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Have nothing to do with care record mess

From Dr Declan Fox, Newtownstewart, County Tyrone

Have we all truly lost our brain power in recent years? Have we so dismally failed to take on board one of the central tenets of nGMS – no new work without new money?

Your story 'Opt-in care record is 100 years work' (News, 3 May) was remarkable indeed for what it didn't state – that somehow we have allowed ourselves to be manoeuvred into taking responsibility for a vital part of the farrago of nonsense that is Connecting for Health.We have the BMA, GPC IT subcommittee, GMC, Medical Protection Society, patient choice tsar and Connecting for Health arguing over precisely how much work will result for GPs if patients get the choice to opt in. Since when did any part of this godawful mess become part of GPs' work?At what point, in what carefully minuted meeting between which bodies representing GPs and the Department of Health, was it agreed that GPs would take on responsibility for explaining this IT white elephant to patients and asking their consent for uploading their records?This project is not our idea. We have far more important things to do with our valuable time. We should have nothing to do with explanations or seeking consent.

• From Dr Mark Field, Crewkerne, Somerset

Regarding your leader article (Comment, 3 May), I hope patient choice tsar Harry Cayton has mistaken early May for the first of April. It must be an April fool's joke that the managers for the national care record would expect GPs to counsel and obtain informed consent from patients to include their records.

This is a job for the managers and their legal team to perform to the satisfaction of the patient, and then at that time only should we allow access to our electronic information.It is the doctor's role to ensure informed consent has been reached. The current guidance is that the person who is explaining to the patient about access to their records needs to be properly trained and, in a case of access to patient records, they must sign a consent form to confirm that they have adequately discharged their duty. Once this has been done and a doctor is satisfied then the records are released. Certainly, in my practice once a valid consent form is presented to the surgery (provided there is no contentious information) the requested information is forwarded to the requester without further consultation with the patient.However, I do feel sorry for Harry Cayton as it will be his team who has to try to achieve 63 million sets of informed consent to ensure the data set is complete.If they want their database complete by 2010, I calculate that as roughly 66,000 consents a day. He will be a busy boy.

• From Dr Chris Woods, Bolton, Lancashire

The Government tries to link the NHS deficit with doctor earnings. GPs have worked hard for their pay rise and have performed to an excellent standard in the QOF and so on. Perhaps the Government needs to look at its own performance to see where the real causes of the deficit lie.

The NHS National Programme For IT (Connecting For Health) which includes Choose and Book, the summary care record and electronic prescribing, was initially costed at £2.3bn.This soon rose to £6.2bn and now stands at £12.4bn, according to the National Audit Office.Perhaps the Government should try Disconnecting For Health and spending the money more wisely.

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