List of NHS data breaches

Just a quick note to give a link to a list of data breaches by NHS areas/regions (England only). I am not sure if this is all data breaches.

Link to word doc: http://www.independent.co.uk/multimedia/archive/00090/dataloss_90125a.doc

Link obtained from http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/catalogue-of-nhs-data-losses-makes-shocking-reading-1035166.html

Patient rights

As a patient you have the following rights (I have put sources next to most and willing to back the following information up). I will be posting more about this.

1) You can ask for a doctor of the same gender for intimate examinations (source, Strawberry Gardens Medical practice, Morecambe). Even hospitals will allow this but this might not always be possible as it depends on how many doctors they have and I think it would depend on who asked, for example a Childs need might come first, something I can understand. If that is not possible at your GP practice, go to another practice and tell them you are in need of immediate medical attention and due to the nature only willing to see a male/female GP (you do not need to tell them what it is for). In some cases some patients might prefer a doctor of the opposite gender. You should also be asked if you want a chaperone to be present and they should be of the same gender as you.

2) You can refuse to have a trainee present. Might sound obvious, but this was not always followed in the past, especially by some teaching hospital (http://news.bbc.co.uk/1/hi/health/2642861.stm). In the words of a friend of mine “they viewed those patients as a piece of meat on a slab”

3) You can refuse to allow data to be shared with admin staff and others. “You must respect the wishes of any patient who objects to particular information being shared with others providing care, except where this would put others at risk of death or serious harm.” Source, GMC. This is also seems to be backed up by the NHS code of practice 2003 and the BMA. It is also something the Clinical Governance Support Practitioner NHS Grampian (although he seems to have turned a blind eye to the fact that this is happening and practices in the Grampian area). You can also have clinical data withheld from other doctors/nurses unless it would put others at serious risk. For example if you have been raped/abused, you do not need to let every doctor you see know if that helps you cope.

4) You can refuse medical treatment. This can be overridden if you are not deemed to me mentally competent. This has been controversial in the past (http://news.bbc.co.uk/1/hi/health/6213546.stm).

Tam Fry, the chairman of the Child Growth Foundation seemed to be planning on forcing children to give data for the ‘fat stats’ exercise the government wanted when he stated “The Social Care Act says that when there is an urgent need for medical information it can override an individual’s right to refuse.” (The Times, 21/12/06, p.24). In the future they will most likely get this info from their National Care Records (http://www.thebigoptout.com/?page_id=30) without consent  

Employer access to medical information

So what can employers ask you? Quite a lot actually!

For example I have had questionnaires that ask  if you have ever had emotional problems, had diarrhoea, vomiting, dysentery, food poising and any other medical problems. In other words if you have seen a GP/nurse for something, you must declare it directly to the employer and anyone else that handles the form. You also have to supply ‘details’ for each thing. Even if the employer does not misuse the above info (we all know this happens) and does not tell anyone (again we all know this happens), I for one think asking those sorts of questions is bang out of order and the CO-OP should not be asking them. I have also had questionaires that go as far as asking if you have ever been sexually abused because the job involves working with children!

What happens after you start? Well think about it. If you had to declare this sort of info before starting, they will most likely want to know it after you start, so no way to get help with emotional problems or anything else without telling the boss. I for one think that is bang out of order. I am all for employers knowing if you are capable of doing the job, but that in no way should allow them to know our medical info. The Job? Stacking shelves and serving customers at a shop in Bucksburn area of Aberdeen.. Why would that thrush, UTI or bleeding from your rectum prevent you from doing the job?

Some employers can also ask you to have a complete medical examination, such a the ones BUPA offers for employee screening (http://wellness.bupa.co.uk/for-business/health-assessments). With that in mind, you might want to ask for doctor of the same gender if you are being asked to have a medical for an employer, just in case in involves anything more than very basic stuff (you are allowed a GP of the same gender for intimate examinations even if it is not for a job). If your not bothered then that is is up to you.

The UK health profession refuse to do anything to stop this sort of thing and last time I contacted the MSP for my area (an SNP guy in Aberdeen) he seemed far from interested in stopping it, he even seemed to think it was a good idea for employers to invade our privacy.  

Organ donor plan to be rejected by scientists?

It would seem that the goverment might not be able to go with their implied consent idea for organ donation.

Implied consent is something that I am against. Taking an organ from someone on the assumption that they would want it taken is not good and lacks ethics.

With expressed consent the doctor and family know for a fact the patient wanted it, with implied consent there will always  be the possibility that the person did not want it. Implied consent has been shown time and time again that it does not work, so why rely on something that is serously flawed? With implied consent there are also legal problems that might come up. What happens if one mamber of the family says yes and another says no? With implied consent not being reliable, would taken the organ with only implied consent open the doctor facing legal action? Expressed consent gets over this.

It is easy enough to get people to opt-in. You could ask colleges/uni’s to give them out at registration, GP practice staff could ask patients as they arive if they have thought about it and news papers could give them away. The way to get donor cards to people is not a problem.

As always, here is the link:

http://www.timesonline.co.uk/tol/life_and_style/health/article5151532.ece

Child protection

Breaking the distrust

Catchy titles are not something I’m good at, so I thought I would keep it simple.

 

Everyone knows there are 2 sides to every story and that those on opposing sides often think they know best. The question nobody seems to ask is, is that the best’s opinion to have and am I really right?

 

There are people that do not trust child protection officers and there are people who think they are brilliant. At the same time you get people like me who are always on the side of the child which means I am often against both sides. You would think that would be the best place to be, but in reality it is a rather uncomfortable and at times upsetting place to be because I see both sides go at it, often like they were possessed, and I see the child stuck in the middle. I know of people who have been saved because of child protection workers and I know of others that have had their life ruined by child protection workers.

 

Having never done an article like this before, I thought it would be easier to play devils advocate for both sides. I am hopping that by putting both sides in the same article along with some solutions I think would help, at least some of those on the opposing armies will have a truce and do what is best for the child, that is stop thinking they are always right, get rid of their ego and start talking to each other.

 

Why the distrust?

There are various reasons why the public distrust paediatricians who work in child protection and other child protection workers. They operate in a world more secret than the security services, they are perceived to assume they are always right, the court hearings are among the most secret anywhere in the world meaning there is little or no transparency, they rely on things that are virtually impossible to defend against and they are often seen as being able to do what ever they want.

 

Despite all these concerns (I’m sure there are more), child protection officers still can’t seem to understand why they get such a hard time.

 

Whilst child protection workers do need to have some powers to act in the child’s best interest, is it right for them to have so much power whilst working under such secrecy? Some of the concerns might be unfounded, but the perception of child protection workers is important, simply thinking or saying it is not right misses the point and fails to address the concerns raised.

 

There is an argument that these levels of powers, secrecy and lower standards of proof are all needed to protect the child, but do they hold water and who is benefiting the most, the child or the profession?

 

Secrecy

Whilst there is an obvious need to protect the child’s privacy, is this done to an extent that goes far beyond what is needed and worse still, does this level of secrecy mean the child’s right, both under the human rights act and the Convention on the Rights of the Child are breached? After all, does the child not have a right to a family? How many times have we read/heard about the rape/sexual assault of women and even children in the news without them being identified? Whilst it would be far easier to work out the identity of the child if the identity of those involved were released, is it impossible to release any information without revealing their identity?

 

Some time ago there was a TV programme about the way the family courts work. In part of the programme it was reported that they were not allowed to say if 3 ‘experts’ talked to the parents before deciding if they harmed the child. Would the reporting of such a crucial thing really risk the child’s right to privacy? Would revealing the ‘experts’ did not talk to the parents show that there was a serious flaw in the evidence?

 

These courts are so secretive that reporters are not allowed in the court room, yet reporters are allowed in courts that involve serious sexual offences. What is the difference?

 

Burden of proof

This is a very touchy subject in fact even suggesting the burden of proof is to low can get you in trouble with some people.

 

Whilst the burden of proof does need to be lower, especially for those that can not give evidence, does it need to be so low?

 

It is well known that what would be thrown out of court, can be used to have children taken into care and child protection workers see themselves as being better than anyone else. Some stories that have been reported simply go to show how dangerous it is to have such a low level of proof, especially in courts that are so secretive. I took just 10 min to find a few examples, given an hour or so the list could be longer even with the secrecy surrounding child protection.

 

Experience

Have you ever noticed how young some child protection experts and social workers are? Granted some are getting on in years, but others look as if they are not long out of school or worse still, should still be in school. Can someone who has never had to raise a family and has had very little life experience be expected to know what’s best? If their background has been both parents, well off, private school and brought up in a nice area, can that really prepare them for dealing with a single mum/dad from a poor family staying in a housing estate in Glasgow where you don’t go out after dark? Are they really going to know what’s best simply because of their training? Are their personal experiences going to have an influence on what they think is best for the child?

 

Granted, not every child protection expert or social worker should have had a crap upbringing and be old enough to get a free bus pass, but should there be a balance of backgrounds and age in cases involving child protection?

 

Combination of things

The combination of the low standards of proof, the attitude of child protection workers and the secrecy surrounding what happens only makes things much worse, yet very little, if anything, is done to change this. This leaves us asking the question, why?

 

The ‘experts’ side

I write this not based on much experience (although I do have some), so others might think I am wrong on what I have to say.

 

Protecting a child is one of the most important things anyone can do and saving a child from abuse or neglect has got to be one of the greatest things anyone can do.

 

There is nothing more upsetting than thinking a child is at risk and not being able to do anything about it, I should know, I have been in that position. If you thought a child was at risk, how far would you go to protect them? That is an important question, because thinking of an answer might give you an insight into how child protection workers might feel.

 

Child protection workers have one aim, protect the child. They are often stuck between a rock and a hard place. If they get it wrong and the child is harmed, the press complain about them and if they take a child away when they should not have, the press complain about them and parent groups get vocal.

 

There is also the amount of work involved to be considered. Back in 2005 social workers took to picket lines over their casework load. Putting aside the details of the Victoria Climbie case (one often sited by government as a example of how we need more and more intrusion into private life’s), this was a tragic example of excessive work loads. It was reported back in 2001 that the case worker involved was overworked and not properly supervised. Instead of having to deal with her target of 12 caseloads, she was reported to have had 18. This not only shows what harm can come to a child by workload overload, but it also raises the question about the workload of other social workers etc. If you have a workload far in excessive of what you can cope with mistakes will happen, children will not only be harmed, but children might be taken away without good reason. The latter of these is crucial when thinking about some social workers and child protection workers. Whilst there is no doubt there will be people determined to get children away from parents regardless of what everyone else thinks because they think they know better or they simply don’t like the parents lifestyle, but does this extra workload mean some child protection workers are overly keen to get things done and dusted, something that could be causing them to get it wrong?

 

Is it right to target a group of workers who are often overworked and often stressed? I am not saying it justifies what they do, but it can help understand why they work the way they do.

 

There is also the fear of getting it wrong. If you get it wrong and the child is taken away you might get the odd slap on the wrist, but who else will know? The secrecy surrounding the system is so tight, will anyone else ever know? Public criticisms of such people rarely make the headlines and when they do, other child protection workers often come to the rescue. You only have to look at the case involving Prof Southall to see how this can happen. Putting aside whether or not he should have been allowed to keep doing the work, it is not only an example of how no matter how bad you get it, people will protect you, it is also a excellent example of how the press and family groups will go for your throat. On the other hand if you get it wrong and harm comes to the child, you can start emptying your desk because when the shit hits the fan, the fan is usually held by your boss and politicians who aim it at you. You only have to look at what the social worker involved with Victoria Climbie went through to see how people can be used as an escape goat. Faced with those options, can anyone say that this has no effect on judgment?

 

There are also those dreaded targets that have to be met. I am not saying children should be taken away to meet targets, anyone who thinks that quite clear should not be working in child protection. What I mean by this is there are targets to be meet and people get in trouble for not meeting targets. If this is having an affect on the amount of children taken into care, then would it not be better for both sides to work together to get rid of these targets?

 

The combination of workload, targets, stress, fear of getting it wrong and a lack of life experience could be having an affect. That does not make the person evil or even just not a nice person, it means they are human beings working under extreme pressure yet they are often viewed as hostile and the enemy.

 

Improvements?

Whilst being the first to admit to not being a child protection expert, I fail to see why giving people a massive workload is better than taken on more staff to allow more contact time for staff and helping to reduce stress levels.

 

The stress levels is something I think is crucial. Can someone under extreme stress be expected to get it right every time? Allowing child protection workers uninhibited direct access to a specialist counselling service without their boss knowing (unless they were thought to be a risk) and decreasing workloads could do far more than simply collecting data in ways that have now been described as ‘data rape’. Does anyone know the amount of social workers and child protection workers that suffer from stress? If not, some really needs to do an anonymous survey because that is crucial.

 

To use a specific example, I will use MSBP. For things like MSBP should there be more places/spaces where children can be looked after with only parental supervision? That would allow the child to be safe whilst allowing the parents to see the child on a regular basis meaning if the parent is found not to be harming the child, the bond is not broken. If used in conjunction with more after birth health care for both parents, the parents could get help if they have emotional problems. Having supervised access could also allow parents to eventually take their children home with them if they get better. This would cost a lot of money but considering the £12 billion spent on the NHS database, £300 million spent on the child index and lots of other things, would it not be worthwhile spending something that could keep families together?

 

If you are a parent and you think your child is ill and get help only to find out nothing is wrong, will you ever take him/her back to hospital if you are worried about being called a liar who is making it up simply to subject your child to medical test?

 

All those involved in child protection and other social care work, need to sit back and ask the question, “Are we doing more harm than good”? This might seem like a stupid question, but with the way things are run and the way the government is planning on invading the privacy of parents and children. This is not such a stupid question.

 

Parent groups also need to sit back and think about what they are doing. If you push people, they push back, if you annoy them, they are not going to be all that nice to you ether. Sit back and think of ways to work with child protection workers, you might find you have common ground.

 

Consequences

With the way information, including sensitive information, is set to be shared with more and more people, will this see parents and children withholding information from others and not seeking help sooner for fear of losing their child or future children? It is easy to say they should, but why should the parents or the child not be allowed to get help in confidence? From where I am standing, it makes better sense to increase the ways people can obtain help and make it easier for them to get access. Why spend Billions on spying, when we could spend less on allowing people to get help far easier with not having to worry about the police, employers, insurance companies, social services and others finding out? There will always be people who refuse to get help and others who are determined to harm their child, but are the current systems and the proposed increase on data sharing going to help? I doubt it simply because you can only share data you have and if parents and children do not share info out of fear, nether can you.

 

What also seems to have been ignored are the consequences of collecting so much information when it comes to workload. The child index/database/contact point (its name has been changed a few times) is set to increase the amount of information in a way that there will be very few families not in contact with social services, yet has the government decided to increase the amount of social workers and other child protection workers to match the workload? Will 16 case loads soon be the norm?

 

The system needs to be changed to the point where social workers etc are seen as people you go to for help rather than people who come to your door at 6 in the morning to take your child away. For that to happen, everyone needs to stop viewing the army on the other side of the battle line as if they were in the trenches in World War One because at the end of the day both sides want what is best for the child, a family and to be safe.

 

There are some key question government and child protection workers need to address:

 

1. If a child protection worker thinks someone is withholding information will they jump top the conclusion that the child is at risk?
2. Should we as citizens in a free country have to worry about who will know if we have a drink or gambling problem?
3. Would it be better if we could get help without others knowing or should be denied help if we are not prepared to tell social workers, schools, police etc?
4. What is best for the child, being allowed to get help without others knowing or simply not getting help?
5. Is it better to have more child protection and social workers to lessen their workload to allow them to make a more involved judgment or better to simply invade the privacy of families?
6. Is it best to have more places where families can get help or is it best to simply build databases to collect info about them?
7. Will the way more and more info is accessed and shared mean there will be an increased workload and if so, will this make matters worse?

 

 

There is a balance to be struck between protecting children, protecting child protection officers and protecting privacy. So long as child protection workers use outdated laws to prevent the public knowing what they do, so long as they intrude more and more into the life’s of families and are seen to be protecting each other, the public will have no trust in child protection workers and that will see children harmed. Simply saying you are an expert and expecting people to believe you and making no apology for getting it wrong is not good enough. On the other hand, so long as family pressure groups see child protection workers as the enemy and treat them with disgust, nothing will change and families will be torn apart and worse, children will die.

 

My experience of dealing with child protection workers is not a direct one but I have had close friends who have had direct experience in the past, including a 12 year old girl who was failed because of the way the system worked then (might be different now). That 12 year old was to become the best friend I have ever had, but because of the system in place at the time and not being able to get help when she needed it, she committed suicide at the age of 19, an experience that has stayed with me all these years. On the other hand my experience of being ‘harmed’ because of the way data is shared is something I have a lot of.

http://www.telegraph.co.uk/news/uknews/1468412/Children-are-taken-away-andndash-but-the-system-can’t-admit-it’s-wrong.html?pageNum=3

 

http://www.computeractive.co.uk/computeractive/news/2224775/child-database-hit-fresh

 

http://www.fipr.org/childrens_databases.pdf

http://www.rcpsg.ac.uk/Education/Documents/Good%20Doctors%20Safer%20Patients.pdf

 

http://www.computerweekly.com/blogs/tony_collins/2008/02/police-will-be-allowed-searche.html

 

http://www.guardian.co.uk/society/2006/sep/08/childrensservices.politics

 

http://www.justice.gov.uk/docs/National-Society-for-Prevention-of-Cruelty-to-Children-Data-Sharing-Response.pdf

 

http://www.justice.gov.uk/docs/Childrens-Rights-Alliance-for-England-Data-Sharing-Response.pdf

 

http://www.everychildmatters.gov.uk/deliveringservices/contactpoint/

 

http://www.wilson-nesbitt.com/articles/858/14072008/family_court_concerns_revealed.html

 

http://www.communitycare.co.uk/Articles/2007/03/27/103929/family-court-used-flawed-medical-advice-to-wrongly-remove-child-from-parents.html

 

http://www.hmcourts-service.gov.uk/infoabout/children/famcourt/index.htm

 

http://news.bbc.co.uk/1/low/uk/1115166.stm

 

http://www.opsi.gov.uk/ACTS/acts1998/ukpga_19980042_en_1

 

http://www.unhchr.ch/html/menu3/b/k2crc.htm

 

http://www.timesonline.co.uk/tol/comment/columnists/camilla_cavendish/article4288255.ece

 

http://news.bbc.co.uk/1/hi/scotland/5272092.stm

 

http://www.communitycare.co.uk/Articles/2007/09/14/105785/tape-interviews-in-child-protection-cases.html

 

http://www.dailymail.co.uk/news/article-1064930/8-000-couple-baby-wrongly-taken-away-social-workers.html

 

http://business.timesonline.co.uk/tol/business/law/article2317284.ece

 

http://www.guardian.co.uk/society/2005/jan/11/politics.tradeunions

 

http://www.timesonline.co.uk/tol/news/politics/article2332307.ece

 

Compulsary drug testing for pubs/clubs in Aberdeen

It seems that the police along with pub and club owners in Aberdeen have joined other cities in making it compulsary for pub/club goers to face compulsary drug testing if they want to have access to the pub/club.

Although it is claimed people can say no, they are denied access if they refuse and if the police in Aberdeen are as bad as other areas, those saying no for any number of reasons (privacy, human rights, being wrongly accused of handaling drugs etc) will be investigated by the police. Saying no is not an option.

With some schools and the police wanting drug testing in schools, it is not hard to see a time when the min we walk out the door we are tested for all sorts of things and it is not hard to see that the children of today will be the brainwashed of tomorrow, which is handy for those pub/club owners and the police.

As with the schools, testing is done in public, so you better make sure you wash your hands everytime you touch a surface just incase it has been contaminated because that will get you ether a ‘amber’ or ‘red’ light which will see you getting searched for drugs in public.

If the pub/club owners and the police realy cared about combating drugs in pubs/clubs they would deal with the dealers rather than trying to brainwash us into thinking it is OK to be tested wherever we go.

The cost of these things to test  a few hundered people queing to get in is about £30,000.00 whereas hiring a sniffer dog that can easily go from one pub to the nest and search a lot more people and catch the dealers is about £300.00 a night.

Why would the pub/club owners want to spend £30,000.00 to find out who might have been in contact with drugs (the machine does not know if you handled the drugs directly or if you simply touched a contaminated surface) rather than spend about £300.00 for dog to catch the dealers is something you would would need to ask the club/pub owners because I can only think of 2 reasons. 1) the machine is purley another PR stunt or 2) for some reason they do not want to target the dealers.

http://news.bbc.co.uk/1/hi/scotland/north_east/7702856.stm