Lessons to be learnt from space

There are too many comparisons for comfort between the Challenger disaster and Connecting for Health. We all know about the space shuttle: failure of the O-rings in the solid rocket boosters enabled white-hot exhaust to escape on to the main fuel tank causing the loss of the shuttle and death of its entire crew.

Yet the disaster had been anticipated. A year earlier, engineers had identified problems with the O-rings and repeatedly alerted management - who took no notice. In turn NASA was jealous of its own reputation and reluctant to postpone a launch because of adverse publicity.

What a parallel with Connecting for Health. You might think, with £6 billion at stake (to say nothing of medical safety and confidentiality), that managers would have consulted widely, especially among the medical IT community. You'd be wrong. A few individuals have been brought in, but no formal representation has been sought from established user groups and until recently there was no mechanism for passing on individual doctors' concerns.

Indeed, the atmosphere has been poisonous. Any doctor or organisation involved with Connecting for Health is subject to draconian non-disclosure agreements. External criticisms are largely ignored, often brutally. The impression given is, 'We know what we are doing, don't question it.' (Think O-rings here.)

Yet the medical IT community has repeatedly identified significant flaws in Connecting for Health. One surfaced two weeks ago with the revelation that anyone with an NHS smartcard might be able to access confidential Choose and Book patient information they have no right to see - their address, who they've been referred to, mobile telephone number, disabilities and password.

The initial response from Connecting for Health management was, as usual, to deny that this was possible - and, significantly, to threaten to punish anyone testing the system in this way. Only when GP publicised the matter did the managers acknowledge the seriousness of the problem.

The managers must wake up and recognise that the medical IT community has important concerns which need addressing. Otherwise, as with Challenger, Connecting for Health will be heading for a disaster of monumental proportions.

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