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The Caldicott Report

The previous government attempted to defuse the privacy row by setting up a committee under Dame Fiona Caldicott to consider the non-clinical uses of medical records. She identified dozens of systems, either fielded or under development, which share personal health information with administrators and others who are not involved in the patient's care. This committee did not include anyone with expertise in computer security.

Its main recommendation was that data should be de-identified by replacing the patient's name and address with an NHS number (the postcode and date of birth are also to be retained). As virtually everyone involved in patient administration will need to be able to link names with numbers, the NHS is building a tracing service which will enable names to be found from numbers and vice versa. So the privacy problems will become worse rather than better. The tracing service has had significant teething problems, with millions of pounds wasted on systems that do not work. If it eventually does work, it will provide a history of each patient's associations with healthcare providers. This appears to conflict with the Human Fertilisation and Embryology Act, which prohibits staff at fertility clinics from disclosing any information which might identify any person born as a result of in-vitro fertilisation; the fact of a woman's registration with such a clinic before the birth of a child will become widely visible throughout the NHS. There will be similar problems with mental health and sexually transmitted diseases. (The Caldicott committee should also have included a lawyer.)


next up previous
Next: The nub of the Up: Information technology in medical Previous: Cultural problems with privacy
Ross Anderson
1998-11-13