NHS computer network will breach venereal disease regulations

EDITOR,--Ross Anderson raises the serious concern of potential breaches of confidentiality because the proposed NHS network has insufficient safeguards to protect patient information.1 Aggregated databases containing the records of tens of millions of patients will be a great temptation for dishonest NHS employees, who could access the network to find sensitive medical health records to sell. It would be a dream come true for the blackmailer. Breaches of confidentiality of the kind envisaged in the editorial have the potential to cause much harm to the individual patient.

I have grave concerns about the network and its proposed extension of access to the wider NHS. The changes, if implemented, will be a serious breach of the NHS (Venereal Diseases) 1974 Regulations. Service provision in genitourinary medicine is based on confidentiality, and this has encouraged patients to seek medical advice. It is not enough to concede that databases on patients with AIDS should not be connected to the network. Because of absolute statutory confidentiality, genitourinary physicians have been able to reassure patients of confidentiality of service and encourage patients and their consorts to attend clinics. There are moral, legal, and ethical arguments in maintaining patients' confidentiality within general medicine and genitourinary medicine and HIV and AIDS in particular. Patient confidentiality, if compromised, will considerably damage confidence in the NHS, destroy the trust that is crucial for a successful clinical relationship, and have a serious impact in the control and prevention of sexually transmitted diseases and HIV infection.