Select Committee on Health Written Evidence

Evidence submitted by the Socialist Health Association (EPR 62)

  The Socialist Health Association was founded in 1930 to campaign for a National Health Service and is affiliated to the Labour Party. We are a membership organisation with members who work in and use the NHS. We include doctors and clinicians, managers, board members and patients. Our interest in public and patient involvement is longstanding. Our members are involved in a wide variety of ways in health and social care. This submission is made on behalf of the Association.

  1.  There is a lot of hysteria about electronic health records. Those of us who have worked inside health institutions have no illusions about the safeguards applied to paper records which in most healthcare establishments are open to casual inspection and interference by anyone who has sufficient determination to find them. Furthermore the paper records are very often not available when needed, even in the institution where they are created. There is almost no system for making records available to any other institution. We think that any decisions made about electronic records need to be put in that context. Electronic records, however imperfect, are likely to be an immense improvement on what exists now.

  2.  We would want to see the most comprehensive information kept in electronic record systems. We are alarmed to discover that it is proposed to exclude mental and sexual health from the record. In our view that seriously undermines the clinical usefulness of the system. It also contributes to the continuing stigma attached to these areas. If this foolish idea continues we hope that it will be possible for patients to decide to include this information in their record.

  3.  It is important that patients have free access to anything in their own record. That should improve trust between patients and clinicians and encourage both to be truthful and to see healthcare as a joint responsibility. For some patients—children and those unable to make their own decisions—it will be important that carers also have full access. We would like to see computers made available in GP surgeries and hospitals which could be used by those who do not have access to their own facilities. Some information in the record may need some sort of interpretation if the patient is to understand it. And the record might include reference to information which is not there—like recent records of blood pressure or alcohol intake. We suggest that it might help confidence in the system if individual patients were able to make their own decisions about who was allowed to access their records and in what circumstances. However we find it hard to see who any clinician could be expected to take responsibility for the care of a patient if they were not allowed access to the record. A system which alerted patients when their electronic record was accessed, if they were not present, might also help instill confidence.

  4.  We would want to see widespread access to aggregated data which did not identify individual patients. Anyone wanting access for research purposes to data about individual patients should need to demonstrate informed consent.

  5.  The question of whether patient data can be adequately protected is a technical one on which we are not qualified to comment. However it seems hard to see how electronic records could be less protected than the existing paper systems.

Martin Rathfelder,

Director, Socialist Health Association

16 March 2007

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