We think the ladies protest too much . . .

As we drove one of our many practice Ferraris home from ND Central this evening across the high moorland and forest covered hills of rural Northernshire we were listening to the bleatings of a poor Northernshire citizen an alleged victim of the current cause celebre in the UK the phone hackings by the Press of certain peoples’ private data.

In medicine we would call this a breach of confidentiality which is a serious charge against a doctor and yet the loudest of the little bleaters was not one of the numerous maturing lambs we drove past on our way home but one of the biggest advocates of weapons of mass disclosure in our history none other than Gordon Brown something MP, sometime unelected Prime Minister and “saviour” of the World from the destruction of his own making.

On the Radio 4 news programme this evening he said as follows and if there are any factual typographical errors in this transcription it is because we are not audio/touch typists (our press officers had gone to get a late appointment but they were delayed due to leaves on the line):

“. . . if I with all the protection and all the defenses and all of the security that a chancellor of the exchequer or a Prime minister, am is so vulnerable to unscrupulous tactics, to unlawful tactics methods that have been used in the way we have found, what about the ordinary citizen?"

Yes what about the ordinary citizen Mr Brown? It is reckoned that perhaps 4000 peoples’ mobile phones in a population of 60 million have been hacked but you were, in your ignorance and while in power, more than happy to rush through a process to allow 60 million UK residents’ personal medical records to be uploaded without their active consent on to an inherently insecure government sponsored database with at least a million plus users?

Try doing something you have never done in your life called thinking. Which network is most likely to be hacked? Which network has the most holes?

If you are outraged by the disclosure of your family’s records to a select few journalists via dubious means how do you think an “ordinary citizen” will feel when their medical records are hacked for £ 20 of smack to a receptionist dismissed for drug misuse whose smartcard has not been cancelled? That is how easy it is to hack the Summary Care Record.

That is your creation, it is flawed and useless and if you feel that the disclosure of your childrens’ medical records is a problem then perhaps you ought to start thinking instead of bleating with your political colleagues like a Northernshire lamb.

Praise be to the Party for all of their leaders’ concerns about the confidentiality of the privileged. It would seem that they are all biting the hand that feeds them but what will happen when the hand slaps back?

More importantly when will they finally realise the inherent dangers of centralization of patient’s confidential medical information?

NHS Rangers lead the Way Confidentialiy #2 -> 20 years on.

Fast forward 20 years to another galaxy closer to Northernshire. A good mate of ND invited ND down South to show how you could see X-rays, CT scans and MRI scans taken at the local hospital on a GPs’ desktop computer. Given the far North where ND works and distances involved this was a wonderful invention and could be of so much use until ND asked was it available to all?

ND was disappointed to hear that a few pilot practices had got this system with obvious benefits e.g. GPs seeing fractures on patients requesting home visits after A&E attendances that had been missed by more junior A&E Drs and even incorrect radiology reports being corrected because of the ability of a local GP to actually see x-rays with the patient at the same time.

ND’s former comrade at arms told him how a patient had seen them and as a result he had saved the local Politburo a few grand because the x-ray report was wrong from the radiologist but ND’s friend had years of experience at looking at this type of x-ray and so correctly treated the patient purely because of the ability to see the incorrectly reported x-ray and the patient at the same time. If he had relied on the type written report several tens of thousands of pounds of compensation would ultimately have been paid out.

(Aside: in medicine the ideal is that you see the patient and the x-ray together. In some of Northernshire patients were sent for x-ray by their GPs and the reports came back from overseas some 3 months later due to a shortage of radiologists in the UK. Another reason why this could be useful but we digress dear reader.)

However the good comrade commissar idiot managers at the local Politburo had decided to restrict its roll out to further practices while encouraging and forcing the use of Choose and Book, Connecting for Health and Summary Care Records against the wishes of local GPs and most informed patients.

The reason?

“Patient confidentiality”.

Déjà vu or what?

The local Politburo felt that a roll out of the ability of a few 10s of local GPs to see a few 10s of thousands of patients’ X-rays from the local hospital serving a 100,000 patients would breach “patient confidentiality” while the roll out of the ability to see 60 million records by over a million unaccountable users would not.

NHS Rangers lead the way onto victory.

Praise be to the Party for they see what ND and other GPs cannot. Patient confidentiality. And they don’t treat patients.

NHS Rangers lead the Way Confidentiality #1

ND has for as long as ND can remember been aware of the duty of confidentiality with regard to patients’ medical information. It was drummed into ND from basic training onwards. Indeed ND and the team have often been accosted by a patient’s friends/family/employers’ when they find out from the patient that ND or the team have been giving the patient sick notes sometimes for years which the patient’s friends/family/employers’ have not appreciated.

NDs’ team did not tell their patients’ friends of this relationship the patient did. The Team knows what confidentiality is, how valued it is by patients and that it is a keystone of good ethical medical practice.

However, NHS managers and the Party have a different view on this issue.

They want all of the population to give their medical data, without consent to the Party, but as a responsible Party they are not prepared to do the same with their medical information. Certain senior Party comrades will not have their medical details on the system as they enjoy the Blair option (for they are Holy and divine) unlike the people that they serve and enjoy the all Pigs are equal option of opt in or else but some Pigs, as they are Holy, may opt out.

Many, many light years ago in a galaxy far, far away ND was a junior grunt. While toiling in the small hours mindlessly but conscientiously labeling small bottles with patients’ names, ranks and serial numbers ND noticed in the faint light provided by the hurricane lights that there was a computer and a printer by the side of ND that could print labels faster than ND could write them. To label all the samples required for a sick patient with meningitis would take ND 20 minutes but, if labels were printed, this labeling process would take less than 5 minutes so speeding up the diagnostic and treatment process.

So ND did ask of the seniors why, during daylight hours, were labels printed off by the ward clerks, but at night this did not happen?

(Hint: clerks work 9-5 grunts work all hours). They did not know and suggested several people that ND could speak to about having access to printing labels at night a seemingly simple task.

ND, feeling supported in this matter, did follow the leads for 2 months rising higher and higher into the intellectual black hole known as Management with each level saying “I don’t know sounds like a good idea I will ask the next level” up until he eventually reached the high point the Manager person dude who could explain the inefficient use of resources (capital purchase of expensive technology used only one third of daylight hours but available for 24 hours with a limited life expectancy, use of lowly paid junior staff to write labels, delays in patient diagnosis due to inefficient use of doctors time and skills, ward clerks employed for a mere 8 hours a day).

ND had reached the summit and hoped that ND would see into the chosen land and be able in matter of seconds to print off enough labels to avoid nights of 20 minutes of handwriting while dealing with seriously ill patients.

Did ND achieve this simple task of access to a hospital’s computer system out of hours?

No.

ND did not.

The reason?

“You cannot print sticky labels at night because it is a breach of patient confidentiality.” (Crawl back into your hole worm and use your pen).

“So clerks can print labels with the same information on them as grunts can write and that does not endanger ‘confidentiality’ ”. (Yes worm)

NHS Rangers protecting your confidentiality from doctors but not from managers and the Party (and speeding up your child’s treatment by delaying prompt diagnostic tests while a junior grunt handwrites labels next to an idle printer).

Remember, where were the managers and ward clerks when grunts were handwriting labels next to idle printers and your child was ill?

In bed, thinking, and protecting patient confidentiality as they always do 24/7.

Rangers lead the way.

Praise be to the Party.