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!

On election day Health Direct quotes this cancer specialist- The internal market has been a costly disaster. Let the professionals manage medicine.

It’s election time, and our glorious political classes are marching forward on the massed ranks of the electorate with banners that claim that their party, only their party, will save the NHS.

Politicians clamour to praise its world-class status and laud the dedication of nurses and the skill of its doctors. And all parties are united in the view that, despite the need for austerity measures, frontline staff and services will not be cut. So where are the savings planned? Watch the hand and not the mouth.

When I started in medicine, the hospital was run by about three people. Things were so much more simple when doctors and nurses treated patients, doing their best without the guidance of guidelines and targets, doing their best … yes … to make the patients better.

How did we manage without forms to fill and waiting times compliance? Quite well actually. The medical director ran the medical side of things while matron and the accountant handled the rest. It wasn’t much of a business then: it didn’t have to be, because there was no internal market to manage.

The internal market — Mrs Thatcher’s plan to introduce efficiency by having hospital compete against hospital to provide patient treatment — has wreaked havoc. It has spawned a nation of administrators, here today and gone to another post tomorrow — while doing nothing to bring costs under control.

The internal market’s billing system is not only costly and bureaucratic, the theory that underpins it is absurd. Why should a bill for the treatment of a patient go out to Oldham or Oxford, when it is not Oldham or Oxford that pays the bill — there is only one person that picks up the tab: the taxpayer, you and me.

And there are big problems with the billing process. For example, if a patient is seen in an outpatient clinic then there is a charge made by the hospital for his or her first attendance — but follow-up appointments are not charged. And if many treatments are given in a hospital to a patient, only the most expensive of the treatment episodes is charged.

There are savings to be made. It is alleged that there are just 75,000 administrators at work in the NHS but this figure is laughably mythological. Doctors and nurses know that there are many more than this. They look around and see the numbers increasing.

One report by the Centre for Policy Studies published in 2003 indicated that there were 250,000 administrative staff employed in the NHS: at least one administrator for every nurse. In recent times the rate of increase of admin staff within the NHS has exceeded that of nursing staff.

There is a general feeling in the NHS of disempowerment of the professionals. People can’t face up to the incredible struggle, the disapproval that faces any of them if they have the temerity to suggest that things should be run differently.

The principle of care for all from cradle to grave is worthy and wonderful. But the current reality is a cradle rocked by accountants who are incapable of even counting the number of times that they have rocked it. The reality is gravediggers working with a cost improvement shovel made of rust.

Over the years politicians have made dramatic changes to the way that the NHS has been run. Recent changes have caused fragmentation and not led to any cost saving. Moving patients from one place to another does not save the nation’s money, though it might save a local hospital some dosh. So the internal market has failed because it does not consider the health of the nation as a whole, merely the finances of a single hospital department, a local hospital or GP practice.

So what should we do? Let us go back to the old discipline of the NHS. Let the professionals manage medicine, empower the professionals, the doctors and nurses and shove the internal market in the bin and screw down the lid.

At this election time please let us hear from all political parties that they will ditch this absurd love-affair with the internal market. Instead let them help the NHS do what it does best — treat patients, and do so efficiently and economically without the crucifying expense and ridiculous parody of competition.

Professor Jonathan Waxman is a consultant oncologist

http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article7112167.ece

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 has become embroiled in a row about the use of personal data after sending cancer patients alarmist mailshots saying their lives could be at risk under a Conservative government.

Personalised cards addressed to sufferers by name warn that a Labour guarantee to see a cancer specialist within two weeks would be scrapped by the Tories. Labour claims the Conservatives would also do away with the right to be treated within 18 weeks.

The offending mailshot
Cancer patients who received the personalised cards, sent with a message from a breast cancer survivor praising her treatment under Labour, said they were “disgusted and shocked”, and feared that the party may have had access to confidential health data.

Labour sources deny that the party has used any confidential information. However, the sources admit that, in line with other political parties, it uses socio-demographic research that is commercially and publicly available.

The postal campaign started last month before the general election was called. This is the first election in which parties have been able to use internet databases and digital printing to personalise their mailshots.

Labour has sent out 250,000 “cancer” postcards, each addressed to an individual, asking: “Are the Tories a change you can afford?” Many of those receiving the cards have undergone cancer scans or treatment within the past five years.

- In the Labour constituency of Sherwood, Nottinghamshire, two of a group of eight women friends received the breast cancer card. They are the only two to have undergone cancer treatment. One of them, Phyllis Delik, 80, described it as “callous” and “despicable”. The second woman, Shirley Foreman, 58, who received the card a fortnight after undergoing surgery, said: “It is bad taste after what I have been through.”

- In the marginal east London constituency of Poplar and Limehouse, the card was sent to a 44-year-old television producer who had a potentially cancerous lump that turned out to be a cyst. She appeared to be the only person who received the mailshot among 50 neighbours. She said: “It’s crude and insensitive.”

- A card was sent to a woman who has died of breast cancer. Her 33-year-old husband was so upset that he sent a message to the Facebook page of Diane Dwelly, the woman whose case is featured in the mailshot, accusing her of being a pawn for the Labour party.

This weekend Dwelly, 48, from Rugby, admitted she had “probably been used by Labour”. She believed her photograph had been taken for use in a magazine for the National Health Service, not as part of Labour’s election campaign.

The cards are being distributed by Ravensworth, part of Tangent Communications, which has won accounts sending out mail for the Department of Health and Cancer Research UK.

Tangent claims that it specialises in “highly targeted marketing”.

The cancer cards are part of a wider postal campaign targeting various groups. Others are aimed at parents whose children attend Sure Start centres, pensioners and the owners of small businesses.

Labour has so far sent out 600,000 cards. It plans to distribute 4.5m during the election campaign.

Janet Arslan, 40, a graphic designer who also lives in the Sherwood constituency, said: “When I received the breast cancer card at first I thought it was from the hospital.

“I did not think Labour would be that crass to deliberately target a terminal cancer patient like me.”

Damian Bentley, managing director of Tangent, said: “Our company does a lot for the Labour party but I don’t work on that side of the business.”

He failed to respond to a list of questions on how the addresses of the cancer victims were obtained.

Emilie Oldknow, 29, the Labour candidate in Sherwood, worked for the NHS before she became the regional organiser of the East Midlands Labour party. She is the fiancée of Jonathan Ashworth, Gordon Brown’s deputy political secretary and a member of his “kitchen cabinet”.

Oldknow has denied all knowledge of the cards.

“I had not seen the mailshot before and it wasn’t sent out by my campaign,” she said.

In an email to Arslan’s mother, she said her details had been “obtained from the electoral register, which is available to political parties”.

Experian, the data management company, confirmed that both Labour and the Conservatives use its Mosaic database, which divides voters into 67 groups. The databases can use anonymised hospital statistics, including postcodes and the diagnoses of patients, to identify the likely addresses of those with particular illnesses.

It cannot identify potential breast cancer sufferers because the disease affects adult women of all ages and backgrounds.

Andrew Lansley, the shadow health secretary, said: “For Labour’s campaign to deliberately distress or scare sufferers from breast cancer is shameful. Because we are going to increase the NHS budget in real terms and cut bureaucracy and waste, we will have the capacity to ensure that cancer patients are seen sooner than they are at the moment and to meet the quality standards that they expect.”

From: http://www.timesonline.co.uk/tol/news/politics/article7094308.ece

Health Direct doubts labour spin about this approach being a “one off” as they have given themselves the right to snoop on all of your medical data- as well as their nightsoilmen at the Deptament of Health.

Highlighting once again the need for you to opt out of their expense white elephant that is the NPfIT propgram.

Private companies get access to millions of NHS medical records

September 29, 2008 By: Dr Search- Principal Consultant at the Search Clinic

The confidential medical records of millions of NHS patients could be handed over to private companies under controversial plans being drawn up by labour ministers.

Patients’ postcodes, medical conditions and treatments – and in some circumstances, their names – could be passed on to third parties without their consent.

http://www.healthdirect.co.uk/2008/09/private-companies-get-access-to-millions-of-nhs-medical-records.html

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

Elderly people have been left ‘waiting for God’ by the labour Government’s decision to shelve plans for a comprehensive National Care Service for at least six years, charities have warned.

Gordon Brown described Labour’s proposal for an NHS-style universal scheme as “bold and ambitious,” despite postponing the plan until the election after next.

Andy Burnham, the Health Secretary, defended the delay, saying: “Rome wasn’t built in a day” as he unveiled a White Paper setting out the staged introduction of improved care for the elderly

MPs last week voted through the first part of the proposals, a law to provide free personal care in the home for 400,000 people with the “greatest needs”.

If Labour is elected, Mr Burnham said, this would be followed in 2014 by the provision of free nursing care for those in residential accommodation for more than two years.

Questions were raised immediately, however, over how ministers would meet the scheme’s £800 million price tag, after it emerged that most of the costs would be met from “efficiencies”.

The Conservatives also pointed out that care home residents would still be required to pick up their own accommodation costs, such as utilities and housing fees, which average £14,000 a year.

Labour had originally hoped to fight the forthcoming general election on a radical pledge to establish a comprehensive National Care Service, paid for by elderly people from a range of methods including an inheritance levy.

The plans were shelved at the last minute amid Tory accusations that the party was planning a “death tax,” leading to Cabinet fears that the proposal would prove unpopular at the ballot box.

Instead, Mr Burnham announced that a commission to be established during the next Parliament would seek a “consensus” on funding for a comprehensive, compulsory National Care Service “based in need rather than the ability to pay,” which would then be put to voters in the election expected in around 2015.

The Health Secretary confirmed that the “death tax” option remained on the table for the review, which would follow an earlier Royal Commission, chaired by Lord Sutherland, which concluded in 1999 and which the labour Government failed to act on.

Charities immediately criticised the delay – and questioned how the labour Government proposed to meet the costs of their more modest residential care plans when councils were already being ordered to make massive cutbacks.

Steve Barnett, chief executive of the NHS Confederation, said: “We have significant concerns about the further delays in implementing a long-term solution.”

Dot Gibson, general secretary of the National Pensioners’ Coalition, added: “Social care in Britain has been in crisis for decades, but many older people and their families will not be able to wait until 2016 before they get any help.”

The over-50s group Saga warned that elderly people had been left: “Waiting for God – and for care funding.”

Emma Soames, Saga spokesman, said: “We’re disappointed by the delay, lack of detail and any figures. Overall, it seems like a lot of waiting just to be told that they are going to a Royal Commission – which they could easily ignore as they did with long term care in1999 – to draw up proposals for a change in the system for 2015.”

Opposition politicians also criticised the delay. Andrew Lansley, the shadow health secretary, said: “The Government is in complete retreat and they have ended up with not a White Paper but frankly a train crash.

“We seem to have arrived at the point where Andy Burnham is saying he wants everyone to have free care but he doesn’t know how to pay for it.

“The death tax is alive and kicking – despite their attempts to bury it in the small print of policy in the hope people won’t notice. The simple fact remains that if Labour win the election, they’d introduce plans for a death tax to pay for care.”

Norman Lamb, the Liberal Democrat health spokesman, added: “After 13 years in power spent ducking social care reform, we probably shouldn’t be surprised that Labour has once again hit it into the long grass.

“A White Paper without any commitment to substantial change in the next Parliament is barely worth the paper it is written on. We’re now being offered a series of piecemeal reforms that have not been properly thought through or costed.”

From:
Government plans for-elderly care branded a train crash