Imagine what happens when you're asked to check what they've got on you and it's confused with somebody else (this did happen to my nephew in the NHS system). Do they trust you to sort out the rubbish for them? Do they think you're a criminal trying to destroy the evidence? Do they wipe the other person's data from your mind? And what about all the people like me who won't give consent? Is it assumed "must have something to hide; everything to fear"? It really isn't feasible to do it well, is it?

There are techniques, technologies - and even science - for managing national-scale complex data structures. It's not easy, but it's do-able. Building on legacy systems is another thing. BCS members have practical experience of how complex this is, but it's hard to explain to those who haven't seen it. One of the common issues is 'the workaround'. The horrendous breaches of security and data protection that people on the ground end up using to fix system-wide issues. Same 'ol same 'ol!

I count myself as relatively enlightened on such matters as I work with, but not for, central government - as a consultant not a civil servant. Cross-government databases do indeed worry me but we are a long way from that. I worked in the NHS 9-10 years ago and saw the costs of poor information-sharing in healthcare. Indeed the NHS number which I helped to introduce has still, ten years later, to be made a compulsory component in patient administration systems and would have avoided the issue of identity confusion mentioned above. That's pretty basic! We need to agree what the final destination of a journey towards the industrialisation (there must be a better word but it's Friday evening) of public service information is, of course, but this report seems to suggest that any step in that direction is a bad one without saying how else we might address the very real issues we face today. I attended a large number of workshops, seminars, etc on health information sharing all those years ago and a certain report author spoke at one of them. He stood out from the crowd like an extreme right or left politician, unable to see any validity in the arguments of those elsewhere on the spectrum of opinions. Clearly this was someone on an evangelical mission, almost laughably extremist if he hadn't been taking such a narrow and fundamentalist view on a (literally) vitally important subject. Did he/does he for example know how much the NHS spends on litigation as a result of erroneous treatments and how many of these arose from inaccurate or misunderstood patient information? It's not about the £, it's about the wrong leg amputated, the wrong operation on entirely the wrong part of the body in the wrong patient... real people with real lives changed in a way no £ can put right but several billion (yes, billion) is spent on every year. I didn't know whether to laugh or cry when said fundamentalist was appointed to a prestigious post in a prestigious academic institution a couple of years later. What on earth were they thinking of? And here's the result. When I saw this story break in the Sunday Times, the aforementioned was described as the author and was the only named individual in the article. When my wife drew my attention to the article and I read the sensationalist headline I even scanned it looking for his name...and there it was! I laughed then cried...The old health information arguments recycled and extended but no more constructively than 9-10 years ago. Still, I suppose it's one way of keeping your name on the seminar and conference circuit. Are we, the citizens and/or taxpayers of this country, paying for this "research"? In whose interest? Anyone who really cared for the patients in whose name (amongst others) he speaks and writes would propose constructive alternatives to addressing the healthcare problems we face. Whether we agree or disagree with much broader initiatives such as the identity register and scheme also covered in the report, surely we can see why any discussion which includes healthcare information in its scope needs to consider the pros and cons of information sharing and focus on asking under what circumstances which data should be accessible by whom. I find it insulting to the many people who genuinely tried to engage constructively (and with creativity, tenacity and openness) with these issues over many years that credence and coverage are given to such arrogant fundamentalism by, substantially, one individual. I'm pleased the BCS played its rightful professional role in objecting to the Coroners and Justice Bill, buried in which was a cynical attempt from those at the other end of the spectrum of opinion to gain almost carte blanche data-sharing rights for government. What will it take for us to find or create the middle ground where constructive and creative dialogue can take place and, eventually, disempower the fundamentalist perspectives which seem to dominate discussions in this important area and hold us back from making real progress.

The problem with the middle ground is that it is defined relative to the two opposing conditions. As these are relative, so is the middle ground. It's lazy thinking to try and occupy it, because by implication it's defined by other people. The press is particularly good at this. Much more appropriate to have an opinion of your own. The problem with the data sharing debate is that we are discussing red herrings. We should ignore the practical issues and discuss the philosophical and political points. By the way, I'm against data sharing, and so, I suspect, is Jacqui Smith. "Nothing to hide,... etc."