The Tamil Nadu government plans to set up a population health registry and a unique health ID (UHID) that will be allocated to residents across the state, Health Minister Ma Subramaniam said on Sept. 2.

In a speech to the State Assembly, the Minister of Health claimed that the health ID would improve the state health index. He announced the project along with a number of decisions by the Ministry of Health. Further details about the project were not given.

This comes at a time when the Union government has issued over 11 million Unique Health IDs via the CoWIN platform as part of the National Digital Health Mission. The government was before criticized for the inclusion of vaccine recipients in the 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 long been underway. As part of the National Digital Health Mission, “every Indian is given a health card” that contains a person’s medical history, including “any tests, any illness, which doctor gave you which medication, when, what your reports were,” and will do so Doctor’s appointments, payments, etc., said Prime Minister Narendra Modi. The mission consists of six key components Health ID, DigiDoctor, Health Facility Registry, Personal Health Records, E-Pharmacy and Telemedicine, the NHA statement reads. “All of these digital products except e-pharmacy and telemedicine have been deployed and are up and running,” she added

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Questions and concerns crop up about UHID. in Tamil Nadu

Citizens on social media pointed out that in the absence of a data protection law like the Draft Personal Data Protection Act, the introduction of Unique Health ID could prove risky.

Other questions that have emerged following the announcement by the Tamil Nadu Minister of Health include:

  • How is this proposed UHID different from the one issued by the Union Government?
  • Are the operations that fall under the state-issued UHID not counted under the national health card?
  • What if you don’t have a government issued UHID and have a UHID issued by the National Health Authority?

Tamil Nadu also uses 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 that involves building a cross-departmental database of electronic records for all citizens of the state.

The element that holds everything together in the SFDB is this Makkal number (translated into the number of people): a unique number that the Tamil Nadu government has already allocated to nearly 7 million residents in the state. Each person’s records in various departmental databases within the SFDB are linked to that person’s Makkal number. In contrast to Aadhaar, the Makkal number is not necessarily known to the citizen. Rather, it is used to consolidate data records in the backend.

It is not clear when exactly the government started issuing Makkal numbers, but it appears to have emerged 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 wanted to do many things that the new SFDB wants to do now. But SRDH mainly used Aadhaar to provide its services in accordance with the regulations granted by Section 57 of the Aadhaar Law, 2016. This section was deleted in 2018, albeit a separate one modification in 2019 allowed states to still use aadhaar to some extent. Around the same time, the Tamil Nadu government began issuing the Makkal number to its citizens. At that time a top official from the IT department told Hindu: “The idea is to anonymize Aadhaar and give citizens a number as this is foolproof. This will be based on the consent of the person. “

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