Last week saw a fairly low key, little publicised report from the NHS: Coding for Success. Part of the idea is that hospital patients will wear wristbands which are coded to identify them accurately. Doctors, nurses and other hospital staff will be able to scan the band to ensure that they are dealing with the correct person.

Perhaps surprisingly I'm all in favour of this. Mistakes in hospitals happen too often and can be disastrous. Confusion is hardly surprising in the chaos of a busy hospital with overworked staff. Mixing people up is especially easy when the patients are confused, infirm or even unconscious.

So I completely approve of a simple, reliable bar-coded wrist strap which hospital staff can check quickly with hand-held scanners.

But... (unfortunately there's always a but)

I start getting worried when I realise that what's actually being suggested is not just a bar code but probably an RFID chip. Why? That's totally unnecessary for the requirement.

Unless it's planned as part of a wider system.

RFID tagging of patients would allow not just checking of patients at operation time but also tracking them throughout the hospital. And it could easily be extended to staff and visitors - all in the name of security of course. It would be another step towards a world where we all routinely expect to be numbered, tagged and tracked "for our own good". A very dangerous precedent.

It's also likely that such a computerised system would eventually be linked up to full patient records and other personal information with the massive privacy implications of such a linkage.

It's also inevitable that at some point someone would suggest linking the whole scheme up with the proposed compulsory national Identity Card and National Identity Register (NIR) - all in the name of efficiency of course.

Paranoia? Scare-mongering? Perhaps. Until you read the NHS report.

RFID tagging is already being used in Birmingham with a WiFi connection to the central computer system and RFID scanners on theatre doors to identify patients. Birmingham is one of the case studies in the report. Patients are of course "happy to be photographed and tagged as a means of ensuring they receive the right treatment". Who would want the wrong treatment? Would patients be so happy if they were offered the choice of a less intrusive option?

The document also makes it clear that the patient tagging is not intended to be an isolated process. It integrates with other Auto-Identification and Data Capture (AIDC) systems such as those for labelling medication and identifying test samples sent to external laboratories. Again this is justifiable on efficiency grounds but carries a huge social and privacy cost, especially when taken in the wider context of the surveillance state the UK is becoming.

To its credit the report does state that "Systems may be based on simple linear
barcodes [...] or on RFID tags...". However there seems to be an implicit support for the RFID option, if only because this would allow easier linkage with the RFID based EU Bridge Project ("Building Radio Frequency IDentification for the Global Environment" - *shudder*)

To report this scheme as merely identifying patients to avoid incorrect surgery is seriously misleading. This is likely to become part of a much larger and all-pervasive system undoubtedly linked eventually to the NIR. Whether or not we approve of that it needs to be discussed openly.

I'm sure that the people behind this system have the best of intentions and are genuinely aiming to improve patient care. Unfortunately it seems that they have been enthralled by the technology and haven't given enough thought to the social and political implications.

The stated requirements could be achieved with a stand alone low-tech, barcoded wristband. I'd support that. But for as long as the plan includes RFID chips incorporated into a wider system then I'll oppose it.

RFID NHS NIR RFID privacy UK