NHS = No Health Secrets?

NHSSo there’s a plan afoot to upload all your NHS records to a central database. That’s not such a bad idea if it means that anyone who treats you has immediate access to your complete medical history.  In fact that was the idea behind the National Programme for IT, a multi-billion pound programme which was ignominiously abandoned a couple of years ago.

This time round it’s different because it’s not being done for clinical reasons. In a leaflet sent out with the junk mail you get through the post, the NHS says that the data will be used to see how well the organisation itself is doing and where improvements need to be made. It avoids spelling out exactly who will get access to the information, but does say that:

NHS organisations share information about the care you receive with those who plan health and social care services, as well as with approved researchers and organisations outside the NHS(my emphasis).

‘Approved researchers’ could include insurance companies, pharmaceutical corporations and the like.

The data uploaded will need to be able to identify you personally so that the information from various NHS sources can be brought together. But the leaflet tries to reassure readers:

Records are linked in a secure system so your identity is protected. Details that could identify you will be removed before your information is made available to others, such as those planning NHS services and approved researchers.

Even if the database itself is secure (and the Bradley Manning and Edward Snowden cases suggest that putting large amounts of data together in one place where lots of people can access it is an invitation to leak) it doesn’t mean that the information in it will stay private.

Mark Davies, the Public Assurance (sic) Director of the Health and Social Care Information Centre, which is running the project, even admitted to the Guardian newspaper that there was a “small risk” that patients could be “re-identified” because health sector companies had their own medical data that could be matched against the “pseudonymised” records. Who’s he kidding? By now we all know that there is much more information stored on each of us than anyone cares to admit and companies will soon be working flat out to match it all up with our medical histories.

The leaflet says you have to speak to your GP practice to opt out of your records being passed on in this way. But in fact all you need to do is fill in a form and deliver it to your surgery. There’s a web site – medConfidential – where you can download a form.

If you value your medical privacy you should fill it in.

What particularly galls me about all this is that the information has been sent out in junk mail.  If you’ve opted out of receiving these unaddressed Royal Mail deliveries then you may never have known what’s going on and of course your medical records will be uploaded by default. I only found out from John Naughton‘s weekly column in the Observer, which I would recommend for those that have an interest in how technology is impacting all our lives, whether we like it or not.

Government by numbers – statistics and lies

The headlines yesterday included the news that the UK unemployment rate has fallen to 7.1%, apparently the best since early 2009. But the comments and discussions that followed are a reminder of the dangers of using statistics as a shorthand for government achievements.

For a start the 7.1% is a national figure and disguises significant variations. For those under 24 not in education, 18.1% are out of work and more than a quarter of these have been looking for a job for over a year.

Nor does the headline figure mean that all problems have been solved for those people who have found work. The newsworthy figures don’t show how many more jobs are only part-time, temporary or on zero-hour contracts. If there’s no guarantees of actually work in a role that can be whipped away at a moment’s notice, it hardly counts as a success. The resulting low wages also mean that for the first time since records began the majority of people in poverty are actually in working families, according to a report from the Joseph Rowntree Foundation published last December. And Ed Miliband claims that average wages have gone down £1,600 a year since the 2010 general election, making it tougher for everybody. Employment figures only tell part of the story of how well we’re doing.

Government figures always need to be taken with a pinch of salt. They can be selective and misleading after ministers apply their own spin. But they can also be just plain inaccurate or self-fulfilling.

Last week the UK Statistics Authority, the independent body who’s aim is to safeguard the production of official statistics, downgraded the crime figures for England and Wales because of a belief that the police figures may not be reliable. In its Statistics on Crime in England and Wales report the organisation refers to comments from the Office of National Statistics (ONS) that the problem in crime figures could be due to the fact that ‘a growing number of crimes reported to the police are not being captured in crime recording systems’.

Just today, the National Audit Office released a report into NHS waiting times for elective care in England which found significant errors and inconsistencies in how NHS trusts record waiting time, masking ‘a good deal’ of variation between trusts in actual waiting times.

Even if reported government figures are correct, they may not be all that they seem. My own favourite example also relates to the NHS and the government’s aim of ensuring that patients can see their GP within 48 hours. In the case of my local surgery, the initial response was to ensure they fulfilled the target by not allowing appointments to be booked more than two days in advance. If there were no slots available, tough. It resulted in a Glastonbury-like phone scramble every morning as people speed-dialled to try and book an appointment – heaven help those too ill to participate. But it helped the government to claim that the 48-hour rule was being complied with.

Another example of figures not quite being what they seem is the recent panic over immigration, now that Bulgaria and Romania are in the EU and their citizens entitled to work in Britain. Leaving aside the way the government has spread panic about an invasion of workshy foreigners, it turns out that the goal for reducing immigration is actually based on net migration, i.e. those arriving minus those leaving the country. So the target can equally be met by getting more people to leave the UK, which means there are alternative solutions. One springs to mind. Bankers are continually threatening to leave the country if their bonuses are cut or taxes increased. So with one piece of legislation we could simultaneously prevent the increasing wealth inequality in the UK and at the same time reduce immigration. A win-win.

When you hear the claims of government success based on a set of figures, it pays to look more closely. Check, if you can, to see if the numbers are accurate, what they actually mean and if they tell the whole story. Remember, the police can’t even get the crime figures right.

The light at the end of the tunnel has been switched off

© anna for openphoto.net

Before the last general election I advocated staying away from the polls. It seemed to me that there’s no real choice, so why bother to vote.

But I’m a concerned citizen. I studied politics in the dim and distant past, stood as a party candidate in local elections, although safe in the knowledge that there wasn’t a snowflake’s chance in hell of being elected where I lived, and sometime later was co-opted onto a (non-party) Parish Council, where I was part of the fight against fly tipping and dog fouling.  So when it came to the voting crunch I took the ‘undecided’ option and put my cross against the Liberal Democrat candidate.  I should have taken my own advice.

The coalition that formed after the last election has reinforced my non-voting stance. It’s become obvious in recent years that the governments we now elect in the UK only have two goals. The first is to stay in power and the second is to further their party ideology (provided that it doesn’t interfere with the primary objective).

Now call me stupid, but I thought the role of government (via parliament) was to do the best it can for the people it represents, i.e. all of us, although they may have different ways of going about it.  Not now. The coalition government’s aim is unashamedly to pursue its own ideological view of how the country should be run.

We, as a nation, are in debt. Fair enough, we need to do something about it. (And let’s not waste time and energy bickering over whose fault it is – just look around and it’s clear we’re not the only ones).  If you or I get into debt then we cut back on spending until we’re solvent again and then stay within our means so it doesn’t happen again.  Life may be hard in the meantime, but there’s light at the end of the tunnel. Stick at it and things will get better when the debt’s paid off.

That’s how you would expect it to be for the country as a whole. Chancellor of the Exchequer George (Gideon) Osborne insisted that government cutbacks needed to be drastic because of the level of debt the country’s in. We all need to tighten our belts. That makes some sense.  But last month, in a speech at the Lord Mayor’s Banquet in London, David Cameron said:

“We are sticking to the task. But that doesn’t just mean making difficult decisions on public spending. It also means something more profound. It means building a leaner, more efficient state. We need to do more with less. Not just now, but permanently.”

So there it is. The light at the end of the tunnel has been officially stamped out.  Cuts will continue until government spending reaches some pre-determined level set by a handful of millionaires. It’s not about the lives of the people the government is supposed to represent, it’s some ideological view of the way things should be done. The NHS will never get any more money, libraries forced to close will never reopen, support for the arts and local communities will wither away and many more jobs will be lost. If David Cameron gets his way, it’s not going to get any better. Ever.

This is not what representative government is supposed to be about and it undermines any belief that it’s worth voting. Maybe if we all withhold our vote we can shame the politicians into research-based, citizen-centric policy implementation. I don’t see how else we can do it.

Thanks to Peter Hain

There’s nothing I can add to the tributes to Nelson Mandela that have been made in recent days, culminating in his memorial service in South Africa. But it’s very hard to imagine anyone who’s been locked up for 27 years and then emerges to worldwide acclaim and support not looking to get back at his captors in some way. It was that focus on negotiation and reconciliation with those that might have been his enemies that marked him out as great.

It gives some satisfaction to know that the UK was active in the anti-apartheid movement that led to global sanctions, Mandela’s release and the ultimate end to the regime. Support was not always official – the Thatcher government maintained that he was a terrorist throughout – but popular support for the movement, of which Peter Hain was a prominent figure, held sway.

I remember it well. While a young student at a small northern college I made my own pathetic gesture against the 1969-1970 Springbok rugby tour. But the Stop the Seventy Tour campaign, of which Peter Hain was chairman, caused major disruption to the South African team’s visit and resulted in sporting isolation for the country. That hurt the sports-loving nation.

It’s hard, now, to remember the strength of feeling that apartheid raised for many years and the protests and demonstrations in the UK against the regime, but if you were there then the memory lives on. The involvement of Barclays bank in South Africa, for example, led to a student boycott and I’m probably not the only person that has never been in a branch of the bank since.

Hain played a significant role in raising awareness and organising protests, for which he doesn’t get as much credit as he deserves, at least from some quarters. And it was at no little risk to himself. He was once sent a letter bomb (which failed to go off) and was also acquitted on a bank robbery charge, allegedly framed by the South African Bureau of State Security.

At least he must have got some satisfaction this week in Parliament when he told it like it was – who among the politicians and parties of the day supported the anti-apartheid movement and the release of the ANC’s leader and who were against it. There were some shamed faces in the House. The fact is that if it hadn’t been for Peter Hain, others like him and the mass support they generated, Nelson Mandela may never have had the opportunity to show how great he was.

The top 1000 albums

You may have see the recent press coverage of the 1,000th No 1 album, achieved by Robbie Williams’ with Swings Both Ways.  But to celebrate this milestone the Official Charts Company published a list of all 1,000 No 1 albums. For anyone born after 1955, when the charts began, looking up the albums from your formative years will take you back to times fondly remembered (or best forgotten).

In my case I was there during one of the most extraordinary periods:

13-11-27 The Beatles V5

Or to quote from an article by Peter Robinson in The Guardian:

“Between May 1963 and April 1965 the only No 1 albums were by the Beatles, the Beatles, the Rolling Stones, the Beatles, the Beatles and the Rolling Stones. This run was broken by Bob Dylon, who was then knocked off No 1 by Bob Dylan. Three months later, the Beatles were back at No 1, unseated by the Beatles, the Rolling Stones and then the Beatles”.