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'Opt-in care record is 100 years' work'

Asking every patient to opt in to the controversial new electronic care record would take 100 years of GPs' time, the Government is claiming.

Patient choice tsar Harry Cayton made the dramatic claim in an attempt to silence growing unease among doctors about the controversial implied consent model being used by Connecting for Health.It follows a Pulse investigation showing two-thirds of GPs oppose the implied consent model and a BMA demand that explicit consent should be sought from every patient.The dispute stepped up a level last week as the health select committee began hearing evidence for its inquiry into the electronic care record.Mr Cayton told MPs an opt-in model would overwhelm GPs. 'It would take 100 years of GP time to go through the consent process for every single patient in the country,' he said.The BMA retorted by claiming the figure was grossly misleading and reasserting its view that an implied consent approach was a threat to confidentiality. Dr Paul Cundy, chair of the GPC IT subcommittee, told Pulse the 100-year estimate was based on a new system being brought in overnight. 'That may be a figure you can compute but I don't think it's relevant to the real world,' he said. 'It can be done on a slower uptake rate as patients come in and see their GP opportunistically.'In its written evidence to the select committee, the BMA said GPs should seek patient consent to upload new information onto the care record at the end of every consultation.Connecting for Health is pushing ahead with the implied consent model in its summary care record pilot at 11 practices in Bolton. Letters have been sent to all patients giving them eight weeks to opt out or have their details automatically uploaded. A spokesperson said just 0.17% of patients had opted out so far.GMC policy adviser Michael Keegan said the forms being used in pilot areas allowed patients to 'request' an opt-out but did not guarantee the right to do so. 'You have to wonder why that is,' he said. 'As many more uses of the information are in place, such as for research purposes, it's going to become more difficult to allow people to maintain that opt-out.' Dr Julie McMillen, whose practice is taking part in the Bolton pilot, said only 16 of its 4,500 patients had chosen not to have their information uploaded. 'It feels like GPs are more concerned than patients,' she said. 'Very little discussion has happened in consultations, and when I've brought it up with patients they all seem to think it's very sensible.'The controversy looks set to feature at next month's LMCs' conference after Devon LMC submitted a motion demanding a public inquiry and warning: 'The public are sleepwalking into a medical confidentiality disaster.'A national roll-out of summary care records will begin next year, with every patient in England who does not opt out due to have one by 2010.

• Opinion, page 25

Opting in or opting out?

For opt-out • Patient choice tsar – 'opt-in would take 100 years of GP time'• Medical Protection Society – opt-in would 'place an unrealistic administrative burden on highly pressed clinicians'• GMC – 'no good basis for obtaining explicit consent'For opt-in• BMA – explicit consent should be sought for every upload of information• 67% of GPs in Pulse poll opposed implied consent model

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