The Tories have long been grumbling about the NHS IT project being over-centalised, over-budget, behind schedule and a waste of tax-payers’ money. Now, after a full report, they have pledged to dismantle the NHS IT system so far and cancel the contracts with current providers. E-health insider rightly points out this may be a false economy given the amount already spent by the Department of Health and the cost of cancelling such massive contracts. But money is only one of the Tories’ incentives. They also call for the system to be more ‘patient-centred’ (a hard one to argue against) and more localised.

Note that the tories aren’t arguing against electronic patient records per se. They’re arguing about how and where they should be held. To understand the Tories’ proposals requires getting to grips with the nitty gritty of the NHS IT plan.

The Tories’ main victim would be the National Data Spine. The Spine is the central connector between different aspects of the NHS IT system. The Spine hosts GP2GP, which transfers a patients’ information when they move GP surgery, Choose and Book, which books appointments electronically, and an electronic prescription service. The Spine also holds Summary Care Records, which contain patients’ basic information such as allergies, blood type and operational history. The Tories pledge to scrap all this.

The Tories’ second proposed fatalities are Local Service Providers which are working at delivering IT infrastructure to hospitals and Primary Care Trusts across a region. The Tories pledge instead to let local health providers choose their own IT services ‘off the shelf’. Although services would be electronically compatible, detailed patient data would only be shared when necessary, and would be held on a much more local level.

Finally, the Tories repeated their determination to replace HealthSpace, which allows patients to access their records online, with services run by private companies like Google or Microsoft.

While it might not save as much money as the Tories claim, the scrapping of the Spine and the introduction of more local databases does address many privacy concerns (although handing HealthSpace over to private companies raises many more). But the Tories also give up a number of potential benefits.

Dismantling Summary Care Records would mean that doctors wouldn’t have access to information on a patient if there was an emergency outside their local area. If Dave from Newcastle is hit by a car while on holiday in Manchester doctors wouldn’t have access to crucial information such as  blood type or allergies. This instant access was seen as one of the main benefits of electronic patient records, and a major contribution to patient safety.

The Tories have also been very quiet about access to patient data for research. The NHS intends to create a database for approved researchers, and information would be uploaded from the Spine and more detailed regional detabases. Without these, we may be losing out on crucial research opportunities.