This government is not going far enough on democracy

Dominique Lazanski, Dan Hannan MEP and Douglas Carswell MP write in Public Servant magazine:

It has been nearly a month now since the Queen’s Speech and already we are seeing some u-turns on the coalition programme’s agreement. The Summary Care Record database was going to be scrapped and then Simon Burns stated in the Commons that records would still be uploaded. Also, the ID card scheme will be dissolved, but not for foreign nationals. Apparently, those ID cards are not ‘real’ ID cards. The list goes on and on, but the point is that even the coalition government isn’t going to deliver on all of its promises.

The Summary Care Record is too important to go quietly

This week’s edition of Pulse, the GP’s magazine, is edited by Dr Dr Gillian Braunold, clinical director for the NHS Summary Care Record Programme. The issue includes an Opinion piece by Dr David Lloyd, medical director of out-of-hours IT at NHS Connecting for Health, discussing how an accurate, reliable record of patients’ medication might improve out-of-hours GP care:

Everyday I come across examples of how the SCR will improve patient care. Take yesterday, and an ordinary four-hour shift in the polyclinic. Two patients came in at either end of the sick spectrum.

A middle aged man with a skin infection arrived who could not get an appointment that day to see his own GP. It seemed minor at the time and I was in two minds whether to treat it. He had already told me about the pills he was taking and I was on the point of sending him away when I commented on his extensive psoriasis-it was then that he told me that the Enbrel (etanercept) injections were not helping very much!

Once I knew that he was on one of those incredibly powerful disease modifying drugs, the whole tenor of the consultation changed and he went out with a bag of pills and stern warnings.

Thirty minutes later and a mother brings in her wheezy three-year-old old. She was worried because the inhalers given to her by her GP did not seem to be working.

What inhalers I asked, she had no idea, so I relied on the usual conversation about the colours of the tubes. I established that he was on a brown one and a blue one but that was it. I had to construct a treatment plan which took into account every possible strength of the brown inhaler that she possessed.

Now even the basic SCR would have changed both of these consultations radically. I would have known about the dangerous drug in the first case straight way and would have been far more suspicious of an infection-I’m sure many of you have seen what terrible things can happen when these new anti-TNF drugs are given. And the second case would have been much quicker and more joined up.

In the comments thread, Trisha Greenhalgh writes:

We need to address the problem of subjuncitivization: the expression of the benefits of the SCR in terms of what WOULD or MIGHT happen. What my team were evaluating was what actually DID happen, and sadly, there was a model-reality gap!

ToryDems add up bill for Labour’s ID scheme

Joe Fay writes in The Register:

The Labour government spent just under £300m to develop the ID card and biometric passport schemes unceremoniously dumped by the ToryDems this month.

The figures came in a commons answer on Monday. Conservative MP Richard Harrington asked “what recent representations she has received on the cost of the identity cards scheme?”

Damian Green said that the Home Office had spent “£41 million developing the policy, legislation and business case for the introduction of identity cards”.

In 2006, the scheme was transferred to the newly created Identity and Passport service, which spent another “£251 million on projects to establish identity cards, second biometric passports and other related programmes”.

Government plans new model for Summary Care Record

Ian Quinn writes in Pulse, the GP magazine, under an “exclusive” tag:

The Government is planning to switch to a scaled back, ‘patient-held’ electronic care record, severing central control over the controversial programme, but stopping short of scrapping it altogether.

A senior Government source told Pulse of moves to substantially reform the Summary Care Record after researchers found it had spectacularly failed to deliver a raft of promised benefits to patients and doctors.

The official evaluation, by researchers at University College London, concluded the programme’s problems were so deep routed they could not be solved, and claimed senior IT managers had deliberately rushed the rollout in the run-up to the election to save it from the axe.

The Department of Health’s signal that it plans a more patient-focused approach to the care record came as it emerged that almost 90% of nearly 9 million patients who have been mailed information may have given consent without realising it.