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The trouble with this issue for the NHS is that UK governments have tried to give away access to the most sensitive of records on a national scale so many times

The trouble with this issue for the NHS is that UK governments have tried to give away access to the most sensitive of records on a national scale so many times now and then rowed back in the face of predictable criticisms that the public would have to be collectively insane to allow broad access to medical records through any centralised system any time soon. It is unfortunate because obviously in principle a single centrally-administered records facility with robust security and audit trails for all access and a Hippocratic Oath level of privacy protections would be far better than the status quo in many ways. But we have no constitutional way to establish adequate legally binding safeguards that some later government can't just overturn for its own convenience in the future.

CRConrad 5y ago
> ...insane to allow broad access to medical records through any centralised system any time soon. > It is unfortunate because obviously in principle a single centrally-administered records facility with robust security and audit trails for all access and a Hippocratic Oath level of privacy protections would be far better than the status quo in many ways. Funny, one would have thought that pretty much is the status quo already: Looks to me like the UK already has (or should have) a single centrally-administered records facility with robust security and audit trails -- isn't that the NHS? If it doesn't at the moment quite fulfill your requirements, it certainly ought to anyway, oughtn't it? So the problem is one of fixing its possible current deficiencies, not one of lacking it entirely. Or?
- Silhouette 5y ago
  The NHS isn't really a single body at all. It's a vast, unimaginably complicated network of healthcare professionals, medical facilities, managerial organisations, supply chains, and so on, under the shared banner of being public-run and with strategic leadership appointed by the central government (modulo some devolution to different parts of the UK at various scales). In normal circumstances an individual's primary point of contact with the NHS is supposed to be their GP, and the GP's surgery will normally hold the main medical records for each person under their care. But then other parts of the NHS, such as hospitals or therapists, may hold their own records in connection with the specialised treatments they provide. There are all kinds of protocols for sharing health records between clinical professionals who are directly responsible for a patient's care and potentially others and successive governments keep meddling with them in ways that make you nervous about those others and what they get to know and what they can do with it.
  - CRConrad 5y ago
    Ah, thanks! I kind of assumed there was some public administrative service run by the national government behind it all. That would have been the logical entity to run a central storage repository, and perhaps to administer and maybe even define the storage and transmission format(s). IMO.

CRConrad 5y ago

> ...insane to allow broad access to medical records through any centralised system any time soon. > It is unfortunate because obviously in principle a single centrally-administered records facility with robust security and audit trails for all access and a Hippocratic Oath level of privacy protections would be far better than the status quo in many ways. Funny, one would have thought that pretty much is the status quo already: Looks to me like the UK already has (or should have) a single centrally-administered records facility with robust security and audit trails -- isn't that the NHS? If it doesn't at the moment quite fulfill your requirements, it certainly ought to anyway, oughtn't it? So the problem is one of fixing its possible current deficiencies, not one of lacking it entirely. Or?

Silhouette 5y ago
The NHS isn't really a single body at all. It's a vast, unimaginably complicated network of healthcare professionals, medical facilities, managerial organisations, supply chains, and so on, under the shared banner of being public-run and with strategic leadership appointed by the central government (modulo some devolution to different parts of the UK at various scales). In normal circumstances an individual's primary point of contact with the NHS is supposed to be their GP, and the GP's surgery will normally hold the main medical records for each person under their care. But then other parts of the NHS, such as hospitals or therapists, may hold their own records in connection with the specialised treatments they provide. There are all kinds of protocols for sharing health records between clinical professionals who are directly responsible for a patient's care and potentially others and successive governments keep meddling with them in ways that make you nervous about those others and what they get to know and what they can do with it.
- CRConrad 5y ago
  Ah, thanks! I kind of assumed there was some public administrative service run by the national government behind it all. That would have been the logical entity to run a central storage repository, and perhaps to administer and maybe even define the storage and transmission format(s). IMO.