No sign of NHS-ID System linkage discussions

I’m very surprised. DoH! tells me there is no correspondence between themselves and the Home Office about linkage between the Benighted ID System and probematic Connecting for Health. But it’s quite clear that Home Office made a major bid to forge such linkage, which was robustly rejected by the D’oH! Stuart Craig sens me a polite FoI reply:

Our ref: DE00000284182

28 March 2008
Dear Mr Heath,

Thank you for your email requesting, under the terms of the Freedom of
Information Act 2000, copies of communications between the Department of
Health and the Home Office about the relationship between the National
Programme for Information Technology and the National Identity Register.
Your request was received on 27 February and it has been passed to me for
reply.

I can confirm that the Department does not hold any information of the
nature you have requested. It may help if I explain that there are no
plans to disclose NHS patient information to the National Identity
Register, and no plans for physical or electronic linkage between what
would be two completely separate systems.

If you have any queries about this letter, please contact me. Please
remember to quote the reference number above in any future communications.

Can such a significant and robust exchange have left no audit trail at all?

Published by William Heath on 28/03/08 at 5:04pm

Comments

Hmmm. Mr Craig’s use of the standard “no plans” formula is hardly reassuring.

Is he saying that, in addition to the “engagement” you know about, there was no communication whatsoever between HO & DH at or before the point they dropped the NHS number from the registrable facts in the *second* Identity Cards Bill? I find that very hard to believe.

Would he confirm that NHS staff will be *statutorily forbidden* from recording the NIRN on any NHS system, should a person show an ID card in the course of seeking treatment or healthcare? If not, why not - and why did the government resist/reject just such an amendment in the latter stages of the Parliamentary battle?

Recording the unique identifier from one system (the NIR) in someone’s record in another (e.g. NHS CRS), while keeping a record of the event in the original system (NIR audit trail) creates sufficient “linkage” to allow anyone with access to the first system (NIR) to locate and pull the person’s medical records at will.

Just how dumb does Mr Craig think we are?

Reply by Phil Booth on 03/31/08 at 12:38 am
According to the IPS website, “At the moment the Department for Work and Pensions, Department for Education and Skills and the Department of Health are all considering how best to use ID cards.”

http://www.ips.gov.uk/identity/faqs-general-services.asp

If the Department of Health have finished considering and have decided not to have anything to do with it, which is what their answer says, then perhaps someone should mention this to IPS so that they can update their web site accordingly

Reply by Dave Birch on 03/31/08 at 6:47 am
Fair points. I replied here:
http://www.whatdotheyknow.com/request/communications_from_home_office_

Dear Stuart Craig

RE: “Communications between the Department of Health and the Home Office about the relationship between the National Programme for Information Technology and the National Identity Register”
---------------------

Thank you for looking into this and for sending me a holding response within the statutory timeframe.

When you say you “confirm that the Department does not hold any information of the nature you have requested” s it possible that you are mistaken? The IPS web site says http://www.ips.gov.uk/identity/faqs-general-services.asp
“At the moment the Department for Work and Pensions, Department for Education and Skills and the Department of Health are all considering how best to use ID cards.”

Officials in DoH have spoken to us of robust discussions between DoH CfH and the Home Office about what the relationship between the CfH computerised health records and the Home Office IPS ID System hsould be.

I cannot say just what specific document or documents (eg emails, presentation slides, repots) this information is contained in it is abundantly clear there have been such communications. It would be very surprising if there were no record of this.

Even if the outcome of the discussions is, as you say, that there are “no plans to disclose NHS patient information to the National Identity Register, and no plans for physical or electronic linkage between what would be two completely separate systems” my request is for the communications (emails, presentatins or reports) that led to that point.

[I’d like to understand the rationale for how the IPS ID plan was developed, and also the likelihood of how they will evolve together in practice. I wonder, for example, whether NHS staff will be statutorily forbidden from recording the NIRN on the NHS system, should a person show an ID card in the course of seeking treatment or healthcare.]

I do not accept therefore that what you have sent so far is a substantive response to my original request. Is it possible, do you think, for your section head to review this decision and have a more thorough and informative response sent?

Many thanks for your help etc

Reply by on 03/31/08 at 12:51 pm
Sometimes I feel sorry for the Cabinet Office. Their misbegotten plans for data-sharing between government departments are forever thwarted by silos.

Reply by David Moss on 03/31/08 at 3:22 pm
Yeah, and what about this from John Hutton in 2004?
“The NHS is already under a clear legal obligation to make sure that free at the point of use services are only provided to those who are entitled to them. NHS resources are finite, and free care given to those who are not entitled to it takes away resources from those who are entitled.

“ID cards will help staff to discharge their legal duty to check the eligibility or otherwise of patients to free NHS treatment. They will act as a deterrent to abuse of NHS resources.

“Confirming entitlement will be much more straightforward for the NHS. Biometric identifiers would prevent identity fraud. Information on current immigration and residence status would be comprehensive and up to date. Our aim will be to maximise benefits and minimise costs so we will look carefully to see what level of checks would be appropriate in each circumstance.

“Although there are certain groups who will be eligible for free treatment but who will not have registered for ID cards, such as short-term visitors from EU countries, they will be able to prove their eligibility on production of their passport or, in the near future, their EU health card. Vulnerable groups such as the elderly, the infirm and the mentally ill could be exempted from the requirement to register if this was thought to be desirable.

“As we have made clear in the past, there will be no question of stopping people who need emergency treatment receiving that treatment in a timely way. No one will be denied emergency treatment because they have failed to produce an ID card or to prove their eligibility in any other way. People with certain communicable diseases, such as tuberculosis, will also be treated regardless of their eligibility, on public health grounds.

“ID cards would help us meet our responsibilities to ensure that the resources of the NHS are used in providing care for those who are legally entitled to receive them and not spent on those who are not. They will reduce the existing burden on frontline staff of checking numerous documents to determine eligibility for free treatment, since in many cases the information available through the ID card alone will suffice, and it is a very robust means of proving identity. I believe that ID cards would make the job of the NHS much easier in ensuring that only those entitled to free treatment receive it.”
http://www.publictechnology.net/modules.php?op=modload&name=News&file=article&sid=942
Reply by on 04/04/08 at 12:14 am
Because even though we all know they want to use it as an entitlement card, they also know that won’t help sell it to the public.

Meg Hillier also claims “there are no plans at this stage to make the delivery of particular public services dependent on the production of an identity card.”

http://www.theyworkforyou.com/wrans/?id=2008-02-25c.188126.h

Reply by ukliberty on 04/04/08 at 10:45 am
’Meg Hillier also claims “there are no plans at this stage to make the delivery of particular public services dependent on the production of an identity card.’

And she’s right, because the plans at this stage are to have the delivery of particular public services dependent on the register, not on the card. Look closely at the words of the Home Secretary. In her speech at DEMOS, Jacqui Smith said “Would Jean Hutchinson have been able to commit her crimes if she had been asked to give a photo and fingerprint as proof of her identity when she registered each new benefit claim? The answer is no. A simple check against the National Identity Register would have revealed the real person’s face and fingerprints.”

There’s no need for the production of an identity card when “a simple check” on the register can be used instead.

Reply by Dave Birch on 04/04/08 at 7:10 pm
Who are these large numbers of people who are to be denied NHS treatment? Who would willingly be a “health tourist” to the UK?

(Two of my elderly neighbours recently broke their hips, became infected with MRSA & C-Diff in hospital and died. Apparently, NHS staff had been too busy even to serve one with food or water.)

So, like all other official justifications for the ID scheme, its use for rationing NHS treatment is unconvincing.

Reply by Richard S on 04/04/08 at 11:38 pm
Dave Birch:
And she’s right, because the plans at this stage are to have the delivery of particular public services dependent on the register, not on the card.

With respect, is that something you have concluded yourself or is it something you’ve been told? Because while it sounds reasonable and obvious to me, they haven’t exactly made it black and white themselves, have they?

Indeed have any public services said how (or whether!) they will use the scheme?
Look closely at the words of the Home Secretary. In her speech at DEMOS, Jacqui Smith said “Would Jean Hutchinson have been able to commit her crimes if she had been asked to give a photo and fingerprint as proof of her identity when she registered each new benefit claim? The answer is no. A simple check against the National Identity Register would have revealed the real person’s face and fingerprints.”

Again it sounds reasonable to me but are we not also told that the Identity Verification Service will only give yes/no answers and not directly reveal any personal information?

I take it then that the Department for Work and Pensions has planned how it will make use of the scheme and is set to procure the necessary infrastructure to read fingerprints.

But wait, I remember (as an avid reader of your blog) when you wrote this based on your experience at DEMOS:
In the question time, I asked her if all claimants would have to do this. As Jacqui didn’t answer, I was able to ask Meg, and she told me that not only will benefit claimants not be asked for fingerprints and photos, they won’t be asked for ID cards either, so I don’t think the scheme will have any effect on benefit fraud: either Jacqui was briefed incorrectly on this or I must have misunderstood Meg.

Reply by ukliberty on 04/07/08 at 10:25 am
"Jacqui was briefed incorrectly on this or I must have misunderstood Meg.”

I stand by this comment. As far as I know, though, Jackie trumps Meg so we must proceed on the basis that the Home Secretary was telling the truth and that the provision of public services will at some point depend on a “simple check against the National Identity Register”. I’ll try asking IPS tomorrow to see what they believe the position to be.

Reply by Dave Birch on 04/07/08 at 9:53 pm
Sorry Dave, re-reading my comment it seems a bit aggressive toward you and that’s not what I intended at all.

I think one of the major problems with this scheme is that the Home Office and IPS still aren’t clear as to what they are doing, and it seems to me there is still no clear indication of how the other government departments will make use of it*. We can read into things and come to reasonable conclusions about what they really mean, but it isn’t in black and white and by no means true. (or maybe it’s just me!)

That’s really the point I was trying to get across, and I apologise if I insulted you.

* Among the most common causes of government IT project failure are “Lack of clear link between the project and the organisation’s key strategic priorities, including agreed measures of success” and “Lack of effective engagement with stakeholders” (Office of Government Commerce).

Reply by ukliberty on 04/08/08 at 4:05 pm
"That’s really the point I was trying to get across, and I apologise if I insulted you.”

No apology is necessary—I appreciate robust debate.

Reply by Dave Birch on 04/09/08 at 2:24 pm
Mr Heath’s Hutton quotation at (5) above would seem to nail the original issue on this thread. Given what the then Health Minister said, surely there must have been some sort of communication between the Health Department and the Home Office. Mustn’t there?

And that communication should show up in an FoI search. But Mr Craig says it doesn’t. If he is right, then Mr Hutton was just theorising. He had had no communication with the Home Office but just like the rest of us he knew something about the plans for ID cards and could see that they might help to ensure that only those entitled to it could access NHS healthcare.

These departments of state guard their empires carefully. They are silos, as noted in the File on 4 programme (4). Other departments are the enemy.

The Cabinet Office can chat away all they like about joined up, transformational eGovernment, but they’re just theorising, too. Because when it comes down to it, the decision-makers don’t turn up to the inter-departmental meetings. That’s what the BBC discovered.

(I’m just theorising there. I haven’t got any documentation to back up my case. Apart from the BBC programme. And apart from the lack of any announcements how any department of state intends to use the NIS.)

Tony Blair talked about the scars on his back and the pain involved in trying to change anything in the civil service. Maybe he spoke the truth. Maybe Mr Craig is speaking the truth.

There’s the Cabinet Office in one corner, chatting away to itself with no-one paying a blind bit of notice. There’s the Health Department in another corner wondering what to do about health tourism, such as it is (8), but damned if they’re going to talk to the oppo at the Home Office.

And the succession of previous Home Secretaries who couldn’t stop talking about how the NIS would cure everything from athlete’s foot to mortgage mis-selling have finally been replaced with a Trappist monk called Jacqui who doesn’t say anything, as per Dave Birch’s Demos note quoted by ukliberty (9). She, too, may be theorising, of course, but she’s she’s in her own corner, keeping her thoughts to herself.

As are DWP.

We have no reason to believe that either Health or DWP have any plans to use the NIS and confirmation from Mr Craig and from Meg Hillier that they don’t.

There was already a split between IPS and BIA. The former have rejected irisprints for the moment, on cost and technnological grounds, while the latter have adopted irisprints. That split grew wider on 1 April, when BIA moved into the UK Borders Agency silo.

Activists against the NIS and prospective suppliers to the NIS are all busy joining the dots, designing a national stock control/surveillance system and either worrying about the horror of it all or dreaming of the money involved.

But the principals in this absurdist drama are doing their level best to keep the dots apart.

It wouldn’t happen in the private sector. But my theory is that that is what is happening in the public sector.

Reply by David Moss on 04/09/08 at 6:37 pm
A related report, from another province of the KableNET.com empire—‘IPS wants service pilots for ID cards’ [*]:

“[IPS] is talking to government departments about how the [ID] card may be used to support service delivery. [James Hall] said the move has the enthusiastic support of the home secretary and that the IPS is aiming to run some early pilots.

So far none have progressed beyond discussions ...”

This move by IPS, an executive agency of the Home Office, has the enthusiastic support of the Home Secretary. I should hope so, too.

But what about the education department? Or the health department? Or DWP or transport or local government? There is no mention of enthusiastic support among their ministers.

IPS are talking to themselves. No-one among their peers is listening.

It was July 2002 when David Blunkett issued his consultation document on entitlement cards. IPS and its predecessors have had the best part of six years on the job and they still haven’t got anyone interested.

They haven’t got any clients. They can’t sell the service.

James Hall says in the article that:

“We want people to accept the card as proof of identity from day one, and I’m sure many will do so, but for departments’ computer systems to use the NIR as a core source of identification will take years. We’re putting in place a piece of national infrastructure for the 21st century, and the full impact will not be felt for five, 10 or 15 years.”

He’s lowering expectations. He’s good at that.

And he’s holding out for another 15 years before anyone can say this project has failed. By then, he will be happily retired, PA Consulting will be well into 9 figures for their fees and the general public will have nothing to show for it.

Nice work if you can get it.

----------

* http://www.kablenet.com/kd.nsf/Frontpage/1216A4DFBA6EF27780257425005597D5?OpenDocument

Reply by David Moss on 04/10/08 at 12:39 am
According to a 2 April article in the Washington Post*, ‘Centers Tap Into Personal Databases’, so-called “fusion centres” in the US have access to mobile phone, insurance claim, driving licence, traffic violation, car rental, firearm licence, investments, wages, property and credit rating data on individuals, their relatives and their associates.

These fusion centres use data brokers—Entersect, Accurint, ChoicePoint, LexisNexis and LocatePlus.

In addition, they have access to FTC, FBI, CIA, NSA, DoJ, US Treasury and in at least one case Pentagon data.

They have access to the data, they collate/fuse it, they mine it, they do pattern-matching, they do profiling, they analyse the results and they distribute their analysis to crime-fighting and counter-terrorism organisations.

Now that is what I call data-sharing.

The Washington Post provide names, locations and facts. Not a lot, it’s patchy, but enough for you to infer that there is a lively data-sharing operation in the US, established following 9/11, funded by individual states and by the DHS and often staffed by the FBI.

So what?

Well, compare that with the UK.

Here in the UK, after years of excitement about transformational government, it seems possible that there has still been no communication between the DoH and IPS.

Here in the UK, Meg Hillier says that benefits will not be dependent on checks on the NIR.

Here in the UK, six years after the consultation document on entitlement cards, IPS is floating the idea of pilot services but the idea has yet to get beyond the discussion stage (please see comment #14 above).

Note that the US apparently achieves its data-sharing objectives without first building a new NIR. Why does the UK need a new NIR? Like the US, we already have dozens of them.

Sir James Crosby made the point that the banks are well placed to introduce identity assurance services. The minute they do, the naked irrelevance of the NIS will be revealed.

A strong case could be made that IPS are laughably ineffectual compared with their US counterparts. They appear to be wasting their time and our money. They have achieved nothing in six years and now they want another 15.

It would be interesting to see how IPS could refute this case.

While waiting, there are a few questions.

Is there no end to the Prime Minister’s patience? What chief executive in the private sector would put up with this level of non-performance?

Will the gentle patience of the British public finally snap, now that we have a credit crunch?

----------
* http://www.washingtonpost.com/wp-dyn/content/article/2008/04/01/AR2008040103049.html

Reply by David Moss on 04/11/08 at 10:16 am
In her speech at DEMOS, Jacqui Smith said “Would Jean Hutchinson have been able to commit her crimes if she had been asked to give a photo and fingerprint as proof of her identity when she registered each new benefit claim? The answer is no. A simple check against the National Identity Register would have revealed the real person’s face and fingerprints.”

Which would be illegal:
http://www.opsi.gov.uk/ACTS/acts2006/ukpga_20060015_en_2#pb5-l1g16
without specific legislation or regulation to require it. I suspect Dave is right, and the Home Office expects to finesse the embarrassment of “papers please” by providing for people to give other look-up information than their ID card when such provisions are enacted.

Reply by Guy Herbert on 04/23/08 at 1:03 pm

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