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HOUSE OF LORDS SESSION 1995-96 SELECT COMMITTEE ON SCIENCE AND TECHNOLOGY INFORMATION SOCIETY: AGENDA FOR ACTION IN THE UK EVIDENCE RECEIVED AFTER 31 MARCH 1996 Printed pursuant to the Order of the House of Lords of 21 November 1995 LONDON: HMSO £23-10 HL Paper 77-II HOUSE OF LORDS SESSION 1995-96 SELECT COMMITTEE ON SCIENCE AND TECHNOLOGY INFORMATION SOCIETY: AGENDA FOR ACTION IN THE UK EVIDENCE RECEIVED AFTER 31 MARCH 1996 Printed pursuant to the Order of the House of Lords of 2] November 1995 INFORMATION SERVICE © LONDON: HMSO £23-10 HL Paper 77-IL eee CONTENTS Page ORAL AND WRITTEN EVIDENCE British Medical Association Srauelt ewnCenceniesstile swtwet criniole.c/ (ransferdag Liree. DMR ene bs 311 Premera mmr pr 1996) i gk es ek ak we | Supplementary Written Evidence yaaionnasl. Sih. KoMaMe FOL az, FM. A 322 Department of Health Smarr wicienices ara) Seliy Bret Lier MIR INUS BNiSiecy eo a bake 324 Pree vinence nro ADT 1996.0 ssc ee ee se oe ASAT OO HONDO CAO 328 Papp rimentarye wetter) Bvidencetm itch, se9 suo Le aovweic jel seek 334 BBC tLe TV ICICIICCHES TEEIURLIIT),. a5 6 wc ce ee ee we oe wk AIO Aveo: 336 341 British Telecommunications plc mr RMEb et IC TIGCIRMIP IN DOES ia ape e aly wle te aw ub aoe ele bee eee 348 BrpmremuencemeorapTil 1996° 2. ee i ow. SOE Syoh PINT a NV EILCTE AVIGCTIC®) bk ok ee ee cede eee we ee ee 368 NatWest Group Pe rilen EeV IGenCenicingthe xine eae oa tol fn tino ah we na bere 372 SeaeemencensOApril 1996.0 en Bat) ite aon oe nope 378 National Association of Citizens’ Advice Bureaux DTI AEC CG ns hoy ke bd ae ore ye ok sewn wets 4 ee OMMOT. Ween 385 Meee eaenec toOrApril 19969 13 setwiers prove toe J ctebros. denna: Pepprmememary. WrittensBvidencerianeaue) icenvolnes.. bras nounowba aot. 402 European Commission (M Robert Verrue, Director-General, DGXIII) eecenen ar. MayiLO0G fhe. iiiowinig aetan....... .eaheoubs.ih eran 409 RET CCE sd 90 a bee op Geto ew ee ve hee w ve OREO Jo. Rone 417 Technology Foresight ITEC Panel Rr ere aencen 97mine oh Jorebasbasie Qo inmenew nsS esleri 423 remence sm anviay LOOGior:. comoem a1; B IT RO 427 Institute of Physics Sec EL WICCNICO MME Ne TAiLameen ate Pe ee GGA em fa Aniuisione 435 Ppeewuencemre Mayel99Gm amin, Bi... ss oo HMMOD. nosrenars 445 Poiementaryawerittcn seV idence: ayyici w. \. Lea yetlonilye)“u e CompuServe menaence, 2 1)M ay:hO9G6 wcrc cae doe aw Ses 6) Lees 447 Dr Mary Dykstra Lynch PeeenocncelsMay 1996.4 of tae “itr aetion Soe higtdy. tee Rel! 457 SePICI CCIE 5. 8 eR aly aoe ie Fe Ee arnt d elect ara ele 5 462 QVC Breer IeniCec ive: fan easier (86 weet eem te. “ooipalerwtee ecere., 466 MEP CINENCENA4 anc loo Omen wai F< LoS sae sk oe ae pans wie eed 469 Mercury Communications Ltd Neer Pela tE MAfTayGg at o ans a) Ale a OAS ey Itt |, ce Pe 476 REE CPTI ees LIME tO ea. ee ec) oat aeg e Stora Sk a hw Gy oeale. tobe ae 482 iv Independent Television Commission Written Evidence’: os .6\c ioe. ous es Rn i di aa ceeh e teria ae eee 489 494 502 News International Written Evidence’ . © é).:05 6 oS ele a Es a a ee 504 516 Mr Ian Taylor MBE MP. Minister for Science and Technology Written Evidence! jn02 bo Pe PT iy it Ce 520 529 Office of Telecommunications (OFTEL) Oral Evidence, 20 June.1996. 2. 04. 0. i. oa 2 ed. RS 537 Written Evidence, 2). 6s Sok an ek I a 543 The Rt Hon Viscount Cranborne DL Lord Privy Seal and Leader of the House of Lords Written Evidence, ii) eae wet ee ee ae Vie a mp 558 WRITTEN EVIDENCE * Also gave oral evidence: see Volume I, HL Paper 77-I. British Association for Information and Library Education and Research, Heads of Departments and Schools Committee (BAILER) (supplementary evidence) 0.2... ns wigl e ac© ee ela een 570 British Embassy, Paris ....de.ta .SY.A. :SRS. .. 576 British Embassy,. Tokyo | 2). 2)o)0 s). Geer se Shs) ao ala a el ale 579 Butterworths (British and Irish)... ...... 0.4%... . OG) He 580 * Department for Education and Employment (supplementary eviderice)) it vawiat 582 * Department of Health (supplementary evidence) |... 9.) 320. 7) 585 Department of National\Heritage.cam) ons) ya BY OMe ee 587 Free. Computers for.Education... 2. .)..5.. 0.00. 0.) 6. ORGS vei rr 592 General, Council of the Bar 0.0). oo jy cages 595 Mr Andrew Graham, Balliol College, Oxford. .....i.277..) .e/e:e we Home Office oo isi a wa Wl, SC 603 Independent Committee for the Supervision of Standards of Telephone Information Services. (ICSTIS) in vnc ek dae te oo ee | ORE err 604 Law Society of Scotland.) 27.0ee2 /24 609 Museum Documentation Association (MDA) ..................000008 610 * National Association of Citizens’ Advice Bureaux (supplementary evidence) .... 610 National:‘Consumer Council... 0.3. ee es es Ss) ORR ee 611 * NatWest Group (supplementary evidence)... / ..-.4. .onaboG 2a eee 612 Northern Ireland Office... 7G)i 613 Open University: 6 sik i ences han lan a ree aMo te ca ek 613 Oracle Corporation UK Ltd wy. cents eo ow es we SR ae 615 Performing: Right Society (PRS): ...00% 056042 Jee «ee ee 619 Reuters (supplementary evidence), ...). 6)... 24... 4). os =. . « ee 621 Visa International). $03. 6005 Se ees PON Ae ol Naas aia ot ue 621 CALL FOR EVIDENCE The Sub-Committee invite written submissions on matters of relevance to this topic, but in particular on the questions listed below. Note: For the purposes of this enquiry the term “Information Superhighway” has been taken to mean a publicly accessible network capable of transferring large amounts of information at high speed between users. 1. What is the current form of the “Information Superhighway”, and how is it developing (i) in the United Kingdom and (ii) worldwide? What specific problems arise from incompatible network standards and why are these incompatibilities arising? 2. What services are being provided, and should be developed/will be required, within for example the following areas: (i) public information, (ii) commerce, (iii) finance, (iv) education, (v) industrial training, (vi) health, (vii) social services, and (viii) | entertainment? 3. Who will supply these services to consumers in the United Kingdom? How can the participating companies be categorised and what is the nature of the commercial relationships between them? How are suppliers likely to develop? What service standards exist and how are they likely to evolve? 4. How can universal access to services provided for the common good be secured within a commercially competitive market framework? 5. What is the role of central Government in connection with the “Information Superhighway” service provision, including the following areas: (i) leadership; (ii) promoting inward investment; (iii) promoting and safeguarding the interests of UK firms worldwide; (iv) promoting network compatibility; (v) access to Government information; (vi) security of payment; (vii) data protection, confidentiality and censorship; (viii) verification of information; and (ix) promoting the development of UK-orientated software? 6. What is the role of local and regional Government in connection with the “Information Superhighway”? How can new services be used to boost (a) the ongoing regeneration of urban areas, (b) other local economies? 7. What will be the impact of the “Information Superhighway” on working practices and employment prospects? 8. Is the dominance of mass-market US software a threat or an opportunity? What hard commercial initiatives can be made (as opposed to “collaborative” ventures such as RACE or ESPRIT) to respond to this dominance? vi MEMBERSHIP OF SUB-COMMITTEE I Lord Butterworth Lord Craig of Radley GCB OBE Lord Flowers FRS Lord Gregson Lord Haskel Baroness Hogg Lord Hollick Lord Phillips of Ellesmere KBE FRS (Chairman) SPECIALIST ADVISER Professor Charles Oppenheim MINUTES OF EVIDENCE TAKEN BEFORE THE SELECT COMMITTEE ON SCIENCE AND TECHNOLOGY (SUB-COMMITTEE 1) 311 NN NN Rn nnn nnn n nner nnn SSS SSS TUESDAY 16 APRIL 1996 Present: Butterworth, L. Hogg, B. Craig of Radley, L. Hollick, L. Flowers, L. Phillips of Ellesmere, L. (Chairman) Haskel, L. Memorandum by the British Medical Association EXECUTIVE SUMMARY The BMA welcomes the opportunity to submit evidence to members of Sub Committee I on the applications in society of the information superhighway. In considering the guidance prepared by the Sub Committee we found that the questions upon which evidence was sought related primarily to the applications of information technology to commercial business and industry. We have, therefore, in this evidence attempted to draw attention to the application of information networks to our prime areas of interest, the National Health Service and patient care. In particular, we have emphasised our concerns over the operation of the information networks within the NHS. 1. What is the current form of the “Information Superhighway” and how is it developing (i) in the UK and (ii) worldwide? What specific problems arise from the incompatible network standards and why are these incompatibilities arising? Both worldwide and in the UK the “Information Superhighway” may be described as an ever-increasing and constantly changing “network of networks”. Currently this means linked server computers and routing structures which allow information to be transferred between computers which have access to a telephone line and minimal software. Information can be transferred immediately or stored for collection at a later time. Sub-structures can be developed within a network and these can be accessed by other computer users. DEVELOPMENT IN THE UK We are aware of numerous service systems all of which are, or can be interconnected. These are operated by companies, industrial bodies, academic institutions and also within the NHS. Development has seemed to occur in a protean way as more computer users gain access to the network. Within the National Health Service, the NHS Executive’s Information Management Group (IMG) has recently launched “HealthNet”, an NHS-Wide Network planned to link regional health care networks throughout England and which will also link (with the protection of a firewall, the technical details of which have been protected from public scrutiny) to the wider information superhighway. Such developments provide a messaging system which will give increasing numbers of people access to a service by-passing the main telecommunications agencies and postal systems. It will also act as a large information data base giving users access to information previously unavailable except to those in the particular professions involved, eg, medicine, law. . WORLDWIDE DEVELOPMENT We believe that the information superhighway is also developing exponentially across the world. As the only limitations are access to a telephone line, a basic computer and the appropriate resources we see in the near future the Internet and the telephone becoming effectively synonymous. SPECIFIC PROBLEMS Problems arise from incompatible technical standards and incompatible user preferences. We are aware that difficulties relating to both network hardware and software, due to incompatible network standards, exist within the UK health care community, and specifically with regard to communications. Incompatibilities exist, not least as a result of the wide variety and age of hardware/software developed for use in the many health care sectors within the UK. The UK market in health care information technology has a history of being supplier-led and a subsequent tendency toward a diversity of proprietary hardware/software products. One example of this is the incompatibilities which exist between the national EDIFACT standard messages 312 MINUTES OF EVIDENCE TAKEN BEFORE THE 16 April 1996] [ Continued system using READ coding (representing a compatible standard) and the current links between general practitioners practices and laboratories or local area networks which are based on e-mail and plain text standards. REASONS FOR INCOMPATIBILITY We believe that in the NHS such incompatabilities are arising primarily as a result of local systems being developed by non-experts using inexpensive hardware and software, which whilst satisfying short term needs has created long term problems. By contrast the National EDIFACT standard is complex and requires a long term national plan and implementation strategy to ensure it works effectively and efficiently. We are concerned that the lack of clear advice from the Department of Health on this is hindering the development of this national standard and thus encouraging the growth of cheaper, less efficient local alternatives. The BMA has supported moves towards open systems technology and the development of proprietary hardware/software which share common standards so that they may easily communicate with one another. We also have continued to emphasise the need for future developments in health care technology to be steered by health care professionals themselves. 2. What services are being provided, or should be developed or will be required, within certain areas, for example, the health service. . The BMA is only able to comment here only on developments within the National Health Service and would wish to draw attention to the NHS Information Management & Technology Strategy which provides a national plan aimed at developing the use of information within the NHS. We are very concerned that the strategy represents many loosely connected aims, the majority of which are laudable, but they'do not appear to be supported by an adequately resourced strategy for implementation. We believe that this has resulted in considerable uncertainty and a lack of clear direction. We also fear that a lack of understanding exists within the service of both the impact and demands that information technology imposes on an organisation as large and diverse as the NHS. There appear to be major uncertainties as to how benefits of such technology will contribute to the care of patients as well as the management of the organisation itself. The BMA believes that the development of current and future services in the health sector may be divided into: Services not handling identifiable patient information: Access to and organisation of the health care literature. Access to knowledge bases for decision support in health care. Multimedia, interactive teaching and learning in health care. Bulletin boards and new groups focusing on general and more specific aspects of health care. Services handling identifiable patient information: Sharing of patient information between those health care professionals directly involved in the care of that patient. The practice of tele-medicine eg computer conferencing, computer diagnosis, remote surgery. Services which currently handle identifiable patient information but which should not handle this type of data: Administration of the newly developed internal market structure of the NHS. | Epidemiological research, without the express consent of the individuals concerned. 3. Who will supply these services to consumers in the UK? How can the participating companies be categorised and what is the nature of the commercial relationships between them? How are suppliers likely to develop? What service standards exist and how are they likely to evolve? The services may be provided both commercially and non-commercially on a co-operative basis. Both will be offered from a wide range of different sources including academic institutions, primary and secondary care institutions, professional organisations, patient organisations and private industry. The BMA has expressed grave concern in connection with the intention to provide services to the health care sector through the NHS- Wide Network “HealthNet” and we explain this in more detail in our evidence to question 5.