GP IT expert Dr Paul Cundy has resurrected concerns about threats to patient confidentiality in the draft Health and Social Care Bill.
Dr Cundy, who is joint chairman of the BMA and RCGP's joint IT committee, has written an open letter outlining his concerns about the impact of the new legislation.
The letter says the notion of patient confidentiality underpins the doctor patient relationship and this trust is threatened by the draft bill currently before the House of Lords.
The Bill establishes the Information Centre as a corporate body and requires doctors to release "any information" that the centre requests of them.
“Doctors will find themselves in an impossible position, on the one hand expected by all to protect patient's information and on the other, subject to a legal requirement to breach that trust,” Dr Cundy's letter says.
“The media focus on GP commissioning has allowed this violation to pass as yet largely unnoticed and unchecked; it is my hope that with the bill now before the Lords corrective action will be taken.”
The Royal College of GPs and British Medical Association BMA raised similar concerns earlier in the year. However, in September, the BMA said it had accepted concessions offered by the Department of Health on the information provisions in the bill.
These included a restriction on the number of bodies that would be able to mandate the NHS Information Centre to collect data from providers and a limit on when such powers could be applied.
Dr Cundy told eHealth Insider that the patient confidentiality issue had dropped “way down the agenda” and his letter was intended to “bring it up again."
He said the Summary Care Record debate showed the issue of confidentiality was very important to the public.
Patients wanted GPs to act as guardians of their information and would be “horrified” to learn that the Bill gave powers to the health secretary to demand information from their doctor.
He said current law - such as the Data Protection Act and a European Union directive - empowered GPs to protect the information that they held on their patients, and attempts by the government to get information in the past had “faltered and failed."
The government appeared to have decided that if it wrote a new law it would “trounce” all the others and GPs would have to give the information up, said Dr Cundy.
“If this new law goes through it will be difficult to know where GPs stand,” he said. “It’s going to be a very very messy situation.”
Former NHS chief information officer Christine Connelly told a Westminster Health Forum meeting earlier this year that the Bill was only intended to give the new organisations being created by the Bill the powers that existing organisations have.
© 2011 EHealth Media.
Lets make sure a sensible approach to data confidentiality does not get over stated.It is I, LeClerc 139 weeks ago
While all the concerns expressed may well be true, the conversation makes me wonder about the old days, which were not that long ago anyway.
In the old days hospital medical records were kept in unlocked stores, thousands at a time. Usually there was no (or only limited) access control, though tracer cards were used (mostly). Oh yes, if not in store or ward/clinic the notes were probably in some doctor's office, car or home, failing that someone had them for research or audit.
In truth, the controls were at best lax and by todays standards totally unacceptable, but no one (clinical) considered it unusual. Was the patient disadvantaged, did they worry? Has there been a history of consequences that demanded better confidentiality? Perhaps, but I think I have heard more about the potential risk than from angry patients. Do we have evidence that patients really care about confidentiality more than their doctors/carers having access to all their records?
Lets make sure a sensible approach to data confidentiality does not get over stated.
A matter of concernJacquesOuze 140 weeks ago
At times like I feel we really need another detailed legal opinion from Dr Paul Thornton to clarify the issues for when the deluge of test cases start pouring through....
But it could be just a bit of sloppy drafting in the bill (I know, how far-fetched is that?) and they just meant that GPs would have to fulfil any reasonable, legal information request that doesn't compromise their duty of confidentiality etc etc.
As is so often the case with Dr Cundy and some of his colleagues I'm reminded of Lyndon B Johnson's famous judgement on J Edgar Hoover. Given that his open letter constitutes one more brickbat being lobbed at Mr Lansley's bill, I'm more than happy to cheer him on.
Confidentiality is gonedyfthegog 140 weeks ago
As a GP in North Wales, I was asked to participate in the Out of Hours access to patient records. These are held in a server, off site and are updated during every day according to everything that we type on our machines in the surgery. We agreed on the understanding that patients would be informed and offered an opt-out. This was something new to the adminidroids who hadn't thought or couldn't care that some patients might find it a potential breach of security. They were going to ask patients, after the initial download, as to whether they could retain their information or would they like it removed. They then said that there would be a campaign before the download. As a patient in the area, I have neither been asked permission for the initial download or subsequent retention of my records.
We did publicise this in-house and have had some coded in the records. However, we don't know if these codes have worked. Irrespective of the potential good use that this upload may have, the method leaves an awful lot to be desired. Confidentiality maybe, consent no way.