Medical Confidentiality Threat

posted: 16/02/2009

The confidentiality of medical records is under even more threat from government plans to relax laws on data protection, doctors' leaders have warned.

Dr Hamish Meldrum, chairman of the British Medical Association, said the profession was "extremely concerned" about legislation tabled by Jack Straw, the justice secretary, which would allow the Department of Health to share information on NHS databases with other ministries and private companies.

Health ministers have no immediate plan to make use of the power, which would give all Whitehall departments a fast-track procedure for getting permission to share data without parliamentary debate.

The NHS is years behind its timetable for putting everyone's medical records in England on to a national database known as the Spine. Ministers have given frequent assurances to patients that the information would only be accessed by healthcare staff who need it. However there are many, many examples of computerised medical and other data being lost or misused.

Health details might be shared for benefit claims

But Meldrum, chair of the British Medical Association, said people could not know whether future ministers or a future government would not share our private medical details with other departments. A future government might perhaps decide that it is administratively convenient to share details from your health records with the Department of Work and Pensions when you claim sickness or disability benefits.

According to the BMA, the trust between doctors and patients would be destroyed if Straw's bill, as it stands, became law.

In an interview, Meldrum said: "The bill gives any minister the right to access patient-identifiable information - and give others access to it. There appears to be no limit to what could be done with this information as long as the minister can make a vague ... justification, claiming that sharing the information is in line with government policy at the time.

"The doctor-patient relationship is built primarily on trust that information is given confidentially and will not normally be shared without the patient's consent. Once we go down the road where that principle can be breached, widespread possibilities could flow."

Hidden in Coroners and Justice Bill

The data-sharing power is included in clause 152 of the coroners and justice bill, which is mainly concerned with reform of coroners' courts and death certificates.

It would let any minister sign an "information sharing order" permitting the passing of data to another department, individual or company if it were "necessary to secure a relevant policy objective" and if the order "strikes a fair balance between the public interest and the interests of any person affected by it".

But doctors fear that in future ministers may see a public interest in making medical records available to vet recruits, or check people seeking benefits. Until now public bodies have not been allowed to pass on personal data - or let information collected for one purpose be used for another- without fresh primary legislation.

Only 3 weeks to object

Meldrum said he was not satisfied by the safeguard in the bill. This gives the Information Commissioner three weeks to comment on a data-sharing proposal, giving MPs an opportunity to vote it down. "I have not seen an argument why the [government] need this general power," he said.

Worried Information Commissioner

The Information Commissioner's Office, the independent authority for data protection, called for "much stronger safeguards in the bill to protect sensitive data, such as health records". If the Information Commissioner is worried, we should all be.

The Ministry of Justice said data would be shared only "in circumstances where the sharing of the information is in the public interest and proportionate to the impact on any person adversely affected by it". The Department of Health added it was "important to ensure that patient confidentiality is preserved and that patients consent to how their records are used".

Coroners and Justice Bill hides other surprises

This bill is a hotch-potch. Do not be deceived by the title given it by Jack Straw. It is a supermarket trolley full of bits of legislation that the government and the civil service want passed.

As well as

• allowing a minister to decree that an inquest should be held in secret to protect the state, or its relations with foreign powers,
• it removes exemption for "discussion or criticism" in the new offence of inciting hatred on grounds of sexual orientation;
• it makes changes to legal aid;
• it reforms bail in murder cases;
• it extends the law of child pornography to include non-photographic images; and
• it facilitates the sharing of personal data by all government departments.

As one commentator has pointed out - the strategy is clear. Secret inquests will draw the fire on the bill and then - conveniently - there will be no time to debate the huge issue of uncontrolled sharing of personal information between government departments and agencies.

As the Lords report on surveillance society stated two weeks ago: "The huge rise in surveillance and data collection by the state risks undermining the long-standing traditions of privacy and individual freedom which are vital for democracy."

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