The British Journal of General Practice has just published an editorial I wrote on Patient confidentiality and central databases. I’m encouraging GPs to make clear to patients that it’s OK to opt out - that they won’t incur the practice’s disapproval. Some practices have distributed leaflets from www.TheBigOptOut.org while others - such as The Oakland practice - have produced their own leaflets. These practices have seen the proportion of patients opting out rise from about 1% to between 6% and 19%. The same thing happened a few years ago in Iceland, where GP participation led to 11% of the population opting out of a central database project, which as a result did not become universal. GPs can help patients do the same here.