Intended for healthcare professionals

Head To Head

Do summary care records have the potential to do more harm than good? Yes

BMJ 2010; 340 doi: (Published 16 June 2010) Cite this as: BMJ 2010;340:c3020
  1. Ross Anderson, professor of security engineering
  1. 1University of Cambridge, Computer Laboratory, Cambridge CB3 0FD
  1. Ross.Anderson{at}

    Ross Anderson argues that the national electronic database of patient records is not fit for purpose and illegal, but Mark Walport (doi:10.1136/bmj.c3022) believes that it will make valuable contributions to better care

    A digital medical record system that shared information when appropriate between care providers, and was dependable and safe, would be of great value. However, the summary care record isn’t it. It must be abandoned—for reasons of safety, functionality, clinical autonomy, patient privacy, and human rights.

    The summary care record was marketed to the public as a way for accident and emergency staff to check up on unconscious patients. According to Tony Blair, if you ended up in hospital in Bradford, doctors could look up your records with your general practitioner in Guildford. But this is nonsense. Very few patients have conditions that must be made known to emergency staff; for those that do, the properly engineered solution is MedicAlert.1 Unconscious patients often can’t be reliably identified, so a database is less robust than a tag or card; the record doesn’t have everything accident and emergency staff might want to see; and it is not even available in Scotland (let alone on a beach in Turkey).

    The truth is that the summary care record was designed to accumulate large …

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