Published: 26/09/2002, Volume II2, No. 5824 Page 8 9 10

With the publication of its consultation document on identity cards, the government's on-off approach to the subject is now on - in a big way. But, as Lyn Whitfield reports, ID cards have ominous implications for the NHS T his year's Tom Cruise thriller, Minority Report, is set in a world in which people's eyes open doors.

Iris scans also control access to the transport that takes people to malls, the credit with which they buy goods and the adverts that influence them (hologram billboards greet people by name and base their recommendations on past purchases).

On the downside (if billboards that act like your friend are an up) the interconnecting databases behind the scanners allow state agencies to call up personal data, pinpoint individuals, cut off their credit and lock shut their cars in seconds.

Cunningly, the film is set 30 years in the future, which allows the creators to play with technologies and political trends just visible now. One of these is the apparently worldwide fascination with new forms of identity checking and identity cards.

Following the terrorist attacks on the US last year, home secretary David Blunkett expressed considerable enthusiasm for the idea of cards to combat terrorism. The idea seemed to vanish as civil liberties groups pointed out that cards are almost no deterrent to terrorists and newspapers dug out stories about ordinary people who refused to show their Second World War-era ID in peacetime.

However, it never went far.When the row over France's Sangatte refugee centre was at its height, the idea of cards was revisited as an anti-illegal immigration measure.

When stories surfaced about people's credit ratings and identities being 'stolen', it was suggested that cards could provide a solution.

And under the radar of the daily news agenda, the Home Office has consistently pursued the development of an 'entitlement card' in 'the broader context of citizenship and participation'.

This pursuit bore fruit in July with the publication of Entitlement Cards and Identity Fraud: a consultation paper. This cleverly sidesteps the issue beloved of newspaper columnists - that old ladies will have to show their documents to every Little Hitler that demands them. The government, it says, 'does not wish to consult on the introduction of a compulsory scheme, by which it means a card which everyone would have and be required to carry at all times'.

Universal scheme

However, the Home Office does wish to consult on a 'universal' scheme, which implies that everybody would be required to register for a card. Indeed, the Home Office wants to see a card scheme underpinned by a population register holding 'core information' such as people's name, address and date of birth and a new, 'unique personal number'.

The consultation paper rules out using the NHS number as the basis of this unique personal identifier - recognising that people would worry about who had access to their medical records if it was.

However, Entitlement Cards and Identity Fraud is conspicuously silent on the subject of what records would be used to check people's registration for the new card.

Professor Ross Anderson, chair of think tank the Foundation for Information Policy Research, suggests NHS records would be used, since these are more complete than other government databases, such as national insurance or driver registration.

Though Entitlement Cards and Identity Fraud describes the data to be held on the population register as 'very limited', this would be linked to 'other databases holding entitlement information'.

A briefing from Privacy International says this 'information matching system' is 'the most significant aspect' of the card proposals, since it would allow individuals' dealings with both the public and private sectors to be monitored.

The cards would also carry 'biometric' identification - almost certainly fingerprints and possibly iris scans. Any registration process would therefore require people to have their fingerprints taken and - possibly - their irises scanned.

As Privacy International also points out, the idea that carrying a card would be optional is a smokescreen. The government suggests that new, credit-card sized passport cards and driving licences should become entitlement cards, with a special entitlement card created for those who do not travel or drive. 'Well over 40 million people', on the Home Office's own estimate, would therefore have to carry a card if they wanted to go abroad or drive on a public road.

However, the Home Office also wants the card to give people access to 'a range of central and local government services' - which could, presumably, include the NHS.

Scattered throughout the 150-page Entitlement Cards and Identity Fraud, there are also suggestions that the card could be used to prove age in pubs, cinemas and shops selling fireworks or knives; to act as proof of identity in banking and other private transactions; to carry season ticket and store card entitlements; and (even) to join a library.

As Privacy International puts it: 'You will not be required to use a card unless you wish to work, use the banking or health system, vote, buy a house, travel or receive benefits.'Or, possibly, buy food and drink in a pub.

Meanwhile, using the card, if it carries biometric information, would logically imply having that information checked with fingerprint readers or iris scanners to prevent fraudulent use. The world of Minority Report beckons.

The constantly changing public rationale for cards is reflected in the Home Office's proposals.

The consultation document claims that the population register would allow public and private service providers to offer more 'pro-active and targeted communications and services' to people and they would find it 'more convenient' to carry one card than many.

It also suggests it would allow the government to administer services more efficiently and to check immigration 'by providing a straightforward way for service providers to check entitlement to services and for employers to check eligibility to work'.

The first is quite clever: as the talking billboards in Minority Report demonstrate, people will take up technology that invades their privacy if there are benefits.

People already give stores considerable amounts of information about themselves and their habits when they join loyalty schemes, in return for money-off vouchers and other targeted promotions.

However, Liberal Democrat MP Richard Allan says the government is being 'deceitful' in presenting its identity card plans in cost-benefit terms since it is, at best, unclear what people are getting that they do not already have.

He is particularly worried that NHS treatment could actually become conditional on production of a card. 'It may be that it is designed to exclude people such as [illegal] immigrants from the health service, ' he says.

'[NHS staff] should check now whether people are entitled to treatment, but they do not tend to do that. They work on the basis that nobody should be turned away.

'The implication [of cards] is that they would be turned away and that is against the whole ethos of the NHS.'

If a card was introduced and became, in Privacy International's phrase, an 'internal passport', then other groups might find themselves excluded.

Roger Bingham, a spokesman for Liberty, says: 'There are lots of people with varying degrees of chaotic lifestyles and this would put them at risk for no obvious benefit.'

Liz Nightingale, a spokeswoman for Rethink, the former National Schizophrenia Fellowship, says that 'at the very least' safeguards would be needed to ensure people were not denied treatment because they did not have their cards with them.

Professor Anderson raises another issue. Linking treatment to individual patients can be fraught, even when they are entitled to it - contraception, abortion and treatment for drug addiction are only the most obvious examples.

Entitlement Cards and Identity Fraud says the card scheme would comply with the requirements of the Data Protection Act 1998. The purpose of the central register would be set out and there would be regulations governing the uses to which the information would be put. But the danger would be that so many uses would be found that this offers no protection at all. As John Wadham, director of Liberty, has pointed out, it is also only limited protection against 'misuse'.

The consultation paper, which refers throughout to the benefits that 'would' accrue from an entitlement card, does admit there 'might' be drawbacks. For example, it says 'people might regard the card as an unnecessary intrusion into their privacy'. It also says it would take time to set up a scheme, which would be 'complex and subject to the risks confronted by large-scale IT projects'.

Professor Anderson is scathing about the understatement contained in the last part of that sentence. Civil servants, he says, are forever being dazzled by the idea that all their administrative woes will be solved by massive IT projects - and are forever failing to learn that these do not work and leave government at the mercy of IT suppliers.

Having many government databases, he points out, at least means that 'if insurance goes down, UK plc does not go down'whereas 'if this goes ahead you are handing over the keys to the kingdom'.

Politicians, he adds, 'will be unable to resist the [managing] companies' demands for 'just a few more billions to make all this work, Mr Chancellor'.'

Even the consultation document admits that a national identity card scheme would be expensive - it suggests£3bn over 13 years if it was based on passports and driving licences. The government has no plans to pay this itself - it is proposing to raise the cost of passport and driving licence applications to cover it. The exact scale of the rise would depend on how much more affluent members of society were prepared to pay to subsidise the cost of the basic card.

Mr Wadham says the plans show a basic lack of trust. '[The government] wants 60 million of us to register our identity so it can check up on us, monitor our movements and decide whether we are entitled to services for which we have already paid our taxes, ' he says.

'ID cards make us suspects, not citizens.' l Privacy: why does it matter anyway?

Nineteenth century philosopher Jeremy Bentham once designed a model prison.

Called the Panopticon, it had cells arranged around a central viewing platform so that prisoners could be observed at all times - but would never know whether they were being observed.

The idea was to change the character of the prisoners.

They would behave as if they were being observed until this became their own nature.

The flaw in this beautiful idea was that a distressing number of the prisoners subjected to it went mad.

But the idea of the Panopticon illustrates an important point about privacy: it is important if people are to live freely.

As a result, the often-repeated argument that 'I have nothing to fear because I do nothing wrong' is misplaced.

What is 'wrong' - meaning both illegal and socially unacceptable - changes, as the law on everything from abortion and homosexuality to membership of a political party shows.

The extent to which people are able to stand out against oppression or social opprobrium will depend, to a large degree, on the extent to which they can be monitored.

Closely watched societies tend to be conformist, when they are not actually repressive.

Anyway, as Stephen Pollard, a senior fellow at Civitas, a non-governmental organisation for civic education, wrote in a pamphlet for Liberty recently: 'on that basis, the authorities should also be able to enter our homes and read our post at will.'

Britain's legal system, meanwhile, is built on common law - the idea that people should be free to do anything not actively proscribed by law, without hindrance from others.

Though other countries have introduced ID cards (without noticeably reducing crime or preventing terrorism), no common-law country has done so.

Mark Weightman, a commercial expert at law firm Weightman Vizards, says judges in Britain have a long tradition of upholding personal privacy, but the position was clarified in 1998, when article 8 of the Human Rights Act enshrined protections for family life, home and correspondence. 'There is no right for anybody to look into your private life, ' he says.

However, this right is in conflict with others. The courts, interestingly, have tended to uphold newspapers' rights to print information about famous figures.

And such rights can always be undermined by legislation aimed at preventing crime, terrorism or other evils.

This is the great fear of privacy campaigners: that the government will use recent events, particularly last year's terrorist attacks on the US, to curb traditional liberties.

Useful websites: www. liberty-human-rights. org. uk and www. privacyinternational. org