RE: Warning of major NHS IT overspend

["Owen Lewis" <[EMAIL PROTECTED]>]

> -----Original Message-----
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] Behalf Of Brian Beesley
> Sent: 02 November 2004 09:20
> To: [EMAIL PROTECTED]
> Subject: Re: Warning of major NHS IT overspend
>
>
> On Monday 01 November 2004 11:19, Owen Lewis wrote:
> > > -----Original Message-----
> > > From: [EMAIL PROTECTED]
> > > [mailto:[EMAIL PROTECTED] Behalf Of Dave Howe
> > > Sent: 01 November 2004 10:55
> > > To: [EMAIL PROTECTED]
> > > Subject: Re: Warning of major NHS IT overspend
> > >
> > > Brian Beesley wrote:
> > > > Why does everything have to be stored centrally?
> > >
> > > It would appear that that is not for anything more
> operational than the
> > > fact that the government wants it that way - as has already
> been pointed
> > > out, these aren't the patients records, but records about the patient;
> > > the system appears to wish to establish the fact that these aren't the
> > > gp's records, but records held at the gp... by removing them
> and putting
> > > them in one central and highly data-minable location.
> >
> > Mineable and mindable, both?
>
> As in, there's only one database to back up. But what a disaster when the
> central database gets wiped out by accidental fire / terrorist
> attack / rogue
> staff member (delete as appropriate to your level of paranoia).


A database of that size and critical value should *never* be without 100%
backup. There is an argument for triple backups with triple comms routing.
I have in mind such a facility for one of the major insurance companies. The
site has virtually no flood or earth tremor risk. The building stands behind
a security fence in a cleared area. The building is cuboid with lateral
sides of about 75m. There are two stories above ground. The building is
windowless and metal skinned. There is only one entrance in use, being a
standard size, single-leafed metal door.  There might be ten or so persons
who work inside the building per shift.


> There's
> probably more risk of incidents if the database is dispersed but
> the number
> of people affected would be smaller. i.e. dispersing the database
> is a form
> of insurance against a collapse of the whole national system.

Only if the standard of physical and electronic protection would be the
same. It wouldn't be.

> > And where the NHS consumes such a large part of the nation's wealth, is
> > data-mining such a bad idea? Leaving such a wealth of
> information untapped
> > might seem to verge on the irresponsible.
>
> It's not _information_, it's at best intelligence, except when applied in
> respect of the individual data subject. And only then if proper
> procedures
> are applied.

Explain?
>
> What is the value of data mining to the individual data subject?

The value is to the community. The individual shares in that benefit.

> If you want to do statistical analysis then the sensible thing to
> do would be
> to work with properly anonymised extracts. This could easily be
> done without
> pooling the medical records data centrally.

At greater cost and probably increased liability of error.

I am 63 years old and have had an averagely healthy life interspersed with
this and that. My entire medical record for the first 50 years was simply
lost. My present medical record should fit on not more than two sheets of A4
and a couple of x-rays. This simply would not happen in a properly run
centralised system. I do not believe that my case in unique.

> A central database does, however, present a convenient resource for "data
> mining" done by marketeers (and worse), and an obvious target for
> crackers
> determined to subvert the database, perhaps with terrorist intent.

So you say. The truth is that 'cyberterrorism' is a nice '90's  buzz word
but there are no known occurrences of other than of a trivial nature.
Cybercrime *is* a clear and present danger. The NHS database is simply not
that attractive a target for either. Which would you choose to crash your
anthrax lade aircraft into, some anonymous bunker in a field somewhere
(possibly with 20 ft of top cover) or the House of Commons?

Owen

Owen