John Saunders

The effective collection and management of personal data of rapidly migrating populations is important for ensuring adequate healthcare and monitoring of a displaced peoples’ health status. With developments in ICT data sharing capabilities, electronic personal health records (ePHRs) are increasingly replacing less transportable paper records. ePHRs offer further advantages of improving accuracy and completeness of information and seem tailored for rapidly displaced and mobile populations. Various emerging initiatives in Europe are seeking to develop migrant‐centric ePHR responses. This paper highlights their importance and benefits, but also identifies a number of significant ethical, legal and social issues (ELSI) and challenges to their design and implementation, regarding (1) the kind of information that should be stored, (2) who should have access to information, and (3) potential misuse of information. These challenges need to be urgently addressed to make possible the beneficial use of ePHRs for vulnerable migrants in Europe.

The effective collection and management of personal data of rapidly migrating populations is important for ensuring adequate healthcare and monitoring of a displaced peoples’ health status. With developments in ICT data sharing capabilities, electronic personal health records (ePHRs) are increasingly replacing less transportable paper records. ePHRs offer further advantages of improving accuracy and completeness of information and seem tailored for rapidly displaced and mobile populations. Various emerging initiatives in Europe are seeking to develop migrant‐centric ePHR responses. This paper highlights their importance and benefits, but also identifies a number of significant ethical, legal and social issues (ELSI) and challenges to their design and implementation, regarding (1) the kind of information that should be stored, (2) who should have access to information, and (3) potential misuse of information. These challenges need to be urgently addressed to make possible the beneficial use of ePHRs for vulnerable migrants in Europe.

Bad things happened at Mid Staffordshire National Health Service (NHS) Trust (mid Staffs). The key question, having determined what, is to ask why. Why do good people do bad things? Upon this depends the sorts of actions that we might propose, extending and realising those made in the Francis report itself. In their valuable paper, Newdick and Danbury analyse the issues from the perspectives of individuals, systems and then through the lens of cognitive psychology.1 All three perspectives offer food for thought and all three factors contributed to the failure. But which offers insights into the best possibility of progress? Wisely, that is left for us readers. We are reminded at the outset of the 2001 inquiry into the deaths of children at the Bristol Royal Infirmary.2 That event is now so distant that many younger doctors are entirely ignorant of it and many older doctors will, like me, remember it as primarily a failure of three men, all disciplined by the General Medical Council (GMC). We can recall, for example, the demonstrations outside the GMC building as those accused of substandard practice arrived—perhaps most notably against the surgeon, James Wisheart, an obviously decent man. But return …