When reorganising health services becomes an Olympic sport, Team GB is sure to do well. Our politicians’ enthusiasm for change seems unrivalled. The only problem I foresee is their tendency to promise more than they deliver. Take the 2000 NHS Plan, for example. This included two pledges to provide patients with more information. The first stated: “Letters between clinicians about an individual patient’s care will be copied to the patient as of right.” The second: “Patients will be provided with smart cards to allow easy access to their medical records.”

Eight years on, in a threatening economic climate, the unedifying saga of Connecting for Health, the NHS’s £12bn (€15bn; $20bn) computerised records system, continues. Recent concerns—raised by a review of the programme (www1.imperial.ac.uk/resources/4565EF18-662B-448B-90C2-E7372B4C2E09/) and “live” experience with smart cards in one NHS trust—have centred on its potential to put patients at risk of iatrogenic harm. Now its very future is being questioned (Financial Times, 28 Oct, www.ft.com/cms/s/0/50b13312-a48f-11dd-8104-000077b07658.html).

Progress on copying letters has been …