Intended for healthcare professionals

Rapid response to:

Head To Head

Do summary care records have the potential to do more harm than good? No

BMJ 2010; 340 doi: (Published 16 June 2010) Cite this as: BMJ 2010;340:c3022

Rapid Response:

Straw man arguments

Mark Walport delivers many of the typical straw man arguments put forward by those who demand Summary Care Records.

The way in which his health information is being stored is not changing. His GP will continue to store detailed consultations electronically in what are widely regarded as some of the best record systems in the world. Whether he opts in or out of the SCR will not affect how his GP stores this data. But what is changing that his health information is being extracted and disseminated.

Walport talks about incomplete and lost health records. The Summary Care Record cannot nor ever will replace local detailed care records held by GPs and hospital trusts. There's no question that transfer from paper-based to secure, electronic storage of hospital records is necessary, but the SCR has nothing to do with that, and indeed its abject failure cannot and must not hinder that migration.

He is correct when he states that the foundation for much of this research is information contained in patient records. But it is the data-rich, locally held GP and hospital records that contain the information that he so desperately wants to mine - not the incomplete, possibly inaccurate and (at present) very limited SCR. Lawfully and ethically consented data extraction from detailed care records will prove useful to research, but it will never find oil in the barren fields of the SCR.

The SCR aims to share data in a way, and under a consent model, that the BMA, LMCs and very many GPs do not agree with. There is a clear need for secure IT messaging systems that push or pull information directly and only between the clinicians who are truly involved in the care of the patient. The widespread broadcasting of highly personal information via the SCR is flawed in design and not just in implementation. The latest UCL report simply confirms that.

Competing interests:
author of and one of many urging for an opt-in consent model

Competing interests: No competing interests

17 June 2010
Neil Bhatia
Yateley GU46 7LS