The Pharmaceutical Journal
Vol 279 No 7475 p480
27 October 2007

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Insecurity of medical data

What does it mean to live on a pittance?

Our hidden heritage of private libraries

An unwelcome import

Insecurity of medical data

Computer technology continues to advance, and one of the biggest forms of advance has been in the storage of data.

Early mainframe computers had huge magnetic drums onto which data were stored, while many “home” computers, such as the BBC Micro, of blessed memory, used the kind of tape cassettes on which music could be recorded.

We then had a variety of discs, from floppy (referring to the circle of magnetic tape within the disc) to CDs and now DVDs — all with massive increases in storage capacity within a small space.

The latest storage format is the USB stick, which is inserted into a vacant universal serial bus (USB) port on a computer. These offer the ultimate (so far) in convenient, portable data storage.

A letter in a recent BMJ, from a doctor at a large teaching hospital, describes how a junior doctor’s USB stick, containing confidential patient information and much medical data, was stolen. This has profound implications, not just for “patient confidentiality” (whatever that really means) but most importantly it offers yet another route whereby identities can be stolen for criminal purposes.

A survey of 50 junior doctors in that hospital revealed that 30 of them used USB sticks for storing patient data; most sticks had no encryption or even a password, so anyone could access the data. Presumably, discipline will be tightened over this potentially devastating loss of personal data.

However, this poses another problem. It is extremely easy to download data from any computer using a USB stick. It would take only seconds to copy a large database, and no one would be any the wiser as there is no immediately obvious trace left of the theft.

Some organisations (the “A”-level examination boards, for instance) now forbid the carrying of USB sticks and mobile telephones with cameras (most of them nowadays) into the secure areas of their offices. Should the NHS not take a rigorous stand over when it is acceptable to use these devices?

Also, are you certain that no one could go into your dispensary armed with a USB stick and steal your patient data? Not only would this breach patient confidentiality, but would also allow a rival (or potential purchaser of your business) unprecedented access to your business data.

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What does it mean to live on a pittance?

The phrase “to live on a pittance” is usually taken to mean having little money. Some people refer to their state pension as a pittance and it is, in those circumstances, used almost as a term of derision. But what is a pittance?

The term pittance (from the Latin pietas, loving kindness) goes back to medieval times and was a gift made to the members of a religious house, such as a monastery, consisting usually of an extra allowance of food or wine on occasions such as festivals. The word was also used to cover charitable donations and any small gift of food or money.

The pittancer was a religious officer in charge of accounting for and distributing donations to the monks or nuns. The actual pittances were small, consisting of something like an egg or a small piece of fish, to enliven the monotonous diet of the members of the religious house. Hence, to live on a pittance was to live on these small amounts of food.

Probably the only place in England still to have its official Pittancer is the market town of Selby in Yorkshire. The post had been vacant since 1517, when the then incumbent was sacked. The young comedian Tim FitzHigham asked if he could have the job and was appointed in 2005. His duties are to attend the morning service at Selby Abbey on Maundy Thursday, ensure that any monks present have sufficient eggs and cheese, and to pay the vicar the pittance of £1 per year to augment his stipend.

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Our hidden heritage of private libraries

Among our country's hidden treasures is its chain of independent subscription libraries. They constitute a little-known but important segment of our cultural heritage. Most were founded between about 1760 and the 1840s. This period, before the advent of the free public libraries, was a time when more and more people wished to read books but books themselves were expensive. People therefore formed themselves into societies for the purchase of books which were then lent to members.

Many of the societies acted not only as libraries, but as clubs for like-minded people and also as museums. Many, if not most, still have social activities and lectures in addition to their function as libraries. Many are registered charities with the aim of promoting public education.

Probably the largest and best known is the London Library in St James’s Square. Founded by Thomas Carlyle in 1841, the London Library has over 8,000 members and more than one million books. It is said to be the world’s largest independent library.

By contrast, the smallest in the UK is the Tavistock Library in Tavistock, Devon, with under 100 members; the oldest is Chetham’s Library (founded 1653) in Manchester. The famous “Lit and Phil” — the Newcastle upon Tyne Literary and Philosophical Society — with some 1,600 members, is one of the few subscription libraries really to be in the public eye.

The less well-known include the Sybil Campbell Library in Winchester, the Morrab Library in Penzance, Bromley House in Nottingham and the Armitt Library in Ambleside. In addition to a wide range of books and documents covering the social and intellectual life of the Lake District, the latter has a splendid collection of watercolours by Beatrix Potter.

Our private libraries are indeed a national treasure.

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An unwelcome import

I became aware of another potential threat to my beloved collection of cacti.

This is the cactus felt scale, a small insect Acanthococcus coccineus (Cockerell) which hides among the spines of the cacti. The pest feeds on the phloem of the plants, thus slowing their growth and perhaps also injecting bacteria or viruses which can do serious damage.

A native of North America and now a global problem, the cactus felt scale was introduced to the UK in 1997 on a batch of cacti imported by a nursery in the South of England.

Although the nursery concerned has apparently now controlled the infestation, the insects are probably well established in this country by now. They are approximately 3mm long by 2.5mm wide and are bluish purple to reddish purple.

There is probably no treatment for an infestation with this creature other than isolation and destruction of infested plants, but it might be worth trying methylated spirit on a fine paint brush — the technique used to deal with mealy bugs that are sometimes found on cacti.