Opinion: To the point - When trust is off the record

It's curious how the Government is going through a phase of admitting to losing our personal information while trying to convince us that we need to spend millions on sundry national databases. Let's consider the proposed health service fantasy along these lines. For a start, it is stupid to do away with paper records, as all would be lost without electricity - not something to be taken for granted.

Electronic records are a good idea insofar as they can be easily stored and transferred to another specialist; but a central data bank is open to hackers, corruption, disaster and incompetence. There is no reason why the health service cannot hold duplicate electronic records at a team level, so that when personal details get handed out there is automatic damage limitation. These records begin at birth, and if read correctly they will reveal more intimate personal details about you than anything else. Just a list of who you have met in the health service is a clear path to follow, and indeed is part of good practice. This does not need to be all stored in one place. Personal e-mail means that information sent to a specific clinician can only be picked up by them. The health service is built on confidentiality and trust. There is no way that this will be preserved by a centralised database.

But from inside the health service it is clear that professionals are no longer trusted to do their work to the best of their ability simply because they take a pride in it. We are more trussed than trusted; constricted and standardised by policies, protocols and procedures set up by those who can't and so do not believe that others will. This also keeps forests of dead wood in post-auditing and monitoring, rather than meeting patients.

The need to control is the result of a lack of trust as much as a fear of powerlessness. And with this goes the obsessive need to accumulate and command personal information, as if information will stave off disaster.

- Robin Balbernie is a consultant child psychotherapist in Gloucestershire.