igb’s posthaven

The first part was interesting but unexciting.  Phil Booth (Medconfidential, ex-No2ID) and Nick Pickles (Big Brother Watch) outlined the concerns about the identifiability of data when combined with other data sets, issues of consent and issues of safe processing and transparent policies around release.  Sharmila Nebhrajani (AMRC) and Peter Weissberg (BHF) made a strong case for the benefits of processing data for public health while admitting that the execution of this project left a lot to be desired.  Chand Nagpaul for the RCGP presented the issues confronting GPs, particular confidentiality with patients and responsibilities as data controllers, while again making it clear that the project has a whole has massive potential benefits.

There were attempts to get Phil and Nick to condemn the processing of the data in any circumstances, which was rightly seen as the straw man it was, but in general terms there was nothing to surprise those familiar with the saga.  The Committee showed impatience with presentations of benefits as though those of themselves negated risks, but in general proceedings showed a broad agreement.

This was not true of the second part.  Daniel Poulter (undersecretary of state for health), Tim Kelsey (NHS England, Director for Patients and Information) and Max Jones (Director, HSCIC) were under-briefed and unimpressive.  The committee drew harsh inferences from the fact that they had not attended the first part, and Poulter, in particular, was clearly not on top of his brief.  All three appeared to assume that the committee would roll over in the face of a presentation of benefits, and at several points Kelsey seemed to think that the meeting was a platform for him to set the agenda, rather than answer questions.  Jones relied on the defence that the HSCIC was a new body and therefore the actions of its predecessors were neither relevant nor knowable, which is an extraordinary legal theory.   

A massive backlog of points to be confirmed in writing later built up, as Jones blustered and repeatedly claimed not to know about the key operations of the body he is director of: for example, the code of practice for the HSCIC's processing of Caredata assets has yet to be written, but he could not provide a timescale for its production.   Sarah Woolaston and Charlotte Leslie, who clearly _were_ on top of their briefs, picked away at the inconsistencies, and got very little hard information for their pains.  The threat hangs in the air of the HSC summoning the staff of of HSCIC's predecessor bodies: I don't have Erskine May by heart, but I would have thought that the summoning of Mark Thompson in his guise as former DG of the BBC sets a precedent.  

What did we learn?  Firstly, we learnt that the NHS has a habit of promoting middle-managers to leadership roles without getting leaders: Kelsey and, particularly, Jones looked under-prepared, under-briefed and under-rehearsed.  Their endless recourse to "we don't know, we'll write to you" was completely unacceptable for senior managers of major NHS functions: they should know, or have it in their briefing pack in front of them.  Secondly, we learnt that treating a select committee with contempt, by assuming that an invitation to appear in front of them is a platform to make statements, goes down very badly.  Thirdly, we saw how shallow the talent pool in the Tory party is, given Poulter's hesitant, blustering and uncertain performance: his civil servants will be very cross, I suspect.

But to my mind, the most shocking revelation was that the HSCIC is collecting data, and releasing it to consumers, without having a code of practice in place.  Everything I've ever done in information governance --- I've run an ISO 27001 accredited operation --- says that this is insane.  Coupled with the HSCIC's claim that it does not hold the records of its predecessors (a claim I intend to test with some FoI requests) and you are left with the obvious conclusion that information governance in the NHS is a Potemkin village, thin sheets of painted board concealing a swamp of poor practice.

It's to be hoped that the HSC follow through.   If they do not, Jones and Kelsey will be able to get away with not knowing and not telling.  But if these are the best people the NHS can put up to make their case, and the best arguments, then Caredata is dead in the water, either because the HSC will stop it, or because the rate of opt-out will render the scheme useless.

And Dan Poulter?  I think he can forgot his ambitions, to be honest.

ian