With its rollout coming closer, critics of the German smartcard project are once again becoming louder. Three regional political representative bodies of doctors, dentists and pharmacists are now supporting an anti-smartcard alliance.

The “Stoppt die e-Card” alliance was launched in January this year and is a rather diffuse conglomerate of civil rights organisations, regional interest groups and patient organisations, most notably the German AIDS-aid.

As a reaction to recent headlines about poor data privacy protection among health insurance companies, the alliance has stepped up pressure against the smartcard project.

And its latest statement has been publicly supported by the Kassenzahnärztliche Vereinigung Hamburg (KZVH), the Kassenärztliche Vereinigung Hamburg (KVH) and the Apothekerkammer Hamburg. The KZVH represents all dentists in Hamburg. The KVH represents all doctors in private practice in Hamburg. And the Apothekerkammer is Hamburg’s chamber of pharmacists.

Their move is remarkable because all three organisations are legal corporatist bodies that are bound by instructions from the ministry of health. Even though they only cover Hamburg, they represent the highest political level that the anti-smartcard protests in Germany have reached so far.

KVH-representatives focussed their objections on data privacy issues while dentists and pharmacists pointed to unresolved technical problems. “It is not that we are against progress per se”, said the head of KVH, Dieter Bollmann. But he said the smartcard project meant an enormous collection of private data that would automatically create the potential for illegitimate use.

As an example, Bollman cited a recent episode in which the German health insurance company DAK gave patient data to an American subcontractor that is running DAK’s callcenter for chronically ill patients – allegedly without seeking consent first.

The episode did not have anything to do with the smartcard project. In fact, the law that rules the introduction of smartcards in Germany says the patient is the only one who can consent to give access to his card. However, this has not stopped it influencing the debate.

The head of the chamber of pharmacists, Rainer Töbing, said that tests in pilot regions have not been satisfying so far. “Every other day, a technician has to come in because the smartcard readers don’t work,” said Töbing. Most of the problems come from electronic prescriptions, which are not part of the initial rollout that is scheduled for early 2009.

Eric Banthien, head of Hamburg’s dentists, also pointed at problems in the test regions, notably unresolved workflow issues. He also criticised plans to record a citizen’s willingness to be an organ donor on the smartcard: “If this information is part of the emergency data set, a doctor will have to ask the dead person for his PIN.”

Again, though, one of the things that has been clear for years is that doctors do not need a PIN to look at emergency data.