Papering over cracks in NHS: The digitisation of health records should have been completed long ago

Anyone who has had to be wheeled from a hospital radiology department back to their ward, clutching their own X-ray, will have wondered why it is that the NHS seems to be so behind the times in information technology. Despite a failure to keep up with demands on it – and contrary to much of the one-sided press treatment it receives – the British health service continues to provide some of the best care in the world, backed by advanced technology, modern drugs and extraordinarily talented and committed professionals.

But the digital issue does present a conundrum. Until recently, every GP’s prescription was issued on paper (though, mercifully, the days of illegible, handwritten dosages are gone). Hospital wards still have patient notes attached to clipboards pinned at the foot of each bed, and paper abounds across the wards and surgeries. It does seem odd, in the age of MRI scans and stem-cell research.

Though cumbersome and costly, the digitisation of patient data has huge potential healthcare benefits. When an unconscious victim of a road accident is rushed into A&E, it is obviously better if the medics can instantly determine that patient’s medical history. Immediate access to reliable information saves valuable minutes and, thus, lives. Digitisation is literally a vital project.

Progress has been made, but clearly it is not proceeding as rapidly as it should because the target date for completion has been put back from 2018 to 2020. That does not sound too outrageous for a public-sector IT project, but by the standards of the outside world it should have been completed long ago. When compared with enterprises such as Facebook, or the banks, or even HM Revenue and Customs, the NHS seems a long way behind. Of course, the data the NHS holds is even more sensitive and more complex, but the impression is that IT has been somewhat neglected.

The issue of confidentiality is a crucial one, and private-sector holders of information show what can be done – as well as what can go wrong. When we consider the anguish and misery – and very likely suicides – as a result of the hacking of the Ashley Madison website, the dangers are all too clear.

NHS data could be a lucrative source of business for fraudsters (to obtain drugs, for example) and blackmailers, and there is no reason in principle why the criminal or the plain malicious would not be able to steal the medical records of virtually everyone in the country. The data is also valuable to legitimate purchasers – drugs companies, private healthcare providers, life assurers and the rest. It would be reassuring to be told that it is not about to be sold on.

Given the numbers of people working in the NHS, it is difficult to see how such a system with so many potential users could be made truly secure. If attempting to find an answer to that challenge is the cause of the delay then it is more understandable.

This is hardly the first setback in the NHS’s long journey on the digital road. Various partial attempts have been made since the 1990s and it was Tony Blair who initiated the National Programme for IT in the NHS in 2002.

Like a patient suffering periodic relapses, it has been a complicated case, and more intensive care will be needed to make the health service’s IT systems fully fit for purpose. Meanwhile, those X-rays are still going to be delivered to the consultants via a wheelchair rather than by broadband.