The government has once again returned to the vision of giving each of us an electronic health record shared throughout the NHS. This is about the fourth time in twenty years yet its ferocity has taken doctors by surprise.

Seventeen years ago, I was advising the BMA on safety and privacy, and we explained patiently why this was a bad idea. The next government went ahead anyway, which led predictably to the disaster of NPfIT. Nonetheless enough central systems were got working to seriously undermine privacy. Colleagues and I wrote the Database State report on the dangers of such systems; its was adopted as Lib Dem policy and aspects were adopted by the Conservatives too. That did lead to the abandonment of the ContactPoint children’s database but there was a rapid u-turn on health privacy after the election.

The big pharma lobbyists got their way after they got health IT lobbyist Tim Kelsey appointed as Cameron’s privacy tsar and it’s all been downhill from there. The minister says we have an opt-out; but no-one seems to have told him that under GPs will in future be compelled to upload a lot of information about us through a system called GPES if they want to be paid (they had an opt-out but it’s being withdrawn from April). And you can’t even register under a false name any more unless you use a stolen passport.