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Tamil Nadu government’s plan to roll out its own Unique Health IDs raises eyebrows

The state’s decision to provide UHIDs for all residents has only led to more questions and some concerns.

The Tamil Nadu government is planning to establish a population Health Registry and a Unique Health ID (UHID) which will be assigned to residents across the state, Health Minister Ma Subramaniam said on September 2.

Speaking at the State Assembly, the Health Minister claimed that the Health ID will improve the state health index. He announced the project along with a number of decisions taken by the Health Ministry. No further detail was given on the project.

This is happening at a time when the Union government has issued over 11 crore Unique Health IDs, through the CoWIN platform as part of the National Digital Health Mission. The government has previously been criticised for enrolling vaccine beneficiaries into NDHM without obtaining their informed consent.

What is the NDHM? On August 15, Prime Minister Narendra Modi announced the National Digital Health Mission, a project that has been a long time in the making. Under the National Digital Health Mission, “every Indian will be given a health ID”, which will contain a person’s medical history, including “all tests, every disease, which doctor gave you which medicine, when, what were your reports” and will also include doctors’ appointment, payments, and so on, PM Narendra Modi said. The mission is made of six key components Health ID, DigiDoctor, Health Facility Registry, Personal Health Records, e-pharmacy, and telemedicine, the NHA’s statement said. “All of these digital products except e-pharmacy and telemedicine have been deployed and are up and running,” it added

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Questions and concerns emerge on Tamil Nadu’s UHID

Citizens on social media pointed out that the introduction of the Unique Health ID in the absence of a data privacy law like the draft Personal Data Protection Bill can prove to be risky.

Other questions that have been raised following the Tamil Nadu Health Minister’s announcement are —

  • How different is this proposed UHID from the one that’s being issued by the Union government?
  • Will the operations that come under the state-issued UHID, not be considered under the national health ID?
  • What happens if one does not have a state-issued UHID and has a UHID that has been created by the National Health Authority?

Tamil Nadu also deploying State Family Database, Makkal numbers

The Tamil Nadu government is developing the State Family Database (SFDB), a mammoth e-governance project announced in January 2019 which involves building a cross-departmental database of electronic records for all the citizens of the state.

The element that ties everything together in the SFDB is the Makkal Number (translates to people’s number): a unique number that the Government of Tamil Nadu has already allotted to nearly 7 crore citizens of the state. Each person’s records across various departmental databases within SFDB will be tied to the said person’s Makkal Number. Unlike Aadhaar, Makkal Number is not necessarily known to the citizen. Rather, it is used for consolidating records in the backend.

It is not clear when exactly the government started issuing Makkal Numbers but it appears to have stemmed from another e-governance project. Back in 2013, the Tamil Nadu government created the State Resident Data Hub (SRDH), later renamed Makkal, an e-governance project that sought to do many things that the new SFDB is now looking to do. But SRDH primarily used Aadhaar to deliver its services under the provisions granted by Section 57 of the Aadhaar Act, 2016. This section was struck down in 2018, although a separate amendment in 2019 allowed states to still use Aadhaar to a certain extent. About the same time, the Tamil Nadu government started issuing Makkal Number to its citizens. Back then a top official from the IT Department told Hindu that “The idea is to anonymise Aadhaar and provide a number to the citizens as it is fool-proof. This will be based on the consent of the individual.”

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Among other subjects, I cover the increasing usage of emerging technologies, especially for surveillance in India

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