- Smart Healthcare, Wednesday 11 November 2009 09.00 GMT
No sign of interest: Google has no immediate plans for a UK version of its online health record service. Photo: David Paul Morris, Getty
Conservative Party leader David Cameron raised the prospect again earlier in November, as part of a speech in which he renewed his attack on the NHS National Programme for IT and reaffirmed the party's distaste for a centralised database of patient records.
While he went into little detail, and did not actually name the Summary Care Record, he spoke of the option of people being able to store their health records online. This is consistent with earlier comments in favour of people choosing their own providers to hold personal information in online repositories, granting access as they see fit.
Cameron said the web technology is "already out there", no doubt thinking of Google and Microsoft developing electronic patient records in the US, which he has referred to in earlier speeches. This suggests that, if the Conservatives come to power next year and decide to ditch England's central patient record, a significant opportunity could open up for suppliers of a more commercially driven alternative.
But while the technology may be out there, it has not been developed to the point where it could be easily used in the UK – Google has indicated it is in no hurry to make an offering available here – and the suppliers will not be able to get it there by themselves.
Any solutions would need the confidence of GPs, hospitals and other healthcare providers to be viable, and they are unlikely to respond to a free for all in which there is little consistency in the details and structure of information. It would need a degree of standardisation on interoperability protocols, the limits, terminology and presentation of data, and possibly on what is an acceptable commercial model.
Potential suppliers are not going to make a big commitment before these are in place, and it needs the NHS to take the lead role in their development.
Experience suggests it is not a straightforward job. Work on the Summary Care Record has moved slowly, hindered by arguments over privacy issues and the myriad of technical problems afflicting the development of the Lorenzo and Millennium clinical information systems.
Developing a framework for commercial third party operators would not be as demanding, but it's a process that could easily stretch out for a year or two before they could begin any serious work.
Does that mean that in the meantime the potential for online records is placed on the shelf? This would effectively put the brake on a momentum that has been developing over a number of years, and could easily provoke a reaction among doctors welcome the prospect of being able to quickly check on a patient's background.
Faced with this prospect, a Conservative government could well decide that it is not so hostile towards the central database.
Mark Say is senior editor of Kable
