job and this task is more complex and larger. While taxpayers and the people forced to undergo the ISA’s checks will lose out, the only people to benefit will be the army of bureaucrats needed to attempt the impossible. The Government have already created far too many quango jobs, and the last thing taxpayers need is yet more officials on the public payroll.”

Tom Brake, the Lib Dem home affairs spokesman, said: “The new database is not only a disproportionate response to the problem it is trying to solve, it is also a very expensive proposal. It is not clear that asking public bodies to pay millions to prove their staff are not sex offenders will significantly enhance the safety of children. Asking people to pay £64 to prove their innocence may put a lot of them off working with children.”

Parents who do not register for driving their children's friends to a sports event or Cub or Scout meeting face fines of up £5,000.

From:
http://www.telegraph.co.uk/Vetting-database-will-cost-200-million-and-create-1450-jobs-in-Labour-marginal

NHS IT project still on critical list

“If you live in Birmingham,” declared Tony Bliar when he was UK prime minister, “and you have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you.” Not any more.

Or not, at least, if the Conservatives win the next general election. For the Tories have pledged to scrap the countrywide version of the National Health Service’s electronic patient record.

Back in 2002, the idea of a full patient record, available anywhere in an emergency, was the principal political selling point for what was billed as “the biggest civilian computer project in the world”: the drive to give all 50m or so patients in England (the rest of the UK has its own arrangements) an all-singing, all-dancing electronic record. 

Roll-out was meant to start in 2005 and be completed by 2010.

Under a Conservative government, development of the local record – exchangeable between primary care physicians and their local hospitals – would continue. Nationally, clinicians would still be able to seek access to it when needed from the doctors who would hold it locally. But the idea of a national database of patients’ records, instantly available in an emergency from anywhere in the country, would disappear.

This may or may not matter, depending on your point of view. For many clinicians, the idea of an instantly available national record was always something of a diversion. It is access to a comprehensive record locally that is crucial for day-to-day care.

Nonetheless, the Conservatives’ decision to scrap the central database is a symbolic moment for a £12bn ($20bn, €14bn) programme that has struggled to deliver from day one. 

It is currently running at least four years late – and there looks to be no chance in the foreseeable future of its delivering quite what was promised.

So what went wrong? Too much ambition, too much speed, too much centralisation, too little local ownership and not enough choice have been just some of the problems. 

‘It is more difficult than people think. But I do think that by now, seven years on, we would have been further forward’ Glyn Hayes, former chairman of the British Computer Society’s health section

In hindsight, it is easy to see why the programme was set up the way it was – with big central contracts and a one-size-fits-all central offering. For a start, while there had been some local successes, the health service had also had its share of IT disasters when things were run locally.

“The arguments for centralisation were first that all these systems had to be able to talk to each other,” says someone who was closely involved in the government’s original decision to launch the programme. “Second, there were powerful arguments for economies of scale if the system was bought centrally. And, third, the NHS had a long history at local level of taking ringfenced money, whether for IT or other projects, and finding ways of spending it on something else.

“Looking back, it was the wrong thing to do. It was right to centralise standards for communication and for what should be in the record. It was right to use centralised purchasing power. But the next step, that the whole programme had to be centralised, did not have to flow from that. It proved to be a mistake.”

With a staggeringly ambitious goal to get the first electronic records running just three years down the line – when what was to be in them had yet to be fully defined – Richard Granger, the then director, decided that the fragmented and small providers of IT still in the NHS hospital market did not have the scale or industrial muscle to deliver.

So he brought in some of the big boys of IT – Fujitsu, CSC, BT and Accenture – to install the systems. They, however, were not health IT specialists. And, according to Mr Granger, the two providers of the electronic record software ended up with mirror-image problems.

The US company Cerner had good clinical systems. But software designed for hospital billing systems in the US needed a big rewrite to run all the administration and reporting functions of the NHS. By contrast, iSoft, which at the time was a British company, knew how to run the administrative side of the health service but lacked a clinical record. It has taken years for the often troubled company to come up with one. The first deployments of early versions of it are only just under way.
 

For all the difficulties in getting early versions of an electronic patient record into the NHS, the IT programme has had some success. England is one of the first countries to have fully digital imaging – replacing film X-rays and scans with manipulable digital images that largely put an end to lost films and unnecessary repeat examinations.

In spite of the delays, suppliers insist they will get there in the end. Gary Cohen, CEO of iSoft, one of the record suppliers, says: “It is a bit like swimming the English Channel. If you are 80 per cent of the way there and tired, what you don’t do is say ‘Well, we’ll swim back and start again’.”

On top of that, while there was a £6bn budget for the 10-year central contracts, no money was earmarked for training, in spite of the lesson, from the relatively few successful installations of electronic records in US hospitals, that at least as much has to be spent on changing the way staff work as is spent on the systems themselves.

Furthermore, there was no local ownership of the programme. Local developments of electronic records that were under way were halted. The national programme became something that was delivered from on high to hospitals and clinicians, not something that they chose or voted for. They also had to fund their own training and other costs. On top of that, all the installations of early versions of the software into big hospitals have caused serious disruption.

So where does the programme go now? BT and CSC, the two remaining systems installers, have been given deadlines of November 2009 and March 2010 respectively to achieve a smooth implementation in a big acute hospital. Failing that, the department of health says it will “look at alternative approaches”.

Quite what plan B is, however, remains a mystery. Any decision to cancel the contracts is likely to result in mighty litigation. The for hundreds of millions of pounds set aside to achieve an electronic record could go up in smoke in claim and counter-claim as each side blames the other.

It has been a sorry tale to date- and one that still continues.

From:

http://www.ft.com/cms/s/0/6b74e4c8-8cdd-11de-a540-00144feabdc0.html

Want your NHS records to stay private? Good luck

If you don’t want your health records stored online, you may have some trouble finding the 'opt out' option.

If you are registered with a GP in any of six primary care trusts — Bolton, Bradford and Airedale, Bury, Dorset, South Birmingham and South West Essex — you will last week, have received a leaflet about new “summary care records”. 

It comes with a letter explaining what’s in the leaflet, and a form to order another leaflet in one of 12 formats, from the sensible (Braille) via the surprising (Farsi) to the faintly depressing nanny state (easy-read picture version).

If, like most people, you develop an eye spasm when privacy issues arise, you might want to opt out of having your health records stored online.

If you have no continuing medical conditions (besides the eye tic) and are capable of speaking and listening to doctors, you might think you don’t need your records to be computerised. And opting out means that when the laptop of private information is inevitably left in a pub somewhere in Berkshire, you won’t have to grind your teeth in impotent rage.

The leaflet explains that if you want to opt out, you can do so at www.nhscarerecords.nhs.uk — but go to that site, and you will search in vain for any mention of opting out. And when I say search in vain, I mean by clicking on each available link, not using a search box.

There is no search box. Once you’ve clicked on all the links, you will be no wiser. Many of the links have sub-links, which you are welcome to try. They also yield nothing, other than the occasional derisive hoot when they are called “HealthSpace Troubleshooting”.

You will have need to refer to your glossy leaflet, ignore it and try the covering letter again. Eventually you will discover that you must type www.nhscarerecords.nhs.uk/patients/info to gain access to the list of “early adopter PCTs”. 

Click on your area. Only then can you download the opt-out form. There is no link to a “patients” or “info” page on the site you first went to. The patient page is the internet equivalent of being behind the fake door covered in books that leads to the secret room.

This, you will recall, is exactly why you are incensed about privacy. Because when they tell you that they value your privacy, what they are actually telling you is that they will take advantage of people being too busy to track things down or too polite to bother their GP’s practice manager during a pandemic.

Douglas Adams’s Arthur Dent once sighed that plans to demolish his home were “on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard’”. 

Do not fear the leopard. The form can be accessed from here: https://www.sbpct.nhs.uk/yourservices/technologyandyourcare/nhscarerecords.aspx with the actual pdf form which you will have to print off at:
https://www.sbpct.nhs.uk/yourservices/technologyandyourcare/opt_out_form.pdf
from:
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article6802497.ece with additional research by Health Direct

Ethics could sink Tory plan for Google or Microsoft health records

The plan to transfer confidential medical records to internet servers run by companies such as Google and Microsoft is anything but straightforward.

The chance for patients to have 24-hour access to their doctor’s notes on password-protected websites will appeal to the middle classes and the “worried well” who already diagnose their ailments with the help of the internet.

But there is a welter of ethical and practical difficulties that could yet scupper the idea and must be considered by Francis Maude and his Tory policy implementation unit before the plan can be approved.

The most pressing issue is that almost nine million households in Britain do not have access to the internet. Health experts fear that such a move could penalise the most vulnerable in society. What disadvantage would this mean for the elderly, infirm and technologically inept? And who will store the medical records of those who do not take part?

More chillingly for some is the question of how commercial companies such as Microsoft and Google intend to make money from such ventures if, as seems likely, there are no government contracts on offer and it is left up to individual patients to chose to sign up to a number of free services. “Google is not magnanimous. It will no doubt sell that information at some point,” said a leading health analyst.

Suggestions that Google could display drug or other advertisements based on an individual’s health record, or sell anonymised data for drug trials, have been strenuously denied by the company in the US. Privacy campaigners are nevertheless likely to be concerned.

It has even caused friction within the Tories. The plan is part of a bigger “open source” IT project led by George Osborne’s team, but some staff working for Andrew Lansley, the Shadow Health Secretary, believe that there may still be a need for a central health database in the end. How else, they ask, would a hospital be able to access the medical record of a patient who comes into A&E unconscious and unable to grant them online permission?

The chance for massive cost savings, however, are likely to outweigh these objections: it must seem a hugely attractive alternative to the longoverdue £12.4 billion NHS computer project that Tony Blair promised would provide electronic health records for up to 50 million patients. “You don’t need a massive central computer to do this. People can store their health records securely online; they can show them to whichever doctor they want,” David Cameron has said.

“But best of all, a web-based version of the Government’s bureaucratic scheme like Google Health or Microsoft Health Vault costs virtually nothing to run.”

Unlike in the US, the Tories say that NHS trusts will not be handing out contracts to Google or Microsoft, and that patients will be allowed to chose whether to take part.

“We can 100 per cent guarantee that we will not have a system where there is an exclusive deal on health records with one company,” said a Tory source. “We fully expect there to be multiple providers that will almost certainly be free to users.”

The health plan is a small but highly controversial part of a Conservative agenda to use data currently held by the Government to give consumers more choice, decentralise and, perhaps most importantly, cut costs.

The party points out that there are more than 100,000 public bodies in Britain that produce a huge range of information. It believes that there are significant benefits in publishing the data in standardised and open format, so that it can be plugged into online maps, websites and other applications.

The Tories have been struck by the innovative website theyworkforyou.com, run by the charity mysociety.org, which analyses and republishes data about MPs in a user-friendly manner in a process known as mashing. They want to do the same with the rest of the public sector.

“Some of our key reform policies, for example school reform, depend on this type of information being released to the public, and so enabling effective choice and accountability to be exercised,” said a recent Tory plan.

At the moment, only a fraction of this is available, but in an aggregated and anonymised format. Norwich Union, the Tories say, spent £5 million to develop a UK flood map, which was cheaper than trying to use existing government data.

Mr Lansley has already announced that in health, commercial websites will be able to bid for the data collected by the Department for Health, allowing them to publish ward-by-ward comparisons on everything from cleanliness to readmission rates.

Dr Foster Intelligence has been awarded a £12 million contract to provide NHS hospital league tables. The Tories say that if the underlying data were published, these league tables would be built by charities and companies without any cost to the taxpayer.

At the moment a small amount of data is provided for patients on the government website NHS Choices, but doctors have expressed concern at the way it is used to rank hospitals.

The Conservatives’ agenda does not come without risk. It will inevitably be associated with Steve Hilton, one of Mr Cameron’s principal advisers, who is married to Rachel Whetstone, the head of communications for Google.

According to The Register, the technology newspaper, Google and Microsoft have lobbied hard to get their hands on medical records in the US and elsewhere, and the broader “open source” project is likely to work in their favour.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6644802.ece

Patient records should be given to Microsoft or Google, say Tories

NHS patient records would be outsourced to Microsoft or Google under Tory plans, instead of being held on an expensive, flawed central government database.

The Conservatives, who have close links with Google, argue that developing a database would be unnecessarily expensive, and it would be more beneficial to hold the information on secure systems which already exist, such as Microsoft Healthvault or Google Health.

Patients would be given the choice of storing their records with private companies, although it is not yet clear what would happen to the notes of patients who do not consent.

The Tories estimate that if data were outsourced to sites such as these, the country would save half of the £1.65 billion it spends on IT annually.

Under the plans, which emerged at the weekend, medical staff with appropriate access would log on when necessary, although it does raise issues over security.

David Cameron, leader of the Conservatives, has previously singled out the "Electronic Patient Records system" as an example of the government's wasteful spending.

Winning a contract for medical records would guarantee revenue for Google or Microsoft for years, while it would also help increase the use of their technology in healthcare.

The National Programme for IT, one of the biggest computer contracts in the world, is designed to link more than 30,000 GPs to nearly 300 hospitals.

Parliament's public accounts committee however warned in January that if the scheme was not showing signs of moving forward by July, hospitals should have the option to ditch the plans.

The new system is designed to provide an online booking system, centralised medical records for 50 million patients, e-prescriptions and fast computer links.

But the MPs' report found that progress was "very disappointing" with further delays expected. A revised completion target of 2014/15, already four years behind schedule, was "in doubt", while the report also found the scheme was now costing taxpayers an estimated £12.7 billion.

http://www.telegraph.co.uk/Patient-records-should-be-given-to-Microsoft-or-Google-say-Tories

Health Direct raises one cheer for the proposals. At last- some common sense and recognition that the current project is hopelessly flawed and expensive.

However Microsoft and Google both have bad records for using personal data. The "Opt In" option for patients must be offered and respected.

Warnings ignored over NHS IT system in 2002

Whitehall officials warned repeatedly in private that the NHS information technology programme (NPfIT) would run into serious problems as early as 2002, according to freedom of information requests.

The Office of Government Commerce, a wing of the Treasury, was concerned about the labour government’s ability to take on such an enormous project from the beginning.

Over several years the OGC repeatedly raised issues of unrealistic timetables, unknown procurement risk and an inability to predict costs or value for money.

It questioned whether the labour government had enough qualified staff or an ability to manage large IT programmes. For example, it wrote that there was “no overall concept of affordability or ability to demonstrate value for money”.

The warnings now appear eerily prescient, given that the estimated cost of the project has since ballooned from £5bn to £13bn ($8bn to $21bn). The project is running four years late, prompting the Department of Health to warn that contracts could even be terminated if progress is not made by November.

Companies including CSC, Cerner and BT are involved in the mammoth task of letting half of patients book referral appointments online, setting up broadband connections within the NHS and delivering digital x-ray communication systems.

The OGC’s concerns came to light after the Tories obtained 31 of its reports through an FoI claim.

Nine of the reports gave “red” status to elements of the programme, implying that urgent remedial action was needed for the project to succeed.

“These reviews expose Labour’s incompetence over the NHS IT system,” said Stephen O’Brien, shadow health minister.

“It’s incredible that, right from the beginning, the government should have ignored these repeated warnings about problems.”

The information has only emerged now because the Department of Health previously blocked publication. Six reports, undertaken since 2006 are still being withheld.

From:
http://www.ft.com/cms/s/0/80bcc8c8-604b-11de-a09b-00144feabdc0.html

Reverse e-auctions an invitation to cut standards

One company boss who took part in the London Procurement Programme’s reverse e-auctions in May called them depressing.

The chief executive, who wished to remain anonymous, said he thought that the company had completed the procurement process after submitting a 206 point questionnaire, with 9 attachments, followed by a 122 question tendering document with 18 attachments in February.

“We heard nothing for a month, which was odd given the contracts were to start on April 1. Suddenly we were told, ‘Congratulations. You have been selected to take part in a reverse e-auction’.”

On May 19 the chief executive sat down with his finance director, logged into the LPP website and waited for the bidding to start.

The company had submitted tenders to provide palliative care and care for physical frailty and dementia. It had made bids of more than £1,000 a week for places in its homes. To take part in the e-auction it had to drop its price by at least £8 at a time. When bidding began the company was told its price was in the bottom five in the shortlist of 20.

“We wanted to test the system so we gingerly put in a bid of £10 below what we had tendered. Our position didn’t change,” he said.

“After a few more bids our position had not changed at all. By then we had reached the point where we could not cut the price further without undermining the quality of care so we stopped.”

In all, the company took part in three e-auctions. “In the end we really pushed it and cut our price by over £100 really just to see what would happen. I think we moved up a few places to 15th. It was a very depressing experience.

“You are filled with dread about what you are going to have to cut back on to get within the winning price. It is devoid of any human consideration. It’s fine if you are supplying stationery, but we are talking about human beings. This is an open invitation to companies to cut standards.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401125.ece

Health Direct points out that reverse auctions are the result of the desire to get something for nothing.

They very rarely work as the winning company often has to come back for more money when they find they cannot provide the service to the standard required for the winning bid. It is a fallacy that it saves money!!

Elderly suffer after reverse e-auctions for home care

Labour NHS IT reverse auctions reduce dignity and care for elderly

Andrew Wilson, 78, was one of the elderly people who received poor treatment after a reverse e-auction. This was run by South Lanarkshire for the provision of home care.

Domiciliary Care, a big provider in Scotland, won the contract after companies had driven down their prices. It won with a bid to provide care for £9.95 an hour.

Mr Wilson is hard of hearing, blind in one eye and unable to walk more than a few steps. With no close family, he lives alone and depends on carers. He allowed Panorama to fit secret cameras in his home for 19 days.

The cameras showed Mr Wilson being given a bed bath while his carer was constantly on her mobile phone complaining to the office about her workload. The cameras also recorded that, of his four half-hour visits a day, those at lunch and teatime were often curtailed.

His care assessment makes clear that his lunchtime carer should prepare a meal. However, he was routinely fed sandwiches, crisps and toast.

One GP who specialises in old age care said she was shocked by what she saw. “He has been treated with a complete lack of dignity,” she said.

At the time Domiciliary Care denied that Mr Wilson was neglected. It said that carers were under no obligation to go shopping for Mr Wilson but often did so. However, Care Choices Group, which took over the company last September, admitted that an internal inquiry had found that a number of the allegations were correct, and apologised.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401122.ece

Elderly left at risk by NHS bidding wars to find cheapest care with reverse auctions

An online auction system developed for councils to buy cheap wheelie bins and stationery is being used to buy end of life and dementia care for vulnerable elderly people.

The NHS in London has held a series of 30 “reverse e-auctions”, where bids are driven down instead of up, for £195 million worth of contracts for palliative and dementia care for patients leaving hospital.

Reverse auctions to buy care for the elderly are relatively new and The Times has found that standards and quality have deteriorated rapidly where they have been used.

In one case a company that won a local authority’s reverse auction in the North East of England was struck off the national register of approved providers weeks later because the palliative care it offered was of such poor quality.

The results of another auction in South Lanarkshire to buy domiciliary care were so disastrous for elderly people that the Scottish Parliament is to hold an inquiry into whether they should be banned.

Companies who took part in the London NHS auction told The Times that they were asked hardly any questions about the quality of palliative or dementia care that they provided, beyond whether they complied with minimum standards.

During the e-auction, companies were invited to reduce their prices for one bed with round-the-clock specialist care for one week by £8 a time.

The NHS and local authorities are under increasing pressure to drive the hardest bargain they can for services, such as care for the elderly, which they buy in from the private sector. Reverse e-auctions, though, were intended to be used to drive down prices for basic goods such as office furniture, IT or stationery, which have limited and exact specifications and where quality is not a serious concern. Critics of care e-auctions say that those who hold them are aware that driving prices down affects the quality of care.

Richard Jones, director of adult social services for Lancashire County Council, said that he would never use an auction to buy care. “If you put your providers into an auction, pushing them to a lower and lower price, somebody is going to lose out, and the losers in this case are vulnerable elderly people and their carers,” he said.

Information given to The Times by the BBC programme Panorama showed that four local authorities — Walsall, Bedfordshire, South Lanarkshire and Edinburgh — had used the system to buy care for elderly people.

In Walsall, the Working Together Specialist Care Agency won a contract to provide palliative care to elderly people in the last few months of their life. Within weeks, the local authority stopped the company taking on any new cases, and then terminated the contract after it emerged that dying people were not receiving the pain relief and help with feeding and washing that they required.

The Care Quality Commission (CQC), the health regulator, confirmed that the agency had been deregistered after an investigation. The agency could not be reached for comment.

Walsall said that price was not the sole consideration in awarding the contract to Working Together. Sue Ryder Care, the specialist charity that held the palliative care contract before the auction, said that it could not even afford to start bidding at the opening price because it was so low.

Domiciliary Care has since been taken over by Choices Care Group, which said that it was appalled by what Panorama found and had apologised for the shortcomings. The Scottish Parliament has started a cross-party investigation into the use of reverse e-actions with a view to having them banned for purchasing care.

In England, the CQC warned NHS purchasers and local authorities that it would examine closely what happened to standards of care in areas where e-auctions were used. “We’ll be keeping a very close eye on standards across the health and adult social care sector. Where we see standards slipping, we won’t hesitate to act,” a spokesman said. Martin Green, chief executive of the English Community Care Association, has written to Alan Johnson, the Health Secretary, to alert him to the practice.

The London Procurement Programme, which ran the NHS reverse e-auction, defended its use of the system. Stuart Saw, chairman of the steering board, said: “We are confident the framework will deliver consistent high-quality standards in nursing home care across the capital. Quality has been embedded throughout the procurement process while making the most of taxpayers’ money.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401002.ece