Half of prostate cancer cases may be missed

Half of prostate cancer cases may wrongly be given the all clear due to flaws in diagnosis procedures, a new study has found.Half of prostate cancer cases may be missedExperts say that thousands of patients are being put at unnecessary risk because most NHS hospitals are using outdated and inaccurate techniques.

Prostate cancer is the most common cancer in men, affecting 40,000 people a year and causing 10,000 deaths. One in eight men will develop the disease within their lifetime.

The study by the London School of Hygiene and Tropical Medicine and University College London suggests that as many as half of cases where patients have “significant” levels of prostate cancer could be being missed during standard biopsy procedures.

Thousands more men may be wrongly diagnosed as having cancer which requires major treatment, such as surgery or radiotherapy, the researchers found.

In most British hospitals, men with suspected prostate cancer automatically undergo a biopsy to remove and examine tissue in an attempt to establish whether disease is present.

However, research has suggested that diagnosis is far more accurate if patients undergo an MRI scan first, to examine the area, with the findings mapped via ultrasound, so that the needle can be guided and tissues taken from precisely where a tumour is suspected.

In the new study, health economists calculated that the use of the modern technique could mean that one quarter of men with suspected prostate cancer could be given the all-clear without even undergoing the invasive diagnostic procedure.

For every 1,000 men with suspected cancer, around 250 men could have been reassured simply by undergoing a scan, they said.

Of around 500 of the cases in which significant disease was present, just 50 per cent were detected during the traditional biopsy, compared with 68 per cent detection rates using the MRI-guided technique, the study found.

One in 20 of those undergoing the traditional biopsy were wrongly found to have significant disease levels –meaning they would be likely to undergo unnecessary aggressive treatment, such as surgery, radiotherapy or hormone treatment, with distressing side effects including incontinence and impotence.

Using the MRI-guided technique, around half as many men were wrongly given a diagnosis of significant disease.

The vast majority of prostate cancer cases occur in men over the age of 65. Lung cancer is the only cancer which kills more men.

Symptoms can include needing to urinate frequently and difficulty urinating, but this is also common in older men without the disease.

Currently, more than 100,000 biopsies a year are carried out on men with suspected prostate cancer and 40,000 men are diagnosed with the disease.

If the cancer is found at its early stages, doctors are likely to monitor its progress, but nearly 4,000 men a year undergo surgery, while 15,000 undergo radiotherapy or hormone treatment.

Prof Mark Emberton, professor of interventional oncology at University College London, lead investigator on the study, funded by the Wellcome trust, called on hospitals to update their practice.

Prof Emberton, a consultant urologist at University College Hospital, London, uses the MRI technique for all patients with suspected prostate cancer, but the vast majority of hospitals in this country still carry out traditional biopsies, with little idea of which area to target.

He said: “There is no other organ of the body where we carry out random ‘blind’ biopsies without knowing where we are looking – at UCLH we have been using MRI, followed by a guided biopsy for several years, but there are only a handful of hospitals in this country which currently do this, and that needs to change.”

Third of health authorities still imposing postcode lottery treatment bans

A third of local health authorities are still imposing postcode lottery treatment on certain ailments including hernia operations, IVF, varicose vein removal and even hip and knee replacements, according to a survey of GPs.Third of health authorities still imposing postcode lottery treatment bansLast November Andrew Lansley- the then Health Secretary, banned primary care trusts (PCTs) and health commissioning groups from imposing across-the-board restrictions, describing them as “unacceptable”.

He said patients should always be able to be treated if their doctors said they needed it.

He reiterated his edict this June, after a study found nine in 10 local health authorities were imposing tight thresholds on at least one treatment deemed to be either ‘non-urgent’ or of ‘low clinical value’.

However, there are still widespread bans in place, according to a survey of 682 family doctors by GP magazine. It found 35 per cent said authorities or commissioners were restricting access on the base of cost alone.

GPs who responded to the survey said they were being forced to “fob off” patients until they could refer them on.

Some PCTs were not imposing blanket bans as such, but making it more and more difficult for patients to qualify for treatment, for example by raising the threshold of pain and immobility needed to qualify for a joint replacement.

One wrote the PCT was “not imposing a blanket ban, but it is made increasingly difficult in terms of the hoops you have to jump through to obtain funding, even to get a patient seen for an ever growing list of conditions.”

Some feel Mr Lansley had it both ways on the issue – on the one hand restricting funding and then blaming PCTs who had to reduce their spending.

One respondent said Mr Lansley had been “asking the impossible, with GP commissioners being the fall guys”.

Dr Richard Vautrey, deputy chairman of the British Medical Association’s GP committee, called on Jeremy Hunt, Andrew Lansley’s replacement to sort out the problem.

He told GP: “’The Department of Health has repeatedly said it would prevent PCTs and clinical commissioning groups (CCGs) from rationing treatments on cost alone.

“They are clearly not doing that and need to start putting words into action,” he said.  “This will be a big challenge for the new health secretary, and one he needs to address quickly.”

According to the poll, GPs seem to be strongly in favour of an England-wide list of services it will not fund, to eliminate the current postcode lottery.

From: http://www.telegraph.co.uk/Third-of-health-authorities-still-imposing-blanket-treatment-bans

Andrew Lansley was a disaster who deserved to be sacked

The former secretary of state took a wrecking ball to NHS structures, alienated every interest group and patronised those who disagreed with him.Andrew Lansley was a disaster who deserved to be sackedThere should be no sentiment about Andrew Lansley’s departure as health secretary, no matter how hard he worked, how gutted he is to lose the Tory health brief after nine years or how much he cared about the health service. By every measure of high political office, he was a disaster and he deserved to be sacked.

As a strategist, he failed to look for the most pragmatic way to achieve his desired outcome. He simply would not recognise that taking a wrecking ball to NHS structures – at a time of intense financial stress, rising demand and the necessity for widespread changes to clinical practice – was foolish. He compounded this mistake by imposing a structure that resembles a London tube map.

Compare that with Michael Gove’s pragmatic approach of bending the existing academy programme to his will.

As a politician, Lansley managed to turn virtually every interest group against him, gave the opposition almost limitless opportunities to attack and lost the confidence of the public. He was so inept that even after the extraordinary spectacle of “the pause” – when the government just about managed to get the policy back into some sort of order – he again careered into a political ditch as it went through the Lords. Sharp, charming health minister Earl Howe had to tow him out.

Lansley was a shocking communicator, from ill-tempered media interviews to the hectoring tone he adopted with the professions. His idea of consultation was to repeat what he had said in the hope that this time you would finally concede he was right. Ridiculing managers as “bureaucrats” was just one indicator of his ineptitude – alienating with a single word the very people who had to implement his reforms.

So what has he left for Jeremy Hunt? The new secretary of state has arrived at a particularly sensitive time.

The mandate with which parliament will lay down its priorities for 2013-15 and beyond is out for consultation until 26 September.

This will set the boundary between the political influence of ministers and the operational independence of the NHS commissioning board. Lansley had promised to take the politics out of the day to day running of the NHS. Now Hunt has to decide how he will interpret that. Having just taken on “the biggest privilege of my life”, Hunt may be surprised at just how little direct control of the NHS is envisaged for him.

It is tempting to construe Lansley’s departure as further strengthening the already near-omnipotent position of Sir David Nicholson, the commissioning board chief executive, but that does not necessarily follow. Hunt will not be there simply to provide a more credible front for Lansley’s reforms; he will want to be seen to set his own priorities. He can be expected to champion choice, and may well energise the use of private sector providers. He will also want to stamp out local fires on care rationing.

He can be expected to be pragmatic. While Lansley revelled in the detail, Hunt will want to focus on what works and what can be achieved.

A serious concern is that his priorities may be short term and election focused. On reconfiguration, for example, Lansley eventually came round to the need to concentrate some services in fewer, high quality centres.

Pushing through such changes is essential if the NHS is to have a hope of maintaining quality while finding savings, but it will require strong political nerves and an acceptance of how crucial these changes are to the health service’s future. The temptation for Hunt to stall on these changes until after 2015 will be strong. (He has done the usual constituency campaigning to protect local services, in his case Haslemere hospital and the Royal Surrey A&E, although, of course, it does not necessarily follow that he will adopt the same approach nationally.)

As the tunnel of public sector cuts gets ever longer, he will be needing to balance the great pressure in healthcare with the crisis in social care. Under Hunt, the NHS budget could get more permeable, moving money across to social services under the guise of integrated care.

And finally there is the Francis inquiry (into deaths at Stafford hospital), now reporting in October. In the absence of any stronger indication of his likely response, it is worth noting that as shadow minister for the disabled he expressed concern about the detrimental impact of bureaucracy and regulation on providers. There is a grave risk of the government over-reacting to the Francis inquiry. It will be to the benefit of the NHS and patients if he keeps his questioning approach to regulation to the fore when deciding his response.

This article was published by Guardian Professional at:  http://www.guardian.co.uk/andrew-lansley-disaster-deserved-sack?

Sue NHS if managers deny approved drugs says NICE

Patients should sue their local health authorities if they deny them drugs deemed cost effective for use on the NHS, the head of the National Institute for Curbing Expenditure (NICE) has said in a excellent example of the pot calling the kettle black.Sue NHS if managers deny approved drugs says NICESir Michael Rawlins, chairman of the killer quango watchdog, said “numerous trusts” were “acting unlawfully” in denying patients Nice approved treatments. Health trusts were wrongly using “delaying tactics” before allowing them, to save money, he said.

Sir Michael urged patients not to stand for such behaviour, saying courts would without doubt side with them.

He made clear his comments in an article for the Health Service Journal about problems many patients were having accessing a Nice-approved treatment, called dexamethasone intravitreal implants, for the common eye condition retinal vein occlusion. Installed every six months, the implants help prevent sight deterioration.

He said: “Quite clearly numerous trusts are acting unlawfully. They are denying patients an innovative and cost-effective treatment, recommended by Nice, that significantly improves their quality of life.

“The reason, of course, is that trusts do not wish to use their resources in this manner. Although they know that are required to make Nice-approved products available, they introduce delaying tactics.”

Disputes between primary care trusts (PCTs) and hospitals over payment meant “many months pass with the arguments going back and forth”, he added.

His advice was that organisations such as the Royal National Institute of Blind People (RNIB) should seek a judicial review in the High Court.

“The court would unquestionably uphold the claim,” he predicted.

However, he added such case would not reach court – the implication being that trusts would quickly back down if threatened with the prospect of costly legal action.

He noted that the NHS Constitution enshrined the patient’s right to Nice-approved drugs “if your doctor says they are clinically appropriate for you”.

The RNIB had found 37 of 125 hospital trusts were either not providing the dexamethasone implants or providing a restricted service.

Sir Michael also said NHS managers should show more allegiance to patients and less to their trusts.

“I want my clinical colleagues to start exercising leadership and ‘whistle-blow’ when their trusts fail to meet their legal obligations,” he said.

Steve Winyard, head of policy at the RNIB, who raised the matter with Sir Michael, commented: “If Nice has done all the detailed work on cost effectiveness then I think it’s inappropriate is for PCTs or hospitals at local level to make decisions that run counter to that.

“Nice doesn’t come to these decisions lightly and it would like to see patients across the county benefit.”

Last autumn it emerged that about a quarter of PCTs were blacklisting more expensive drugs, even if Nice-approved, in favour of cheaper ‘generic’ versions.

In January Andrew Lansley, the Health Secretary, promised to introduce an “effective compliance regime” to end “postcode prescribing” of Nice-approved treatments.

Health authorities often put pressure on doctors not to prescribe certain treatments if there are cheaper alternatives available.

However, health authorities themselves are under intense pressure to use ever more limited resources as efficiently as possible.

From: http://www.telegraph.co.uk/Sue-NHS-if-managers-deny-approved-drugs-says-Nice-chairman

Patients can demand a private hospital if they wait 18 weeks for surgery

People will be able to demand they are treated privately if they have to wait more than 18 weeks for NHS care, the Health Secretary has announced.Patients can demand a private hospital if they wait 18 weeks for surgeryAndrew Lansley has made the offer of private treatment which could benefit tens of thousands of people who currently have to wait more than 18 weeks for non-urgent operations.

Patients diagnosed with cancer will also have the legal right to demand a consultation with an “alternative provider” if they have to wait more than a fortnight for NHS care.

Last night, the Health Secretary said: “In the last year the NHS has reduced the number of people waiting longer than 18 weeks for treatment to a record low, which is a great achievement. However, we are not complacent and have already challenged the NHS to keep on improving.

“We want those waiting times to come down even further so we are asking the NHS to identify how best to offer patients who run the risk of waiting a long time an alternative hospital to get their treatment from, which could be an NHS hospital or a private provider.” The new treatment choice is part of plans to be announced today for an NHS mandate which will set out the standards of care that patients can expect following sweeping reforms.

In future, the standards of the NHS will be judged against 60 different “outcomes”, which include the number of people dying after being diagnosed with different cancers; improving care for those with long-term conditions such as dementia; and recovery times after medical emergencies.

In the past, hospitals have been judged on waiting lists and other upfront markers rather than the success or failure of treatment.

The NHS will publish an annual report, with the first appraisal released today, to monitor standards and measure improvements. And a new NHS board will have to write to the Health Secretary to explain if key indicators do not improve.

In today’s NHS report, the Government will also laud health staff for reducing waiting times, cutting mixed-sex wards and reducing infection rates in hospitals.

However, the pledge to increase health standards represents a major political gamble for Mr Lansley.

Earlier this year, he forced through major reform of the NHS in the face of intense opposition from the medical profession. If he fails to meet the new targets, the “failure” of the NHS reforms are expected to form the centrepiece of Labour’s next election campaign.

From: http://www.telegraph.co.uk/Patients-can-demand-a-private-hospital-if-they-wait-18-weeks-for-surgery

Hospital PFI project went ahead despite warnings

A hospital now losing £44 million a year was allowed to go ahead with a private finance deal to build new premises despite the Government being warned that the project was unsustainable.Hospital PFI project went ahead despite warningsA report, commissioned by the hospital regulator, Monitor, reveals that strong concerns were raised that Peterborough Hospital would not have the money for the new buildings.

Despite the warning – to both the Treasury and the Department of Health – the go-ahead was given for the project, which is now costing the hospital trust £22 million a year to service.

Last year, Monitor found Peterborough to be in “significant breach” of the terms of its authorisation and warned that work on a turnaround plan for the hospital had “not progressed at the necessary pace”. In February, the Government was forced to establish a £1.5 billion bailout fund to help pay the debts created by prohibitively expensive PFI schemes, of which Peterborough was one.

Peterborough is judged at high risk of financial failure by Monitor and is likely to have to cut or reconfigure the services it provides and make staff redundant to balance its books.

In the report, from the accountants KPMG, into what went wrong at Peterborough, auditors conclude that while Monitor was aware of the risks of the project it was powerless to stop the Government from giving it approval.

It is embarrassing for Labour because, at the time of the approval, Andy Burnham was a Minister of State in the Department of Health. He is now shadow Health Secretary.

The report reproduces a letter sent by the then head of Monitor, Bill Boyes, to the hospital trust in 2007 and copied to officials in both the Treasury and the Department of Health, warning of the dangers of the project.

But because Monitor had no power to intervene, it went ahead and it was only in 2010, after the hospital had been built, that the true financial picture emerged.

It has now emerged that up to 30 NHS trusts could be forced to merge, devolve services into the community and make jobs cuts as part of a radical restructuring of hospital care – partly as a result of the cost of PFI.

The Department of Health said it considered 21 hospitals to be “clinically and financially unsustainable”.

Commenting on the report, a Department of Health source said: “This was a disastrous Labour PFI blunder. Labour was warned repeatedly by their own regulator that this PFI deal could bankrupt Peterborough Hospital but they pressed on regardless.”

A spokesman for Mr Burnham said he would not comment until he had seen the full published report.

From: http://www.independent.co.uk/hospital-pfi-project-went-ahead-despite-warnings

NHS is paying for Labour’s dodgy deals

The NHS faces huge costs because of flaws in Private Finance Initiative (PFI) contracts agreed by the previous administration.NHS is paying for Labour’s dodgy dealsYesterday afternoon, the Queen opened the South West Acute Hospital in Enniskillen. She will doubtless have been impressed: the facility, the first to be built in Northern Ireland for more than a decade, is a gleaming shrine to 21st century healthcare.

What may not have been mentioned, however, was that the £276 million hospital was constructed not with public funds, but by a consortium under the Private Finance Initiative – and that the deal to build it included a 30 year “facilities management” contract for one of the firms involved.

The Enniskillen deal may be a shining example of value for money.

But many PFI contracts are not.

Ministers are on the verge of taking over the South London Healthcare Trust, after it proved unable to cope with a bill of more than £60 million a year in interest alone.

One of the trust’s three hospitals, the Princess Royal in Bromley, took £118 million to build, yet will cost roughly £1.2 billion. All told, Labour signed 103 PFI deals for the NHS, at a value of £11.4 billion and an eventual price of more than £65 billion.

The diversion of that money away from patient care will put inexorable pressure on budgets, to the point where some hospitals will crack under the strain.

PFI, in short, is not merely about £22 light bulbs and £875 Christmas trees – it is about budgetary incompetence on a monumental scale.

And it comes as little surprise that it can be traced back to Gordon Brown, who turbo-charged the Tories’ fledgling public-private partnerships in order to buy schools, hospitals and more on the never never.

This allowed him first to evade spending restrictions, and later to splurge on public-sector salaries; in the mean time, the credit card bills got higher and higher.

Many PFI deals delivered what was promised – but where things have gone wrong, as in Bromley, the contracts were often drawn up so poorly that there is little the Coalition can do. Ministers have renegotiated some deals to claw back costs, and should make every effort, and twist every arm, to do more.

They should also remind voters of the ignominious parts played in this debacle by Ed Miliband, Andy Burnham and Ed Balls.

But, above all, they need urgently to produce a way of funding infrastructure that draws on the private sector’s strengths rather than exploiting the public sector’s weaknesses.

Jesse Norman, the Tory MP who has led the way in exposing PFI’s flaws, points out that the state must spend more than £200 billion on new infrastructure over the coming decade, and cannot do so without private help.

The Treasury is beavering away on a new model of funding. If it repeats the errors made by Labour, the cost to the nation will be heavy indeed.

From: http://www.telegraph.co.uk/The-NHS-is-paying-for-Labours-dodgy-deals

Coalition ministers take over bankrupt PFI hospitals

One of Britain’s biggest hospital trusts is “on the brink of bankruptcy” and will be taken over by ministers in the coming weeks after being saddled with large debts from PFI deals.Coalition ministers take over bankrupt PFI hospitalsSouth London Healthcare Trust, which runs three hospitals in the capital, is losing more than £1 million a week and will be run by a troubleshooter and a new management team.

It was formally warned last night that it would be the first NHS body to be taken over by Whitehall-appointed administrators under the “unsustainable providers’ regime”.

More than 20 other hospitals in financial difficulty also face being taken over unless they take urgent steps to turn around their fortunes.

A government source said: “This hospital trust was brought to the brink of bankruptcy by Labour. It is losing £1 million a week, money which could be spent on 1,200 extra nurses for local people.

“The standard of care that patients receive at the hospital trust is not good enough, although there have been some improvements in recent months. It is crucial that those improvements are not put at risk by the challenge of finding the huge savings that the trust needs to make.

“We don’t want a repeat of Stafford, where crude attempts to balance the books had tragic consequences.”

“This will clearly be a difficult and controversial process, but we are determined to turn this trust around so patients in south-east London get the care they deserve.”

The trust runs three hospitals – Queen Mary’s in Sidcup, Queen Elizabeth in Greenwich and Bromley – serving more than a million people and employing more than 6,000 staff.

However, it is thought to have been crippled by the costs of two Private Finance Initiatives used to rebuild two of its hospitals. The schemes, which totalled more than £1 billion, cost more than £60 million annually in interest payments alone.

Draft financial plans submitted by the hospitals to the Department of Health show that it faces a shortfall in its accounts of between £30 million and £75 million annually over the next five years.

Stephen Dorrell, chairman of the health select committee, said in theory under PFI the public and private sectors were meant to share the financial risk of ventures, but this did not happen.

“I regret the fact that contracts were signed that paid private sector costs when the public took the risk. That is indefensible,” he said.

A senior Whitehall official visited the hospital to deliver a letter from Andrew Lansley, the Health Secretary, warning bosses that the legal process to effectively take over the trust had begun. New management is expected to be installed next month.

Mr Lansley’s letter said: “A central objective for all providers is to ensure they deliver high quality services to patients that are clinically and financially sustainable for the long term.

“I recognise that South London Healthcare NHS Trust faces deep and long-standing challenges, some of which are not of its own making. Nonetheless, there must be a point when these problems, however they have arisen, are tackled. I believe we are almost at this point.

“I appreciate that any decision to use these [special] powers will be unsettling for staff, but I want to stress that the powers are being considered now so that patients in south-east London have hospital services that have a sustainable future.

“I am determined to improve health care services for patients in south-east London and will take whatever difficult steps are necessary to achieve this.”

Doctors try to justify strike in open letter

Doctors have published an open letter in the national newspapers to try to quell a growing backlash against their industrial action.Doctors try to justify strike in open letter The full page statement, paid for by their union, the British Medical Association, explains why they are striking and taking a day of action.

The BMA announced yesterday that doctors would postpone non – urgent operations, outpatients’ appointments and GP consultations on June 21.

Tens of thousands of patients will be affected and the action will cost the NHS at least £40 million.

The letter doctors have published in the national newspapers

The move has led to accusations of them being “greedy” and leaving patients “waiting in pain” for surgery.

Department of Health figures show that a typical NHS doctor retiring now at 60 will receive a pension of more than £48,000 a year for life.

In addition, they receive a tax – free lump sum of about £143,000, a pension scheme that would cost more than £1 million in the private sector.

The letter, signed by Dr Hamish Meldrum, the Chairman of Council, tries to reassure patients that they emergency cases will be looked after and outlines their reasons for action.

“We will be postponing non-urgent cases and although this will be disruptive to the NHS, rest assured, doctors will be there when our patients need us most and our action will not impact on your safety,” it reads.

“We feel this action is vital in order to address the unfair treatment of the NHS pension scheme.  Despite agreeing to major reforms in 2008, that made the NHS pension scheme fair and sustainable, doctors are now being asked to work much longer, up to 68 years of age, and to contribute much more of their salary, up to 14.5 per cent, for their pensions.

“These contributions are up to twice as much as those of civil servants on the same pay, for the same pension.  We are not looking for preferential treatment from the Government but we do want fair treatment. This is the first industrial action by doctors since 1975 and it is not a decision we have taken lightly.”

The industrial action was called after a ballot of 104,000 BMA members returned overwhelming support for action.

But the day of action has been roundly criticised.

Andrew Lansley, the Health Secretary, said the public would not understand or sympathise with the decision to take action.

Even Andy Burnham the shadow health secretary, urged doctors to “pull back”.

The Patients Association said people would be forced to wait for operations while in pain.

A further day of action would be considered after June 21.

Julia Manning, the chief executive of 2020health, a think tank, said: “This is a massive own goal for doctors that tarnishes them all with a ‘greedy’ brush. Many of my friends in medicine will be horrified and embarrassed at the thought of their colleagues striking.”

Health Direct website for NHS patients booking doctor appointments online

NHS patients will be able to book GP appointments online and get test results online within three years from a new health direct website.Health Direct website for NHS patients booking doctor appointments onlineThe moves are part of a new Information Strategy designed to “take the hassle out of the health service”.

Online communications between patients and their doctors is already happening in some places.

But the strategy sets out plans to ensure there is universal adoption of digital technologies.

The Department of Health is also encouraging the NHS and private companies to develop new health apps for smart phones and tablet computers.

Repeat prescriptions will also be available from 2015 too.

The deadline mirrors the goal of giving patients access to electronic medical records – something thatwas part of tony bliar’s vision for the NHS in his NPfIT £12 billion dream.

Health Secretary Andrew Lansley said: “Our NHS reforms are about making life easier for patients.

“By allowing people to access the NHS online, we will put an end to the 8am rush to phone your GP to try and book an appointment. Reforms like this will take the hassle out of the health service.”

Dr Laurence Buckman, chairman of the British Medical Association’s GPs Committee, said: “There are GP surgeries which have been pioneering online booking and repeat prescriptions for a while now so we would support the wider implementation of this, as long as it doesn’t impact on patients without IT access who can continue to book appointments in the usual way.

“However, we would caution against the potential use of email for consultations, because compared to a telephone or face-to-face consultation it is difficult for GPs to assess someone quickly and safely this way.

“When it comes to patients being able to view their records online, we believe patients should have access to their health records but we’d want to be satisfied that their records would remain secure before this was implemented – for example it would be important to be certain that it couldn’t be an abusive partner or a parent trying to access their teenager’s records. All patients need to be confident that their records are held safely otherwise they may not feel comfortable talking to their GP about confidential issues.”

Given that the government has an appalling record on leaking and losing your records from everything from DVLA to the tax office we caution against rushing out and signing up for similar treatments.