Professor Seb Bacon delivers inaugural lecture on why health data should always leave a public trace

In this inaugural lecture – a university tradition in which a new professor sets out the ideas and questions that shape their work – I argue that when we work with health data, we don’t have to choose between saving lives and protecting privacy. If we keep health data private, while making every use of it publicly traceable, we can do both.

At the centre of my argument is a civic claim: civilisation advances when we stop relying on virtue, and build systems that assume fallibility. Good people make mistakes. Institutions drift. Incentives change. Trust matters, but trust alone does not scale. Accountability has to be built into the system, before anything goes wrong.

This argument is also about the future of the NHS. The NHS is not only a system of pooled money, services, or risk. It is also a system of pooled vulnerability. And privacy is not just about secrets; it’s about power, context, and the possible consequences of exposure. When we allow institutions to query intimate knowledge about our bodies, histories, families, and futures, we do so because we believe that knowledge will be used carefully and for public good. A public audit trail is how that promise becomes visible.

This is the principle behind OpenSAFELY, the secure analytics infrastructure I designed at the Bennett Institute during the COVID-19 pandemic. In OpenSAFELY, researchers bring code to the data, rather than taking data away. The data remains protected, but the questions asked, code run, and outputs produced always leave a public trace, by design. When openness is built into the system, accountability stops feeling exceptional and starts to feel normal.

In the lecture, I also discuss open-source software, Freedom of Information, research integrity, water companies, medical record breaches, and the strange ways hidden systems can mislead us. These examples all point to the same conclusion: visibility is not only a safeguard against failure. It is a form of care.

Watch my inaugural lecture on the Bennett Institute’s YouTube channel.

To learn more about the Bennett Institute’s work with big data, visit our website, follow the Bennett Institute on LinkedIn and @bennettoxford.bsky.social (BlueSky), and sign up to receive notifications of the latest blog posts and newsletter updates.