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Auf wiedersehen, national programme for IT

Privacy concerns, chronic delays and mounting costs – now an incoming government has decided to shelve an ambitious national care records project, writes PulseToday editor Steve Nowottny.

Privacy concerns, chronic delays and mounting costs – now an incoming government has decided to shelve an ambitious national care records project, writes PulseToday editor Steve Nowottny.

Not in England, of course – or not yet, at least. But in Germany, after a coalition government won the election, the new health minister Phillipp Rösler has taken the decision to dramatically downsize the country's £1.5 billion e-health card scheme.

The idea of the scheme – similar in scope but very different in application to the Summary Care Record rollout – was for every citizen to be given an electronic card which held their health data, medical history, prescriptions and insurance status.

The scheme was supposed to have been used by Germany's 72 million health insurance company customers from January 2006, every time they saw a doctor or went to the pharmacy – but it has been substantially delayed.

ComputerWorld reports:

'Doctors and other German health industry experts had raised vocal concerns, over the feasibility of the technology, the costs of buying equipment to read the cards, and the security of the data. Last year, there were even doctors' marches in the street, in protest to the plans.'

The scheme hasn't been abandoned entirely – according to Computer Weekly, ‘cards will continue to be issued in specified trial areas but will contain only the patient's basic personal data, insurance status, a photograph and a small set of health data in case of emergency if the patients has agreed to this information being put on the card.' But the move signals a massive reduction in the ambitions of one of the most extensive e-health communication projects in the world.

Will the National Programme for IT, and in particular Summary Care Records, suffer a similar fate?

Many grassroots GPs will no doubt hope that where Germany leads, England follows. But things are not as straightforward as they once were. In fact, over the past few months, as the national rollout of the Summary Care Record reaches a critical phase, GP leaders have been tying themselves in knots trying to work out where exactly they stand on the project.

The BMA was, of course, previously highly critical of the national programme, frequently raising concerns data security and implied patient consent. But in December, Dr Grant Ingrams, chair of the GPC's IT subcommittee, actually attacked plans to scale it back– warning of a possible impact on patient care.

The RCGP, meanwhile, has swung the other way. In June, the college's chair Professor Steve Field and vice chair Dr Clare Gerada backed the scheme, saying that: ‘We had concerns over this scheme initially but now believe there are enough checks and balances to make it a significant move forward in patient safety and clinical care.'

This week, though, Professor Field changed tack. ‘It has cost a lot, hasn't it?' he told the Westminster Health Forum. ‘The idea was right, but the easier solution is to have local solutions that work and national standards that they adhere to.'

But while GP support is helpful to a massive care record rollout from the centre, both the German experience and our own over the last few years has shown that it's by no means the deciding factor. Like it or not, the future or otherwise of the UK's national care records project ultimately will depend on the next Government.

Only time – and a general election – will tell.

Steve Nowottny

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