Over at the Guardian’s Smarthealthcare, details of a new announcement by David Cameron may prove concerning for privacy advocates. Against a background of significant criticism of the NHS IT programme by the opposition, the Tory leader has suggested a different approach to the management of our healthcare data. His inspiration is Google Health and Microsoft Health Vault, which are up and running in the US. The sites are linked up to hospitals and GPs who upload the patients’ records on request. Patients can then view them, check information and make changes to the information. Such a simple system springing up instantaneously across the atlantic may seem rather an embarrassment to the NHS IT programme, especially with their recent shelving of HealthSpace – their closest equivalent. Should the NHS follow suit and use Google to manage patient records?

Although this is currently just a suggestion from the opposition, handing data over to a private web provider raises a whole new set of questions – ones which we will no doubt need to face as healthcare becomes increasingly electronic.

Taking the records system outside the NHS could be a way for patients to gain increased control over their own records. Unlike the NHS’s proposed HealthSpace, patients on Google and Microsoft can not only view and comment on their health records but also add to them, delete them or change them. While this will no doubt infuriate various healthcare professionals, it would give patients greater ownership over their healthcare – one of the aims of the IT programme.

But it would also re-cast previous debates about privacy and security. These companies make their money from advertising. John Caulthard of Microsoft argues that sharing patient data with companies could be ethical and beneficial, allowing the NHS to target those with potential health problems. But could we also see nightmare scenarios where those with a history of anorexia were targeted by beauty experts, or by dieting pills? And would Google staff be added to the list of hospital staff, clinicians and GPs secretaries who can get access to our records? Regardless of privacy policies, such a system would have greater security risks with data moving between the NHS and private providers. Privacy advocates have long been critical of the amount of data which Google accumulates on its users – search histories, emails, documents and much more – but the storage of health data would be far more significant.

Like so many questions at Who Sees What? this one comes down to who the public trusts more with their personal information. At present, the answer is far from clear.