The Opt Out that is no Opt Out

December 16th, 2006

The Guardian has a piece today, as Jane Affleck reports, which trails plans to offer patients an opt-out from having their details uploaded to the NHS ‘Shared Care Record’ next year:,,1973338,00.html

There is a story on the BBC website that tells the exact opposite story, namely that no-one will get an opt out except in the most extreme circumstances:

Isn’t this curious?

We suspect that the Department of Health is planning to announce on Monday an opt-out that they know will be attacked as fraudulent, and is trying to see to it that by Monday the story will be ‘old news’.

The background is this. We understand that the firms writing the software to support the opt-out have been instructed to use the following algorithm:

(1) Each GP’s surgery records will first be uploaded to a hosting centre run by a department of Health contractor;

(2) Then a program will trawl through the data creating a ‘Shared Care Record’ for upload to a central system; this will contain your current prescriptions and things like that;

(3) In respect of each patient who has ‘opted out’, a blank shared care record will then be created and uploaded ‘on top of’ the first one to the central system (whose audit facility will ensure that the original upload can still be reconstructed).

This clearly makes a mockery of the concept of ‘opt out’. If you don’t opt out, then your medical data will be available to any hospital that gives you emergency treatment, and also to the Department of Health. If you ‘opt out’, the data will be available to the Department, but not to a hospital treating you. This is clearly the wrong way round.

The shared care record is just the first step in creating a ‘Care Records Service’ which will unify GP and hospital records, but whose main function is to allow health data to be siphoned off for many other uses. (See yesterday’s BCS report on NHS computing at That is the cornerstone of the NHS IT strategy and no change in it is proposed.

There is a press release from at

So it seems the BBC has a better grasp of what’s going on than the Guardian (though to be fair to them, their usual health man seems to be away this week),

Ross Anderson

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