A Tale of Life, Death and Healthcare in the Information Age

Everyone warned old George Henderson that he was too ill to travel to the reunion, but he wasn't listening. He wouldn't allow the minor fact of awaiting a heart, liver and lung transplant spoil his big day. It was a time to fly the colours, to count the survivors, to prove the circle was still unbroken. Most of all, it was a chance to relive the good times. After all, the fortieth anniversary of the Isle of Wight Pop Festival didn't come by every weekend.

As it happened, Mr Henderson's heart, liver and lungs held out fine ­ until his vintage Norton Commando motorcycle, greatly exceeding the 30 km/h speed limit, failed to negotiate a roundabout on the A32 outside Southampton.

Witnesses, including an ambulance crew, saw the bike start to drift sideways halfway through the turn, strike a curb and somersault into the crash barrier. The first impact dislodged the rider, who flipped over the barrier and into a ditch beyond.

An ambulance had been stationed at the spot for just such an eventuality ­ neural network computers at service headquarters had analysed data from traffic surveillance cameras, weather forecasts and news reports, and identified the roundabout as a likely holiday black-spot.

But in Mr Henderson's case, it didn't look as if their preparations would do much good. Especially when the paramedics saw the rider's age, compound fractures in both legs and signs of serious internal abdominal injury.

They stabilised the unconscious motorcyclist where he lay and fed his vital signs back by radio to a rota team of intensive-care specialists, who happened to be in Birmingham. A casualty officer urged them on, guided by video pictures from the paramedics' headsets.

­ Have we got anything with his records, yet ?

­ Hold your horses. He's not wearing a chip-locker.

­ The old 'uns hardly ever do. Any sign of a smart-card? Try that pocket, there.

­ Yup, here we go. Hang on while I read it.

The paramedic on the scene swiped the card taken from Mr Henderson's wallet through a portable scanner and entered his own personal identity number. Somewhere in Britain, a computer logged the fact that an authorised NHS employee was seeking emergency access to an individual's health record. A few, maddening, seconds later, the paramedic began to read out details as they appeared on her portable computer.

­ Name: George Henderson, date of birth twelve two forty five... Look at that ECG; I'm amazed he's got a driving licence. Oh, he hasn't; withdrawn after medical alert. Don't think we're going to be able to do much for this one.

Certainly, Mr Henderson's online medical record was voluminous; the legacy of a lifetime's damage to lungs, liver and brain-cells. The list of organs suitable for transplant was correspondingly short. And the "living will" panel, signed by the statutory two witnesses, was marked "Do not resuscitate". Touchingly, Mr Henderson had hand-written at the age of 63: "Still hope I die before I get old."

­ Better take him into Winchester, the casualty officer advised.

­ Looks like they've got Plenty of A&E slots. I'll zap a booking and a care protocol down the line from here. But I don't think he'll qualify for those transplants he's applied for, now. I'll put in an advisory to the assessment agency. Best of luck, guys.

The ambulance set off, red lights flashing. Automatically, it transmitted its change of status via satellite to Southern Control, where a computer despatched another to take its place. The decision was approved and activated by a human controller (old habits die hard in the emergency services).

By the time the ambulance had arrived at Winchester high-dependency centre, one of the handful of full-service acute hospitals remaining in southern England, Mr Henderson was in a very poor state indeed. He went directly to intensive care.

By now, his next of kin, as identified on the smartcard record, had been informed. His daughter, Bonneville Henderson QC, was sorting through her Thursday evening paperwork at her firm's London chambers when the phone rang in the tone indicating a personal call.

As the co-author of Videophones as a Feminist Issue, Ms Henderson ignored the request for a picture link-up and took the voice-call only.

She cut briskly through the solicitous tones of a trained patient affairs officer gently breaking the news of "a serious accident to your father".

­ What's he gone and done now?

But she felt a little sorry in the mortuary viewing room in the early hours of the next morning, even though it was the way George would have wanted to go. Her fellow mourners agreed noisily and left in search of their bottle of tequila which the mortuary attendant had tactfully confiscated at reception. It was time to plan a suitable wake for a truly righteous veteran Hell's Angel.

Outside, police video-surveillance computers took in the sight of elderly men noisily misbehaving on motorcycles and alerted their human controllers to expect a busy holiday weekend.