GPs and their families urged to boycott NHS ‘spine’

GP representatives are advising GPs and their families to consider withdrawing themselves from the NHS spine “as an example to the nation” because of concerns about the confidentiality of demographic data.

Last week’s local medical committees’ conference voted in favour of a proposal to advise GPs to consider withdrawing from the spine after hearing about access to the personal demographics service (PDS) which holds demographic data on every patient in England.

Dr Preston de Mendonca, a GP in Plymouth, Devon, told representatives that he was very concerned about the security of the “single biggest public database in this country.”

He told the conference that the PDS could be accessed with an NHS smartcard and claimed there are about 250,000 NHS smartcards in circulation including about 50,000 in general practice.

He added: “Any lock that can be opened by 50,000 keys is not secure.”

Dr de Mendonca claimed it was possible for anyone with a smartcard to access the PDS and use it to find the address of any other person on the spine in England.

He told the conference: “It doesn’t matter whether there’s an audit trail, there are going to be millions of footprints in the system. We are the guardians of our patients’ confidentiality and if we don’t have a view about this then who will.”

A total of 54% of representatives voted in favour of the proposal with 46% against despite a speech in defence of the PDS from Dr Gillian Braunold, national GP clinical lead for Connecting for Health and a GP in London.

She told the conference that the spine was subject to eGIF level 3 security, that an audit trail would detect unauthorised access and that ‘stop-noting’ would mean those with legitimate reasons to withhold their data from the spine, such as abused partners, would be able to do so.

She added: “There are many, many safeguards and the clinical leads are continuing to work with CfH to bring the concerns of the profession into CfH. If you vote for this the views of GPs are the views of conservatism and you will be disabling benefits to patient care.”

Dr Paul Cundy, chair of the IT sub-committee of the British Medical Association’s General Practitioner Committee (GPC), had told the conference that the sentiment was consistent with GPC policy which was that individual patients should make their own decisions about the PDS but he questioned whether it was appropriate for the conference to advise individual doctors what to do.

The conference also backed a motion calling for an opt-in consent model for the NHS Care Records Service, reaffirming GPC’s policy which is contrary to the opt-out model proposed by Connecting for Health. The same motion, which was passed by representatives, called for progress on the National Programme for IT (NPfIT) to be halted until “all matters of confidentiality are assured.”

Dr Richard Dales, from Herefordshire LMC, failed to convince representatives that they should vote for the whole programme to be abandoned.

He described NPfIT as a “juggernaut out of control” and added: “Now is the time to spend this huge sum of money elsewhere.”