The Government has just published their response to the Health Committee’s report on The Electronic Patient Record. This response is shocking but not surprising.

For example, on pages 6-7 the Department reject the committee’s recommendation that sealed-envelope data should be kept out of the secondary uses service (SUS). Sealed-envelope data is the stuff you don’t want shared, and SUS is the database that lets civil servants, medical researchers others access to masses of health data. The Department’s justification (para 4 page 6) is not just an evasion but is simply untruthful: they claim that the design of SUS `ensures that patient confidentiality is protected’ when in fact it doesn’t. The data there are not pseudonymised (though the government says it’s setting up a research programme to look at this – report p 23). Already many organisations have access.

The Department also refuses to publish information about security evaluations, test results and breaches (p9) and reliability failures (p19). Their faith in security-by-obscurity is touching.

The biggest existing security problem in the NHS – that many staff carelessly give out data on the phone to anyone who asks for it – will be subject to `assessment’, which `will feed into the further implementation’. Yeah, I’m sure. But as for the recommendation that the NHS provide a substantial audit resource – as there is to detect careless and abusive disclosure from the police national computer – we just get a long-winded evasion (pp 10-11).

Finally, the fundamental changes to the NPfIT business process that would be needed to make the project work, are rejected (p14-15): Sir Humphrey will maintain central control of IT and there will be no `catalogue’ of approved systems from which trusts can choose. And the proposals that the UK participate in open standards, along the lines of the more successful Swedish or Dutch model, draw just a long evasion (p16). I fear the whole project will just continue on its slow slide towards becoming the biggest IT disaster ever.