A Conservative government would scrap the centralised NHS database and replace it with smaller, local systems.
Shadow health minister Stephen O'Brien accepted the recommendations of a review of the National Programme for IT (NPfIT) by former British Computer Society chairman Dr Glyn Hayes. The report said the national database was 'unnecessary' and 'has caused extreme anxiety' about security.
Instead, patient databases should be as 'small and localised as possible', it said.
Ewan Davis, director of health informatics consultancy Woodcote, welcomed the review's efforts to 'recast' rather than abandon the programme. 'I'm critical about the path taken. But we are where we are, and we need to build on what we've got.'
He called the Tories' willingness to renegotiate monolithic local service provider (LSP) contracts 'a positive sign'.
The Conservatives described their plans as a 'radical shift away from Labour's top-down and centralised approach to IT'.
The party pledged to renegotiate LSP contracts, to give hospitals freedom to choose their own IT system, providing it met certain standards. This could be modelled on the GP systems of choice initiative.
The review slammed the NPfIT's focus on the summary care record, which it said had held back other innovations such as e-prescribing.
It also criticised NPfIT for relying on 'vapourware' - systems designed from scratch - instead of cutting costs by using existing technology. It also proposed buying in web-hosted medical records systems, run by companies like Microsoft or Google, to allow patients to hold their own records.
Dr Vivienne Nathanson, head of science and ethics at the BMA, questioned whether a shift to databases held by the private sector would be secure.
But she said: 'There have been major problems with NPfIT. We support the principle of greater local decision-making.'
Gayna Hart, managing director of software firm Quicksilva, questioned how radical the proposals were, noting that many hospitals were already choosing their own interim systems.
She added that the NHS spine, which will store the centralised patient database, already exists, and a 'rip and replace' strategy could waste time and money.
TORY IT review claims
- National patient record database is unnecessary and has created fears about security.
- Systems should be local and small scale.
- NHS IT programme over-reliant on 'vapourware' - software that is developed from scratch.
- Heavy focus of NHS IT programme on summary care record has held back other initiatives such as e-prescribing.