In January, The Herald published an article reflecting upon my career of more than 30 years as a rural general practitioner and the changes those three decades have brought to the relationship between Scottish patients and their doctors. One of the themes of that article was the progressive dilution of the controls over personal medical details held within the lifelong GP medical record.

With news of yet another breach of confidentiality through the loss of a memory stick by PA Consulting and the report of hackers gaining access to the sensitive personal data of numerous customers of Best Western (Sunday Herald, August 24), it must surely be time that the whole exercise to place computerised medical records on the government's ill-fated Connecting for Health central database is fundamentally reviewed.

The rationale for this initiative ostensibly is patient safety. We are told it is essential that hospital clinicians have instant access to the GP's medical record to avoid drug interactions and better to manage emergency treatment. There are also arguments to secure morbidity data for NHS public health purposes and forward planning, and already there are plans afoot in England routinely to download information from GP computers, supposedly anonymised, to be handed over to Department of Health bureaucrats.

There is no doubt that the underlying intentions of these plans are benevolent, but what of the risks?

Already hospital pharmacists and others within "the NHS family" are demanding access to the Emergency Care Record that is available online for all Scottish patients unless they have actively opted out. Agencies such as the police, the DSS, the security services and HMRC are also eager to have access, offering excuses such as detection and prevention of major crime, benefit fraud, national security and tax evasion.

Against all this, I can point out that only once a decade have I ever been telephoned urgently for a patient's medical history, and that the information I have garnered over many years has been given to me in complete trust by my patients and not for any other purpose.

My concerns have often been dismissed by enthusiasts who point to the access I have given to my clerical staff in order to practise efficiently. They also mention that office cleaners could potentially illegally peruse records. My answer is that all my staff know that to abuse those privileges is to invite instant dismissal. The security I offer my patients, based upon contracts of employment and personal knowledge of the staff involved, must surely be of a higher standard than the loss of unencrypted data on a stolen laptop, mislaid CD or lost memory stick, hundreds of miles from my village of Balfron.

We live in a society that is under the scrutiny of the state as never before. There seems to be a closed-circuit camera on every street corner, in every supermarket and peering down from every garage forecourt, and we now even see television advertisements counselling us against benefit fraud or television licence avoidance with the sinister message: "We know where you live."

This is the result of a risk-averse society that sends health inspectors to assess the food poisoning risk of Women's Institutes' upside-down cakes, that has generated a vast industry in criminal-record checks for anyone who comes within 10ft of a child, and that will introduce hasty regulation instead of public education for any perceived danger. As a result, we have seen children fearful of playing outside, increasing curtailment of personal liberty and a whole generation of overweight citizens that seems powerless to challenge these intrusions, no matter whether they are enacted in Holyrood, Westminster or Brussels.

I believe, however, that there is a greater, more pernicious risk to us personally and collectively: the danger of living our lives without questioning the rationale for the increasing loss of control over our own personal destinies. Intrinsic to that expression of individuality is the right to restrict access to our own personal data, and there can be nothing more personal than those within our family doctor's record that cover not only medical history, but also our social and psychological problems, and those of our immediate family. How many more scandals of information incontinence will it take before the Scottish public demands a fundamental review? Every pernicious outcome I have predicted over the past few years is now in place - inadvertent breaches of confidentiality, illicit access to the records of celebrity patients, extension of access beyond registered doctors, applications for access by non-medical agencies and criminal attempts to hack into clinical databases.

Connecting for Health is already millions over budget and even now, nearly a quarter of a century after George Orwell's 1984, it is not too late for reflection and for a complete rethink. If we do not, I shudder to contemplate life in another 25 years but, paradoxically, it might be that I shall lie quietly in my grave knowing that I have finally escaped Big Brother.

Dr Brian Keighley is a GP in Balfron.