The controversial NHS medical records database system would allow patients to check their medical documents online and raise any inaccuracies or problems with their doctor, however concerns have been raised over the security.The announcement was buried in documents released with the Chancellor’s Autumn Statement ahead of the results of a public consultation due to be published next year.

Patients should be given greater access and control over their medical information, the consultation said.

However, there are worries over the security of the system and that the information will be passed on or sold in so called ‘technology and data markets’.

Patients could be pressured into giving third parties, such as insurers access, to their record or to disclose details contained in it, it was warned.

In documents released with the Autumn Statement, it said: “All patients in the NHS will have online access – where they wish it – to their personal GP records by the end of this Parliament.

“GP practices that can already provide online access are encouraged to do so as soon as possible.

“These measures will help to position UK companies in the development of a personal information market, which is likely to be the next stage of development on from the growth of social networks.

“Online access to one’s own personal data enhances personal control and participation in public services. It also fuels innovation and growth in the supporting technology and data markets.”

Concerns were raised last year that the Summary Care Record was being rolled out too fast with patient records being uploaded to the national system unless people directly opted out.

The roll-out was halted but it now appears that it is to be restarted again and all patients who have already been contacted will have an online record by 2013.

The summary care record is part of a wider online medical records database to allow NHS staff to access brief medical records of patients they may treat outside their home area. However, in pilots, it was found that staff were passing access ‘key cards’ to each other breaching security rules.

Guy Herbet, general secretary of the campaign group No2ID, said: “The problem is this is a Trojan horse for the continuation of the Department of Health’s continuing centralisation of all medical records, and its seeming desire to share them with its friends in the pharmaceutical and medical technology industries.

“That’s a real threat to privacy and medical confidentiality. And the government has continued the previous administration’s work of taking records out of the hands of clinicians who have a direct duty to you.”

Gus Hosein, Executive Director of Privacy International, said: “In theory, this system is a positive development; everyone should have access to their own information.

“The problem is that the NHS is insisting on building a multi billion pound computer system to store records containing our most intimate and potentially compromising information.

“At best, it will fail, as large government IT systems have historically tended to do. At worst, it will create a data protection nightmare. The benefit of giving patients access to their medical records is vastly outweighed by the huge expense of the system and the significant threat to privacy.”

Chaand Nagpaul, the British Medical Association’s GP IT lead, said: “The BMA does believe that patients should be given the option of accessing more information online so that they can make informed decisions about their care.

“However, take-up has been very slow in those areas where patients have been offered access to their records online.

“It is essential that further work is undertaken to assess the level of demand amongst the public before further investment is made. With the NHS being asked to make efficiency savings of £20 billion, we must not waste money on expensive systems that patients will not use. It is also important any electronic system has built in confidentiality and data security safeguards.

“The UK’s research base and wider NHS could benefit from plans to publish datasets more widely and open up new channels of communication between different parts of the health service. It is important though that confidential data is not inadvertently disclosed. Proper safeguards must be put in place to stop this from happening. “

From:  http://www.telegraph.co.uk/All-patients-to-be-given-online-access-to-medical-records

NHS staff are putting patient confidentiality at risk by sharing information about them on Facebook new research has revealed.Private records belonging to ill and vulnerable patients were breached more than 800 times over the last five years by nurses, doctors and administrative staff at 152 NHS trusts and hospitals.

Nearly half said there had been at least one breach in the past year, a report by the campaign group Big Brother Watch found.

In one incident at the Nottingham University Hospital NHS Trust, a member of medical staff was dismissed after taking a photograph of a patient in bed and showing it to friends on the social networking site.

The report comes after the Information Commissioner said tougher powers were needed so that those who break data protection laws to obtain personal details could be jailed.

The figures, released under the Freedom of Information Act, showed there were at least 806 incidents in which NHS employees breached data protection policies between July 2008 and July 2011.

In 23 cases, medical staff posted confidential medical information on Facebook, sharing details about a patient’s name, medical condition or discussing their treatment.

There were more than 90 incidents where employees admitted to inappropriately accessing the medical files of colleagues, and more than 30 incidents where they looked up family members, the figures showed.

Their actions led to a total of 102 doctors, nurses and hospital staff being sacked.

The figures also showed unsecured confidential medical information was lost on 57 occasions across 24 NHS trusts.

Christopher Graham, the Information Commissioner, warned in July that a culture change was needed within the health service to ensure patients’ personal information was kept secure.

Nick Pickles, director of Big Brother Watch, said “urgent action” was needed to keep medical records safe.

“This research highlights how the NHS is simply not doing enough to ensure confidential patient information is protected,” he added.

“The information held in medical records is of huge personal significance and for details to be disclosed, maliciously accessed or lost represents serious infringements on patient privacy.”

He added: “It is essential the NHS is transparent about these incidents and failing or refusing to disclose that a data breach has taken place is unacceptable.”

A new NHS computer system that will share the medical history of millions of patients with drug companies without proper consent is under attack from privacy experts, who say it is misleading, risky and potentially illegal.
The system, the Secondary Uses Service (SUS), is part of the NHS’s troubled National Programme for IT (NPfIT), and massively expands the amount of medical data that commercial and academic researchers can access.

In many cases, patients will not be asked for consent for their data to be shared, because it is claimed it will be “anonymised”, a process which deletes certain information with the aim of making individuals unidentifiable.

However, in a letter to the British Medical Journal, Dr Ian Brown of the Oxford Internet Institute said that NHS rules mean such unwitting participants in research can be “trivially” re-identified. They are also not to be told or given a choice about how their medical records will be used, he said, and misled about the risks to their privacy.

“This is something that is just getting going,” Dr Brown told The Telegraph.

The SUS replaces previous record sharing arrangements that were typically on much smaller scale and involved patient consent.

It will supply data where patients’ names and addresses have been replaced by their date of birth and postcode.

“As a postcode typically contains about 20 houses, almost all patients are easily identifiable by reference to these facts,” Dr Brown said in the letter, which is co-signed by Lindsey Brown, a researcher in public health ethics at Bristol University, and Professor Douwe Korff, a data protection law specialist at London Metropolitan University.

Some of the “anonymised” data also includes the unique NHS Number for each patient, making them even more easily identifiable. According to Dr Brown and his colleagues, such weak privacy policies could be illegal under European data protection laws.

“Patients are not currently being adequately informed about possible secondary uses of their medical data for medical research,” said Dr Brown and his colleagues.

“[Patients] are not asked to give clear, specific, free and informed consent; are not offered unambiguous and effective opt-outs; and are misled about the level of anonymisation of their data and the likelihood of re-identification,” they added.

The Department of Health had not responded to a request for comment.

The letter is a response to suggestions by scientists that the rules on accessing to patient data should be further relaxed. They have welcomed SUS and argued that easier access to sensitive data records will spur medical advances.

“It is irresponsible to insist that no regulation and governance should interfere with researchers’ access to health records or record linkage capabilities,” said Dr Brown and colleagues.

The National Programme for IT was conceived under the Labour government at a cost of around £12.7bn, making it the most expensive pulic technology programme in the world.

Since coming to power, the coalition has announced it will abandon the name and shave an £700m from the price tag, in addition to the £600m cut made by Alistair Darling in 2009.

Several suppliers have dropped out and doctors’ groups have questioned the clinical value of the scheme, which will digitise patient records and make them available throughout the NHS.

From: http://www.telegraph.co.uk/NHS-misleads-patients-over-sharing-medical-records-with-drug-firms

NHS hospitals have quietly created banks of DNA from blood taken from millions of newborn babies without the proper consent of their parents.Freedom of information (FOI) requests to hospitals around Britain have established that the blood samples, taken in heel-prick tests to screen for serious conditions, have been privately stored by parts of the NHS since 1984.

According to guidance obtained by The Sunday Times, the DNA can be looked at by police, coroners and some medical researchers. They are able to identify named individuals.

This weekend Andrew Lansley, the health secretary, was under pressure to order an inquiry into why the NHS appeared to have acted without securing proper consent from parents.

Mothers of newborns are given a leaflet that academic experts say fails to make clear the distinction between consent for vital clinical tests to safeguard a baby’s health and for the use of the baby’s DNA in medical research and police inquiries.

Dr Helen Wallace, director of GeneWatch, a pressure group, said: “Giving mothers a leaflet does not amount to informed consent. No one who has just given birth is in a state to understand the full implications of how their baby’s genome might be used in future.”

The standard leaflet simply explains that the stored blood samples can be used “for research to help improve the health of babies and their families in the UK”.

Up to 4m samples are being held at four of the 16 centres licensed to hold newborns’ bloodspots in the UK, according to the FOI responses. More than 700,000 babies are screened each year.

The police and coroners can apply for access to the infant blood samples, which contain individual DNA, to identify people involved in crimes.

Private medical companies and researchers working for the NHS are also able to access the samples, although most of the research is anonymous and done by the NHS after approval by an ethics committee. The bloodspots have been used for genetic research and mass screening for diseases such as HIV in babies’ mothers.

The UK Newborn Screening Programme Centre, which oversees the use of samples, says that some of the bloodspots can be linked to other information, such as hospital admission records, which identifies the individual.

Government guidance says the bloodspots should be kept for at least five years, but hospitals vary widely in their practices.

Central Manchester University Hospitals Trust has 1m samples in storage dating from 1984. About 250,000 further samples are stored in the hospital’s laboratory. It plans to store them indefinitely.

Cambridge University Hospitals Trust retains samples for 18 years. It stores 400,000 samples at Endex archives in Ipswich, with a further 62,800 samples kept in hospital labs.

Great Ormond Street hospital in London began storing samples in 1990 and preserves them for at least 20 years. It screens and stores the samples of about 120,000 babies a year.

It confirmed that it had occasionally handed samples to coroners but not to the police.

Alder Hey children’s hospital in Liverpool, which was at the centre of a scandal over the retention of children’s organs, has 145,000 samples in storage. It receives about 29,000 samples per year. It destroys all samples after five years.

Dr Jane Kaye, director of the centre for health, law and emerging technologies at Oxford University, said: “It is very difficult to get samples like this to do public health screening. It is an enormous resource. But the problem is that this needs to be done properly and with proper consent. At the moment people are not being asked to sign a consent form or make a distinction between what is for their own child’s health and the fact that this may be used for other purposes.”

The samples are taken from babies, aged 5-8 days, to test for conditions such as sickle cell disorders, cystic fibrosis and phenylketonuria.

Shami Chakrabarti, director of Liberty, the pressure group, said that hospitals might face legal claims.

“As someone who gave consent for my own baby to be tested, I’m horrified that anyone would breach my trust, keep my child’s sample for years on end and use it for all sorts of extraneous purposes.

“If they think that thrusting a leaflet in an exhausted new mother’s hand creates informed consent, they can look forward to a flurry of claims under article 8 of the Human Rights Act.

“Liberty is writing to the new health secretary to ask for an urgent investigation.”

From: http://www.timesonline.co.uk/tol/news/uk/health/article7134061.ece

The NHS is sending millions of patient records and confidential medical notes to India for processing — despite a pledge by Labour that personal information would not be sent overseas.
It is the first time that databases of names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments.

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

The NHS reported the highest number of serious data breaches of any UK organisation since the end of 2007, the Information Commissioner’s Office says.

David Smith, deputy commissioner at the ICO told the Infosec security conference the NHS had highlighted 287 breaches to it in the period.

That accounts for more than 30% of the total number reported.

The NHS – the UK’s largest employer with 1.7m staff – has only started the process of rolling out digital patient records.

Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.

Mr Smith said the problems were not confined to the public sector and that results could be skewed because the public sector has a culture of reporting all breaches whereas not all private sector firms did.

Richard Vautrey, the deputy chair of the British Medical Association’s GPs committee thinks the number of breaches reflect the size and complexity of the NHS as well as its culture of openness.

“So many people have access to data and often human error is to blame. There is an increased attempt to be open and honest about what happens to data,” he said.

He added that he was not aware of a specific case where a data breach had affected patient privacy or care.

“We need to keep their breaches in perspective,” he said.

As part of its plans to digitise patient records, the NHS is asking patients if they want their data stored on national databases. It is important that people are given the chance to opt out, said Mr Vautrey.

Currently the reporting procedure for data breaches in the UK is voluntary although the ICO is “moving towards” a compulsory system.

In April the ICO introduced fines of up to £500,000 for serious data breaches.

The European Union’s Telecoms Package requires telecom firms to report data breaches and Mr Smith said he expected this requirement to expand beyond telcos.

Data encryption firm PGP welcomed the tough new approach to data security.

“Finally the ICO, which has long demanded greater powers, will be able to severely punish those in serious breach of the Data Protection Act. For too long, organisations have continued to ignore the warning signs – risking both the privacy of their customers and the reputations of their brands,” said Jamie Cowper, European marketing director at PGP.

He anticipates “severe fines” for the next private sector company to be involved in a serious data breach although he does not imagine the ICO will pursue the NHS.

PGP calculated that data breaches cost companies, on average, £67 per piece of data lost.

From:

http://news.bbc.co.uk/1/hi/technology/10089066.stm

Health Direct asks- given that the NHS has the worst record of data security and that labour politicans have already sent 250,000 political letters to cancer sufferers- are you CERTAIN that your medical records will be safe on the Snoopers Charter database? If not OPT OUT NOW- whilst you still can!

The National Health Service’s £12.7bn scheme to create an electronic patient record will “no longer provide the comprehensive solution” originally promised, says a top NHS executive.

Until now, health ministers and officials have acknowledged that the world’s biggest civilian information technology project is running four to five years late, and have said they want to make £600m savings on the £4bn-plus worth of contracts held by CSC and BT to deliver it.

Up to now, however, no one has conceded that the programme will fail to deliver everything that was promised back in 2003 when the contracts were signed.

Following a revamped deal with BT – the London supplier, which has cut £112m or about 12 per cent off its contract – Ruth Carnall, the chief executive of the London strategic health authority, has said the spending reduction means “it will no longer be possible to provide the comprehensive solution that was anticipated in 2003″.

Not all NHS organisations in London will now receive the software needed to deliver the records, Ms Carnall makes clear in a letter to London chief executives.

Meanwhile, Christine Connelly, the health department’s chief information officer, has said that only about half of London’s 32 big acute trusts will now get the full solution. Others will be able to add clinical systems to existing patient administration systems.

In place of a dedicated means of sharing records across hospitals, and between hospitals and primary care – a key goal of the programme – London will have to rely on the national summary care record, Ms Carnall says. However, this contains little other than allergies and current medication, and does not yet carry referral or discharge information.

On top of this, the Tories have said they will scrap the national record if they win the election.

BT will no longer have to deliver new systems to London’s ambulance service or GP practices. And London can afford to pay for Map of Medicine, a decision support tool for treating patients, for only one more year, says Ms Carnall.

In much of the country, installations in acute hospitals are stalled after CSC missed a deadline to get its solution running at Morecambe Bay NHS Trust. The supplier risks being fired, but is likely to sign a similar, more restricted, deal if it does hit a new deadline for a successful installation.

Glyn Hayes, president of the UK Council for Health Informatics Professions, said it had been clear for some time that the programme was to be reduced. “But this is the first official admission that there are things it will not do that it was intended to do.”

It was unclear, he said, whether the Conservatives would in fact scrap the national record if they won. “But if they do, it knocks a hole in London’s plans,” because without it the capital had no easy means of transferring patient information between settings.

From: http://www.ft.com/cms/s/0/fba8e660-436d-11df-833f-00144feab49a.html

Labour was caught up in a new row over its use of personal data after emailing NHS professionals using their work addresses to ask for their support.

The move emerged after the party had been criticised for delivering campaign leaflets on the party’s cancer policy to 250,000 women, some of whom had the disease.

The postcards, produced by Tangent, which works for the Labour Party, said that the Tories would scrap a Labour guarantee that patients would see a cancer specialist within two weeks.

One of those who received the latest communication, a doctor, has complained that senior Labour figures are trying to pressure her into publicly backing the party against her will.

Labour is trying to organise a round robin letter from senior figures in the NHS saying that only Labour can be trusted to look after the health service.

The Twickenham GP, whose name has been withheld for fear of retribution, contacted the Conservatives in fury at the attempt to make her sign a petition.

The GP expressed concern that Amy Fowler, a development officer for the Labour Party, obtained her work e-mail address, which she claimed is not publicly available.

The petition that the doctor was being asked to sign, which is likely to have been forwarded to a newspaper, committed members of the health service to explicitly backing Labour.

It says: “We are a group of clinicians, staff and campaigners working in and with the NHS. Every day, every week, we see first-hand the quality of care which the NHS gives to patients when they need it most. At this election we are backing Labour as the party of the NHS which will do the most to improve it for all patients.

“There is more to do to improve the NHS, but it is this Labour Government which has shown commitment to the NHS by investing in more doctors, nurses, more services and new hospitals and GP practices. It is Labour who are making the tough decisions that will allow our NHS to be protected in the future from spending cuts which would harm patient care. And only Labour are prepared to put patients first, for example with guarantees to rapid access to cancer specialists and cancer tests.

“For these reasons we believe only Labour can be trusted to protect and improve our NHS at this election.” The e-mail came from Martin Rathfelder, from the Socialist Health Association, but was signed by Ms Fowler.

The GP said: “[This was] totally unsolicited by me. I have never been to any socialist events and would not mix my personal views with work. He says he got it from a list of trainers which is possible. I feel this is an absolute abuse of a publicly funded service. Don’t know anyone who would have nominated me.”

She added: “I am angry that they have e-mailed me at my work e-mail address and would very much like to know how they have obtained confidential NHS e-mail addresses. You might be interested to investigate a. where they obtained these addresses [and] b. whether it is appropriate to use the addresses in this party political way. Needless to say I do not support the petition!”

Paul Beresford, the Tory MP who represents the doctor, said: “This is a grossly unfair attempt by the Labour Party to draw NHS clinicians into political campaigning. They feel under threat of blacklisting if they do not sign up.” Andrew Lansley, the Shadow Health Secretary, said: “The Labour Party need to explain how they have received these NHS e-mail addresses. If they are using the NHS private e-mail system to reach NHS staff for party political campaigning it is an abuse.

“We know from recent research that NHS staff support the Conservatives and not Labour because we are now more trusted to improve the NHS.”

Mr Lansley has written to Andy Burnham, the Health Secretary, to demand that he apologises for the cancer postcards. He said: “Cancer sufferers across the country have condemned Labour’s scaremongering breast cancer leaflets, but still Gordon Brown and Andy Burnham refuse to apologise.”

When asked where he got the address, Mr Rathfelder replied that he obtained it “from a list of training practices”. However the GP said “I still feel it is an abuse of the NHS.”

From: http://www.timesonline.co.uk/tol/news/politics/article7095225.ece

Bereaved families are being told that organs were removed from their loved ones without consent after a blunder affecting Britain’s donor register.

The records of 800,000 people were affected by an error that meant their wishes about the use of their organs after death were wrongly recorded.

An investigation has found that 45 of those for whom wrong records were stored have since died – and in approximately 20 cases organs were taken where consent had not been given.

Donors can give permission for any of their organs to be taken, or provide more specific agreements. A glitch in the IT system more than a decade ago removed the distinctions expressed by people.

Many donors have strong views about what can be taken. Often consent is not given for eyes to be removed, while some people who agree to donate organs are uncomfortable with the idea of their body tissue being used in research.

Joyce Robins, from the pressure group Patient Concern said: “This Government has got an absolutely dreadful record when it comes to data, but it is absolutely horrific that such sensitive details were handled in such a careless way.”

The NHS is about to contact approximately 20 families who allowed organs to be taken from their relations after being misinformed about what consent had previously been given.

It is illegal to remove organs without prior consent from the person who died or their next of kin.

A view is sought from relations before decisions are taken. In the cases where errors were made, it is understood that families were asked for permission, but their decisions were based on misinformation about the wishes of their relations.

After detecting the fault last year, NHS Blood and Transplant, which holds the organ donation register, was able to correct 400,000 of the flawed records. But 400,000 more people will shortly be contacted to be told that the wrong information may be held about them, and asked to provide consent again.

Until fresh consent is obtained, organs will not be taken from any of those people in the event of death.

The error occurred in 1999, when data held by the Driver and Vehicle Licensing Agency, which includes a request for consent in applications for a driving licence, was transferred to the organ registry.

The mistake came to light when NHS Blood and Transplant (NHSBT) wrote letters to new donors thanking them for joining the register, and outlining what they had agreed to donate. Respondents wrote back to say the information was wrong.

A spokesman for NHS Blood and Transplant, said: “We are taking it very seriously and are urgently investigating the situation.”

From: http://www.telegraph.co.uk/Organs-removed-without-consent-after-IT-blunder

The biggest single supplier to the £12bn NHS NPfIT white elephant programme is on the brink of being fired from a key part of its contract after failing to meet a deadline to install systems at hospitals in the north west.

CSC, which holds the contract for two-thirds of England, missed the deadline to get the Lorenzo electronic medical record product up and running at the Morecambe Bay NHS Trust’s hospitals.

CSC originally said the system would go live almost two years ago, in June 2008.

The failure is the latest crisis for the much-troubled programme which is running at least four or five years late.

CSC and BT, which covers London, had each been given a deadline to get new systems running smoothly in a big, acute, hospital, with the Department of Health warning last year that it would “look at alternative approaches” if that failed to happen.

BT has since installed a system at Kingston Hospital to the health department’s satisfaction. Christine Connelly, the department’s chief information officer, said it now needs to go through a due process under its contract with CSC which could yet see a new deadline set and met.

But if progress is not made, she told the Financial Times, the department has the option of cancelling CSC’s contract to install the systems in acute hospitals and letting hospitals choose from other suppliers.

Morecambe Bay, she said, remained keen to continue and under the contract CSC has to be given time to propose a fresh deadline for deployment, with the programme then assessing the credibility of that and whether to agree it.

“We have to walk through this step by step,” Ms Connelly said. “In a contract as large and complex as this we cannot just set a deadline and say that’s it. We have to act responsibly and not expose the department and the taxpayer to risk.”

But, she warned bluntly, “we cannot wait for ever”.

CSC has contracts worth about £3.3bn to install hospital, community, mental health and GP systems, with the latter elements progressing much better.

But Ms Connelly said if CSC’s plan was not credible the NHS had the option of cancelling the acute hospital part of the deal, thought to be worth around £1bn. CSC did not respond to attempts to contact it last night.

BT, having hit its deadline, has agreed a contract variation, signed yesterday, which the department said would save the NHS £112m, or about 12 per cent of the contract value, as part of the £600m savings the health service is seeking on the programme as a whole.

As part of the deal, BT is now signed up to install much fewer full systems in London, with about half the hospitals likely to add clinical systems to their existing IT arrangements, rather than replacing everything, Ms Connelly said.

Allowing hospitals to choose other suppliers is already starting to happen in the south of England, although the first contracts for that have yet to be signed. That should start to take place from May this year, she said.

From: http://www.ft.com/cms/s/0/6a9f7ee2-3d26-11df-b81b-00144feabdc0.html