Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1996
Licence: Open Government Licence
Credit: Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology. Source: Wellcome Collection.
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![16 April 1996] Lord Craig of Radley contd.] (Dr Anderson) I think that is what we will have to do. Lord Flowers 422. We are all having to deal with that problem, are we not, because more and more the press take it upon themselves to announce our results before we are ready? Admittedly not in everything that goes on but in anything that is potentially publicly exciting that is what tends to happen so the peer review and all that goes out of the window. (Dr Smith) It does, but how many of us as scientists would really take notice of what is in the paper except as an idea? We actually wait for the verified— 423. But your patients will and the public in general. (Dr Smith) But we deal with that now, my Lord. (Dr Macara) I think we should be aware of the fact that the Chief Medical Officer has taken a great deal of trouble to set up a mechanism which ought to secure, if you like, the probity of urgent communications, as the Department calls them, until such time as they are in the hands of those who need to know in the interests of ensuring that patients can have the best advice and so on. That wretched example of the Pill scare, the third generation Pill scare last October, has done so much damage with unwanted abortions and so on. What happened was that one of the individuals initially receiving the information and bound to confidentiality had a wife in the media who could not resist taking advantage of a scoop. That, it seems, is something we also have to live with. May I just add one little point. I am trying to monitor as we go along the points that we are making. We have been discussing the problems about new work, if you like, coming on the record and getting into the Internet and so on before it has really been validated as fully as we would like. I would have thought that in terms of everyday practice as distinct from the new work, the review work is almost in a routine sense more important, in other words clinical audit. It is important to emphasise that there is now an_ unequivocal professional commitment to clinical audit right across the board, and indeed again the BMA is happy to be able to show that it is practising what it is preaching in literally accommodating the National Centre for Clinical Audit along with our friends the Royal College of Nursing, and with funding, I am glad to say, from our friends the Department of Health. We do begin to have mechanisms not just for getting information which assists best practice but for propagating it. Lord Haskel] I was just going to make a comment, my Lord Chairman, while we are discussing this matter of patients having information. Of course, this is nothing new. I remember as a child we used to have a book at home, I think it was published by a soap manufacturer, and if one of the children were ill my parents would look through the book, identify the symptoms and the book would tell you what to do. This was a way in which we saved money by not going to the doctor. [ Continued Baroness Hogg 424. The BMA publishes books of this kind! (Dr Smith) Peer reviewed. Lord Flowers 425. Could we just have a word at not too great a length on security and confidentiality. It has come up in at least three forces already today: keeping records and transactions __ confidential; preventing falsification and corruption deliberately or otherwise; avoiding covert surveillance of medical practice, all these we have touched upon. You have been good enough to put on our tables today, or somebody did on your behalf, a report on Security in Clinical Information Systems. That will be very useful when we have had a chance to read it, I am sure, because I have glanced at it quickly. It makes the whole problem seem very complex, very difficult, very alarming and full of holes and therefore the question one is bound to ask to start with is, is it really necessary to have such an emphasis on confidentiality? I know it is the ethical background of the medical profession but we have to learn to change these things when they become impossible to operate. I just wonder whether information technology has not perhaps reached the point where some of our precious things are going to have to go. Quite apart from that I wonder whether Dr Anderson could summarise the essential points from this report since we have not read it but I do not want him to have the whole of the floor because I would like to see what medical doctors say about it too. (Dr Macara) I am sure Ross will be happy to lead. (Dr Anderson) Well, my Lord Chairman, when we are talking about the security of clinical information as opposed to the other things we mentioned earlier such as the security of administrative information, there are basically two concerns: privacy and safety. It may seem at first sight that the two are sometimes in conflict. For example, if you have a heart condition then you want this to be known to any ambulance team that may happen to rescue you after you collapse in the street. However when you start looking at things in detail the conflict is not that acute. In the case of people with conditions that ought to be known to carers, for example, such as heart conditions then the standard operational procedure is to carry an emergency medical card. This means that the relevant information can be made available to those who need it without it being generally broadcast in circumstances where it might be used against the patient, for example in credit reference enquiries. Now looking at the broader picture, what we find is that in medical systems, unlike say in the traditional banking or military systems where most security technology was developed, there is a requirement for security to be controlled by the user or for practical purposes by the user’s advocate who would usually be the general practitioners. We do not have the environment where you have completely centralised control and centralised access to all information. The reason we cannot have this is if you create a large database with the information on everybody in the country in it, it might be convenient but then hundreds of thousands](https://iiif.wellcomecollection.org/image/b32218631_0018.jp2/full/800%2C/0/default.jpg)
