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2008 may be the year when GPs find themselves in the firing line over confidentiality, as ever more patients try to opt out of ‘the NHS database’ and the government tries ever more desperately to keep the project on track. I believe this should not be seen as a problem, but an opportunity — a once-in-a-lifetime chance to make a decisive change. By acting as the patient's advocate, GPs can, not only retain patients' trust and defend their professional autonomy, but also rescue health policy from a serious wrong turn.Public concerns about the centralisation of health data have grown in recent years, especially since the press took up the issue in 2006. In November that year, a poll revealed that 53% of patients opposed a central medical records database with no right to opt out.1 At the same time, a report for the Information Commissioner (of which I was an author) described government plans to share health information on children widely with other services, including social services, school teachers, and the police. It concluded that the proposed measures were both unsafe and illegal.2 In September 2007, the House of Commons' Health Committee called for more information to be published on the proposed design, and for data placed in ‘sealed envelopes’ to be withheld from the Secondary Uses Service (SUS) — a suggestion that the Department rejected.3These concerns have since been brought into sharp focus by the government's loss of personal information on all the nation's children and their families last November. The Conservatives are now promising to end the National Programme for IT (NPfIT) and go back to keeping data on interoperable local systems where ‘records should be owned by the patient, and stored locally, under the control and protection of his GP’.4The …

Confidentiality and Connecting for Health