PERSONAL medical information on 50 million people will be put on a new national NHS database, whether those affected give their consent or not.

Details of the design of the system, which is expected to cost £2.3 billion, have not been disclosed publicly. However, a 600-page set of documents issued to IT suppliers and seen by Computer Weekly makes it clear that nobody can opt out of the system, which is designed to computerise all NHS patient records.

The benefits of having instant access to everybody’s records on a single “data spine” will be huge, the Department of Health says. It will eliminate the problem of lost or missing records, and ensure that any doctor treating any patient will be aware of the medical history.

However, doctors and IT specialists say that the dangers of security breaches are also huge, and that patients’ attitudes towards computerised records have not been properly taken into account.

Paul Cundy, a GP and the British Medical Association’s spokesman on the use of IT in primary care, said that the specification had been issued without doctors being consulted. GPs already use their own dedicated computer systems, which work well and are as secure as a physical record since they are contained within the surgery. “But once you connect such systems to the outside world it is a completely different issue,” Dr Cundy said.

He has a few patients who do not want their records stored electronically, even in the existing systems. However, the specification makes it clear that this option will not be open to patients when the Integrated Care Record System comes into operation.

A patient will not be able to refuse to allow personal data to be made available to the “spine”, the specification says. Instead, patient consent will be sought for the release of the data for further medical treatment. Patients may refuse this permission, but in “exceptional circumstances” a clinician will be able to override a refusal and access the data without the patient’s consent.

IT experts such as Ross Anderson, of the University of Cambridge, say that the NHS system will be wide open to abuse. Dr Anderson is chairman of the Foundation for Information Policy Research, which has strongly criticised the NHS plans.

In response to a consultation into the plans, the foundation said that making so much information available to so many NHS administrators and civil servants was unethical and would lead to growing abuse.

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