Original URL: http://www.theregister.co.uk/2010/11/24/nhs_connect_facebook_privacy_fears/

NHS enables Facebook to track surfers on health info website

Privacy experts say 'ick, germs'

By John Leyden

Posted in Security, 24th November 2010 16:36 GMT

Privacy experts have expressed dismay at a decision by the NHS to allow Facebook and Google to track users on one of its sites.

The NHS has integrated its NHS Choices site into the Facebook Connect platform, so that surfers can express an interest ("like") for pages on the site and share content with their friends and contacts on Facebook. Google is also able to track the behaviour of individuals on the NHS Choices website, online privacy firm Garlik warns.

Garlik is sharply critical of the designers of the site. Mischa Tuffield, a developer at Garlik, criticised the design decisions as either "ill judged or ill informed".

Most of Tuffield's criticism focuses on the tie-up between the health information site and Facebook Connect which "opens the door to third-party tracking", even in cases where a user is not logged into Facebook at the time of visiting the NHS Choices site.

The site also uses analytics services from Google and Webtrends, something Garlik argues should not be trusted to a third-party supplier, as outlined here. However, it reserves the bulk of its criticism for the tie-up with Facebook.

Tuffield writes: "What right has the NHS to share any information about the browsing of NHS Choices with Facebook? The Like button is engineered such that even if it is not clicked, it still passes information about the user to Facebook, even if they are not logged into Facebook at the time of the visit."1

Garlik, which was the first to warn of the issue, was able to establish that tracking took place using internet logging tools. It knows from this exercise that individually identifiable data is exchanged between NHS Choices and Facebook, but not how it is used.

Users can be expected to be viewing content on NHS Choices that most might normally be expected to want to keep private. Garlik offers an example of a young mother looking for information on post-natal depression, but many others can be imagined.

The sharing is mentioned in the NHS website privacy policy, something few average punters would read, and a point that cuts little ice with Garlik or other critics.

Andy Thomas, Garlik’s managing director, said: "The fundamental issue here is that the NHS believes it is acceptable to share information about users' browsing habits with third parties. This appears to have been a conscious decision, and the NHS believes that a statement buried away in a privacy policy makes it OK."

"NHS Choices has either wilfully decided that sharing the pages visited by all Facebook users with Facebook is acceptable, or has implemented the technology without understanding how it works."

The issue has been taken up by Tom Watson MP, who wrote to the Health Secretary on Tuesday to express his concern that the "NHS is allowing Google, Facebook, and others to track your nhs.uk browsing habits, regardless of the fact that people use the page to seek medical advice".

"The NHS Choices website is used by members of the public in order to find out facts about ailments they may be suffering from and these illnesses could cause an individual embarrassment if the information was leaked," he writes.

Watson wants the link between NHS Choices and Facebook Connect to only exist in cases where users opt in to link the services, rather than (as now) by default.

We’re keen to allay any fears...

Facebook said Garlik and Watson had misunderstood the purpose of the tie-up, which allows users to more easily share information about disease prevention with their contacts on Facebook. In a prepared statement, Facebook also said it didn't share the data from social plugin partner sites such as NHS Choices with third parties.

Medical privacy is a crucial issue and following Mischa’s post we’re keen to allay any fears people might have around Facebook’s use of data associated with the Like button, which the NHS Choices website has chosen to adopt.

The Like button allows people to share information that is important to them with their friends. It appears that Mischa is concerned with what Facebook could potentially do with the data we use to make this experience work. Facebook does not share your data with third parties. It is against Facebook’s terms to use this data for any purpose other than to create a more personalised experience on the web.  In the same way that the NHS would not share you data, Facebook would not either.

On the NHS website, people are opting to raise awareness around illnesses that affect all of us and the Facebook Like button is a great way to help people spread the NHS’s education messages about early detection and prevention of such illnesses to their friends on Facebook.

When a person is logged into Facebook and visits a partner site that is using a social plugin, such as NHS Choices, Facebook can see technical information such as a person’s User ID, IP address and operating system. This is industry standard data that helps us customize the experience on the partner site for the person, such as showing what friends have liked or recommended. Our highest priority is to keep people in control of their information on Facebook. If a person decides they do not want a personalised experience on a partner site, they can log out of Facebook and we will not receive their User ID. We also delete this technical impression data within 90 days of receiving it, which is consistent with standard industry practice.

David Harley, senior research fellow at net security firm Eset, and a former NHS IT manager for five years, was unimpressed by these arguments, adding he could see no good reason for an NHS-produced medical information page to have a Like button. "I'd have thought there were ways of capturing hit data that don't involve Facebook at all, let alone risk allowing it pre-anonymized ID data," he said.

"While the actual risks may not be huge, the breach of principle is major. There is no reason I can see why the NHS, which is bound (or should be) by data legislation that's specific to UK healthcare as well as the more obvious legislation like the Data Protection Act, should have gone into reverse and exposed its customers to the attentions of a company which is obsessed with sharing information rather than protecting it.

Of course there are occasions where healthcare-related data, should be shared, but only with parties who have a right to it. Why does Facebook qualify, however trivial the data?"

"It may not be interested in a young mother's bingo addiction, but I have yet to see any proof that it can be trusted to protect data relating to access to a healthcare site from inappropriate sharing." ®

Bootnote

1Facebook confirmed Garlik's contention that it gets data on users visiting NHS Choices even if they are not logged into Facebook at the time.

"When a person is logged into Facebook and visits a partner site that is using a social plugin, Facebook can see technical information such as a person’s User ID, IP address and operating system. Note: we will still receive their IP address, operating system even if the user is logged out; we just won’t know their User ID," it said.

Users concerned about this on NHS Choices, or other Facebook partner sites, need to opt out of viewing social plugins, a feature that is enabled by default.