The biggest council CCTV spenders per resident: Westminster… then Tamworth

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Big Brother Watch’s newly-released data on £515m of council CCTV spending between 2007 and 2011 (covered by my colleague Sade Laja on Guardian Government Computing) is even more interesting when combined with population numbers. Obviously, camera spending per capita is not a perfect measure, as some areas clearly have security needs beyond those of their immediate populations. This would help to explain why Westminster is the biggest spender per head of population: £46.75 over the last four years, compared to a UK average of £8.27.

But that doesn’t explain why Tamworth is second, spending £43.24 over the same period. The council’s recent spending data (PDF) refers to ‘CCTV camera renewals’, but it’s unlikely to be the only council buying new cameras in this four-year period. It did win a CCTV team of the year award in 2009, however.

Blue: councils spending less than half the national average on CCTV per resident (and those that did not provide spending data). Green: councils spending half to the average. Yellow: councils spending the average to twice the average. Pink: councils spending twice to thrice the average. Red: councils spending more than three times the national average.

Four councils spent between £30 and £40 per person over the four year period: Cambridge (£39.57), Weymouth and Portland (£34.58), Knowsley (£30.57) and Scarborough (£30.50). Again, it’s possible that there are mitigating circumstances such as capital cost of new systems – but in each case, residents have paid around quadruple the national average for council CCTV.

Another way to look at value for money is how much councils spent over the four years per camera. This varies wildly, although some of the most extreme results have reasons: Hounslow’s apparent lavishing of £4.6m on a single camera has to be seen in the context of the fact that the London borough turned off cameras after complaints, something that Big Brother Watch praised. The top of this list has several small-scale schemes, reflecting the fact that CCTV systems have some fixed costs regardless of camera numbers.

However, on this measure Westminster’s 153 cameras, costing £77,330 each – against a national average of £9,969 – look very expensive. Among medium to large sized schemes, Croydon (£63,447), East Ayrshire (£53,213) and Scarborough (£51,756) all spent more than five times the national average per camera over the four years. It also suggests that two councils I compared in 2010 for Government Computing – Wandsworth (£4,120 for each of its 1,158 cameras) and West Oxfordshire (£11,650 for 37) – are both doing good jobs given their respective scales.

Leaving aside value for money, a final measure is the number of council CCTV cameras per 1,000 people, for which the national average is 0.83. The City of London’s 55.47 cameras per resident doesn’t take account of all the people who work there, or the area’s security needs. But second-placed Shetland (9.38 cameras per person, 210 in total – covered here by the Scottish Sun) and third-placed Eilean Siar (Western Isles, 8.02 per person, also with 210 in total) are very high, particularly given that Orkney – the other Scottish island council, with a similar population – manages to get away with just 14 cameras, 0.7 per resident.

Among big cities, as Big Brother Watch notes Leicester is very high with 6.79 cameras per person (covered by BBC News): with 2,083 it has the largest number of cameras overall. Woking and North Ayrshire both have more than five cameras per person. Already mentioned Wandsworth has four cameras per person, the highest figure in London outside the City.

What stands out from this data is the huge differences, overall and also between similar councils, on all three comparisons. While there may be mitigating reasons for some of the outliers, some councils seem to be spending much more on CCTV than is justified. Given strained council budgets, councillors in places like Tamworth, Cambridge, Westminster, Croydon, Shetland, Eilean Siar and Leicester could reasonably ask some questions.

Technical notes: the survey only covers 51,600 council CCTV – a fraction of the estimated 1.85m surveillance cameras in the UK. Even on this it is incomplete, although Big Brother Watch extracted responses from 407 of 434 councils, as well as including data from its previous research, so 99% of councils are covered to some degree.

Another factor is that this survey covers both county and district councils in the two-tier areas of England, which means some numbers are partial in those areas: a resident of West Oxfordshire paid £4.15 for the district council’s CCTV over the four years, and a further 65p for Oxfordshire’s cameras, although as a resident I am happy to note the total is still below the national average. (The most interesting numbers are anyway from unitary areas, such as London and metropolitan boroughs and councils outside England.) Finally, the map dots generally use Google’s idea of where a council is located based on its name: some have been corrected, but there may still be placing errors.

The underlying data can be viewed and downloaded here.

Oxbridge applications mapped: London and the south east dominate

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Red: constituencies with more than 100 Oxbridge applications in 2011. Pink: 75-99 Oxbridge applicants. Yellow: 50-74 applicants. Green: 25-49 applicants. Blue: 24 applicants or fewer. Click on a dot for rank and number of applicants from that constituency.

Where do applicants for Oxford and Cambridge universities come from? According to data from Ucas, the top locations are Oxford, Cambridge – and, in far greater numbers, many parts of London.

The information, recently released through Parliament’s library, records the number of applicants (whether successful or otherwise) to the two universities in 2011 by parliamentary constituency. Oxford West and Abingdon (which covers the university area of Oxford) is top with 232 applicants, followed by Richmond Park in London (230) and Cambridge (208). The rest of the top 10 are all London suburbs, with the exception of 10th placed Chesham and Amersham, just outside the M25.

The distribution of Oxbridge applications is a ‘hockey stick’, with numbers of applicants rising sharp towards the top of the table. Only 34 constituencies (5.2%) have 100 applicants or more – in red on the map – and all of them are in London, the south east and east of England regions. The first from outside these regions is Bristol West, 36th with 95 applicants. The first north of England seats are Tatton, and Altrincham and Sale West, (both in Cheshire, joint 48th with 82 applicants each). Most seats in Scotland, the north-east of England and Wales have fewer than 25 applicants (shown in purple).

At first glance, the data could look off-putting to anyone considering Oxford or Cambridge universities from outside the south-east of England. In terms of numbers, a student from an upmarket London suburb is more likely to find others from his or her area at the two universities.

But these figures are for all applicants, not successful ones. When challenged on why so many of their students are the sort of people one expects to find there, Oxford and Cambridge universities argue they can only choose from those who apply. As this Guardian article details, Cambridge gives extra weight to applicants who don’t come from the ‘right’ background. Oxford does the same: both are under government pressure to demonstrate they take the best people, and find themselves trying to compensate for the geographic (and other) biases in the cohort applying.

As a result, applicants from the places on this map coloured blue are actually a bit more likely to get in than those from the red and pink areas – all other things being equal.

Technical notes: the original data is available here from Parliament’s website as a spreadsheet, and the Google fusion table that generates the map is available here. Comparing constituencies directly is not ideal, due to variations in population and demographics, but the differences are far larger than would be explained by, for example, the smaller average size of constituencies in Wales.

The location of each pointer is mainly automatic based on the constituency name, although with some tidying up (in the separate Location column on the fusion table): there may still be some errors, however. Finally, Ucas states only ‘5 or less’ for the 32 constituencies with the fewest applicants, rather than giving the exact number, citing data protection.

Smart move: use of health smartcards in EU countries

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First published in Health Service Journal, 8 September 2005

Across continental Europe, patients visiting a doctor take a plastic card to prove their entitlement to healthcare. Increasingly, these cards hold a microchip allowing payments for treatment to be processed and if necessary refunded more quickly than in the past.

But smartcards can also be used as electronic keys to patient records, boosting security and demonstrating consent.

The UK, with healthcare free at the point of delivery, has had no need for health insurance cards in any of the four home nations. When it becomes compulsory, the national ID card will probably be used in health only when first registering with a surgery or hospital, and probably only in England (Scotland has ruled out using the ID card to check entitlement for devolved services, including health).

The ID card’s associated identity database, which will eventually contain “biometric” images of the faces, fingerprints and irises of every adult in Britain, could be used to identify unknown, unconscious patients in accident and emergency. Home secretary Charles Clarke has suggested that cards could also hold emergency healthcare information.

Other countries have dedicated health smartcards, sometimes in addition to national ID cards. France’s Vitale patient smartcard was introduced in 1998, with the aim of speeding reimbursements of payments for healthcare. It is now held by 48 million people – everyone aged 16 or above insured by a state-sector health insurer.

Before 1998, patients paid upfront for healthcare, received a paper form from the healthcare professional, sent it to their state-sector insurer, then waited 20-25 days to be reimbursed. Now patients only pay in some cases, and if so, they receive reimbursement much faster because the invoice is sent electronically to their insurer; 78.6 million electronic invoices were processed in June. Surgeries and hospitals save time in processing and receiving payments. The system is currently being extended to cover those who use private health insurers. Healthcare professionals also use a smartcard to show they are providing a service, and claims can only be generated when both cards are present.

France’s Vitale card does not hold or give access to medical records, but this may change. Vitale 2 cards will be issued in 2007, with 16-year-olds likely to be the first recipients. ‘At the end, everybody will have a card,” says Jacques de Varax, director of general management for GIE Sesam-Vitale, which issues the cards and manages the infrastructure, although there is no deadline yet for moving everyone to the new card.

Pending a decision by the French health ministry, the Vitale 2 card may contain data such as general and drug allergies, blood group, a person to call in the event of an accident and their doctor’s name. “As far as health data are concerned, we will have only emergency data on the card,” says Mr de Varax. “The idea is to be able to use this data with a simple access,” using the standard card-readers already used by health professionals for insurance claims.

Most of a patient’s clinical data will be held on his or her dossier médical personnel, a separate electronic patient record project due to start in 2007, for which the Vitale 2 may act as an electronic key.

GIE Sesam-Vitale is involved with the European Netc@rds project, which aims to improve the interoperability of countries’ public health insurance systems. It will use either national health smartcards, such France’s Vitale, Germany’s eGesundheitskarte and Italy’s Carta Dei Servizi, or the European health insurance cards (Ehics). The latter are replacing forms such as the E111 in showing a foreigner has entitlement to the same healthcare benefits as locals.

The UK will issue Ehics without a chip from the end of this year – health professionals elsewhere in Europe will need to type in the details of British patients from the card – but the Vitale 2 card could act as an electronic Ehic as well. “The question is not about the capacity to include this, because it is a good size [of memory], the question is what the process is to read and control the different cards in Europe,” says Mr de Varax.

GIE Sesam-Vitale international project manager Noël Nader, says the Netc@rds project is analogous to banks co-operating through systems such as Visa and Mastercard: rather than issuing their customers with different cards for different countries, they build a communications network to allow their normal credit and debit cards to work abroad.

GIE Sesam-Vitale is also discussing a standard for emergency health data on smartcards, known as Netlink, for use across Europe and elsewhere: it has been adopted by an International Standards Organisation working group.

Other parts of Europe are following France’s lead. In the Andalucia region of Spain, access to electronic patient records was in-built from the start. The system covers 92.7 per cent of the region’s population: those using private healthcare are excluded.

Andalucia’s secretary for health issues Antonio Peinado says that the main driver of the scheme was to bring benefits to patients. “The idea is not to gain economically, but to gain quality of service,” he says. “We haven’t done this with the idea of economic impact.” However, one benefit is that GPs are saving 18-20 per cent of their time through reduced administration: “They can use that time to attend to patients,” says Mr Peinado, adding that the move to electronic systems has other benefits. “It gives us a lot of space in surgeries and hospitals, as we don’t need space for the documents to be kept, and people to take care of the documents,” he says.

‘The most important thing is the unique history, the single medical record for every patient. Any doctor can check the record..” This will include knowing about drug allergies and conditions when a patient enters accident and emergency, although the system is not yet available in an A&E ward.

The most obvious difference between systems in Andalucia and England is the presence of a patient smart-card. “The card’s design is careful to ensure that patients” confidentiality is not compromised,” says Mr Peinado. Smartcards include a microchip containing a security code. “It’s a key,” he says. “Without it, you can’t get into the computer system.”

However, it is possible to bypass this security in an emergency, by either the patient or (if the patient is incapacitated) a healthcare professional signing a form.

The system also includes functionality similar to the “secret envelope” planned by Connecting for Health for English patients. “The patient can ask the doctor to hide whatever he wants,” says Mr Peinado. “The doctor would be the only person who could see that part of the record.” This could apply to the whole record, if the patient wishes.

What could CfH learn from Andalucia? Mr Peinado says that keeping the patient in mind, and developing the system with clinical professionals, are the two most important things to do: more than 400 healthcare professionals helped develop the system.

More specifically, he says that training proved to be more work than expected. “The main problem, the most difficult task, is to help the professionals in the change from one system to the other. We had to intensify teaching, to help them to adapt to the new system,” he says. “Also, try not to rush not only the teaching, but also the [implementation of] applications.”

The UK is following continental Europe in issuing smartcards, but only for health professionals. CfH had issued more than 70,000 staff smartcards as of mid-July, giving professionals access to systems including choose and book, GP systems and patient administration systems. It also allows the application of rules as to who can see and change data, as well as an audit trail of what was done when. CfH says it is issuing about 5,000 smartcards a week, and has registration authorities established in more than 90 per cent of primary care and acute trusts.

The Welsh Assembly government announced a similar staff smartcard scheme last October, initially for student and junior doctors, who move quickly between placements compared with full-time staff. Scotland and Northern Ireland do not have current plans for smartcards, although a spokesperson for NHS Scotland said the technology is something it is considering for the future.

Other parts of the UK state sector – specifically, local authorities – are already issuing citizen smartcards. The Office of the Deputy Prime Minister funded the National Smart Card Project to develop software and standards for use by councils.

Mid-Suffolk district council has issued 1,400 smartcards, primarily to administrate concessions for pensioners, those on benefits and those in full-time education. However, the card can also hold the user’s GP details, any important medical conditions and allergies and their willingness to be an organ donor.

Other district councils in Suffolk are adopting smartcards for access to leisure services, and have the option of including health data through the National Smart Card Project standard. ‘Our vision is that, when we have significant numbers and money, we equip frontline staff with readers,” says Suffolk e-services card manager Geoff Doggett.

The National Smart Card Project is talking to CfH about ensuring their staff smartcards are compatible. Richard Tyndall, programme manager for the project points out that local authority and health service staff have to share sensitive information, such as on children at risk. “The vision is that there will need to be strong authentication to allow different parts of government to access each other’s data,” he says.

And if staff smartcards can be compatible, so can those for citizens, allowing secure access to patient and client records. “But we’re not there yet,” cautions Mr Tyndall.

Copyright SA Mathieson 2005. This article won the inaugural BT IT Security Journalism Award for Best Identity Management Story.