Types of people who ‘protect’ data

When it comes to medical privacy there is often a lot of talk from those who want to share/access identifiable data about how data will be protected and they can control access. Unfortunatley these are often grouped into 3 different groups.

1. There are those who have a low standard of protection. An example of this would be most GPs. GPs often tell patients that what they learn in the course of their work will go no further and their records are protected, yet a lot will often start telling people about tye patient so the information can get into the patients records, as one of my ex GPs said “doctors do not do notes, that is someone elses job”. In other words, the min the patient leaves, the GOP will tell someone else. I have also found that most calldicott Gaurdians come under this group. As with GPs, their standard of aproprate sharing of data is often far lower than what patients think and when it comes to privacy, they rarely, if ever, will hear both sides of any complaint, usually deciding to side with their friends who also have a low standard. This is further complicated in that they are often paid by the people they are overseeing even though this creates a conflict of interest. Who have to ask whos interest they have at heart, their own or that of the patient? Unfortunatly I have found they have the interest of their own at heart and most would rather protect the reputation of health workers and the NHS than tell the truth. This group of people are the low of the low as far as I am concerned. they lie to patients to obtain data/carry out examinations and when patients do get told they ether attempt to make the patient think it is for their own good and those patients that see past this Bull are given 2 simple choices, ’share or die’. This group will also often share data so that it can be passed to others for targets or payments. In some cases it will be identifiable but even if it is not, the people accessing the records to get it will have access to the identity of the patient.
2. There are those who think they have a high standard by are not aware of what is being shared. An example of this are some Calldicott Gaurdians and some health workers (not all are scum, just most). Some will tell you that when it comes to the police and social services they will tell them to ‘get stuffed’. Whilst this seems good, they are often unaware of data sharing. for example data from the new Summary Care Record in the NHS in England will be copied in a way that police and social services have access. This means that when they tell the police or SS to ‘get stuffed’, the police and SS will simply access the data from somewhere else (such as SUS) or they will alreday have the information anyway. At the same time anti-privacy laws/legislation in the UK is being introduced faster, meaning any promise about privacy is no protection. Other groups of people that come under this are those who work in Sexual Health Clinics. These people are often unaware that identifiable data can be shared with researchers, but I have to say that some will know but simply not tell the patient
3. The last, and by far the smallest group, are those who do protect data. These people are far and few between. they will store data in a way that others can not access and they will stand up to those who demand it. Some will even not record data. An example of this are some therapist. If you wanted some therapy, you can often tell the person you are seeing that you do not want anyone else to know what you are there for. Whilst some will refuse to see you unless you ‘consent’ to notes being kept others will agree not to keep notes (the disadvatage of keeping notes is that they can be accessed under some UK laws by others. Although this does not happen often, it is staill a risk). Some of those that demand they make notes willl often make them very brief and a broad outline.

ChildProtectionLine, good or bad?

I only heard about this via the media, so I contacted the Scottish goverment about it. To my suppsrise I got a prity full reply (not often that happens!).

From what I could make out from the reply, there are good and bad points about it (some of the questions/issues are still not sorted).

Good. This is a single phone number that people can call if they are not sure who to call. The people on the other side of the phone will be able to direct people to the relevant department/service. That means if the SS (social services) are the best people to contact, then they will be directed there, if it’s the police, then they will be directed there. This should save time in getting things sorted and it makes sure the right people are contacted. It should (if it works OK) mean that children can be saved/protected more than they are just now.

BAD?. There are few things in life that are all good, and this is no exception. In theory there will not be a creation of a national database of accused, but with the goverment looking to creat things like the childs index, then it means there is a database be default. It also means that that anyone with access to the child index (SS, police, schools, local authorities, fire service, health authorities etc) will be able to find out the family are being investigated. Some of them should know, but why would the fire service ‘need to know’? In theory those accused will be able to clear their names, but that is easier said than done (dont forget that forced adoptions have increased 3 fold in some areas after ‘targets’ for adoption were brought in and the SS are famous for miscarages of justice and operate under secrecy to the extent the concept of a ‘fair trial’ is not a garantee). There is also no way of knowing if their file will be deleted if they are found not guilty (remember even children never charged or cautioned have a ‘police record’ and have their DNA stored nationaly). It could (even if this is not the aim) mean that a national network of accused is set up due to the ‘joined up’ thing the goverment is keen on.

There is also the issue about people own perecption of what is right. There are people that think you should never drink when you have children, so could they report people that fail to meet their own personal standards? The theory is, they accused would be investigated but as I pointed out above, this has it’s own problems. There is also the issue of double reporting. That should be sorted out quickly, but the fact that some others have been brought in, such as the SS, could mean it appears on their childs record available via the child index. Having never done drugs, I dont know if people seeking help are always reported to the police or SS. This new scheme seems to garuntee they would be brought in.

There is also a question mark about how you check people are drinking too much or taking drugs. Would all accussed be forced to have a edical exam to test for drugs or conditions that could be caused by drinking? Would they be required to have a breath test for alcohol on a random basis? With goverment having a ‘nothing to hide, nothing to fear’ card for everything, would this be used against parents? Would children be asked about the acctivities their parents get up to? Would the accused be allowed to chalange claims made by others, such as neibours?

Would info get into the accused medical records? This is something the reply does not full answere. It is important that the choice about having the info stored in the medical record of the accused is only done with explicit consent, yet that is not a garuntee. Dont forget who will have access to this record. It is not just the GP, there are all the doctors/nurses and a large amount of admin staff at the practice (and future practices) who will have access. There are insurance comapines, employers can ask for it and with the goverment looking more and more at national records. I have managed to avoid some of these problems (cant do anything about insurance comapines or employers as the Scottish goverment could not care less about the level of access these scum have), but that was only after being treated like dirt by NHS Grampain and other PCTs, by me endgaering my health and by me not giving in to scum. I dont know of anyone else who has that protection/privacy, yet info could be getting put in their records without their explicit consent.

I fully support the idea of protecting children, but there is so much secrecy (this only protects doctors, SS, creates distrust, causes serious misscarages of justice and allows SS to do what ever it takes to get children. See links bellow).

There does seem to be better ways of helping drug users and people with other problems. The only problem is, this would need to be a truly confidential service and the goverment would ratehr spend money on paying locums £1000 a day or spend money on out of hour services to justify spending hundreds of millions (£20 billion in England) on national medical records that are less secure that the goverment claims. They could spend more money on having enough social workers, but again, they dont seem to fancy that idea. They seem to think it is better to set up a net work where neibour spies on neibour and thos who object to be spied on are simply told ‘nothing to hide. nothing to fear’. At the same time, they complain if they are monitoured talking to a suspected terrorist. I am not saying nothing should be done, but is a national phone number the best way to proect children or would it be better to help the people this number is targeting (suspected drug and alcohol abusers)?

Some links you might want to read:

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/07/15/nadopt115.xml

http://www.forced-adoption.com/introduction.asp

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/05/nadopt105.xml

Sample medical questionaire

medical questionaire

As far as the health profession and MSPs are concerned, this sort of questionaire is perfectly fine. Even the Information Commissoners Office seems to think this is fine.

If you notice option Q, it will be apparent that you must disclose all medical conditions/problems. That measn if you are not prepared to duisclose your thrush from 3 years ago or now, then you can not apply for the job. Thrush is unlikely to be relevant, but they are allowed to know it.

 This goes directly to the employer and can be read by anyone you give the form to or whoever the emjployer allows to handl it. The job is serving customers and stacking shelves.

CCTV in public loos

There I was reading my own page, when I noticed I forgot to mention Virgin Trains spying on men in the loo. If you go into the male toilets in Wolverhampton train station you will notice there is CCTV between the washing basins and the urinals. Apparently this is for ’security’ reasons and to stop people vandalising the urinals or using drugs. The fact that drug users are just as likely to go to the cubical and shoot up, seems to have been ignored by good old Virgin. As for the urnial excuse. How can they tell who did what unless they are looking at the urinal and the lad peeing? Hence my claim that Virgin trains (the people who run the station) are spying on men in the loo.To this serious issue, it has to be asked if it is a good idea to get children to think it is perfectly OK to pee in front of a camera? I don’t and I think anyone that spies on the inside of a loo is rather sick in the head and should concentrate on porn rather than trying to brainwash the public into thinking it is OK to be spied on EVERYWHERE we go 

Who knows who your calling?

I need to get on with some course work, but just before I do, thought I’d do a quicky on this privacy issue as it is very important. Records of who we call or text (and where from if using a mobile, this allows them to track your movements, handy if you want to catch people using a phone when driving) are to be kept for at least 1 year (came into effect on 1st October 2007). These records can include ’sensitive’ information, such as if you called Childline, Samaritans (when I contacted them about this, they could not care less about the fact so many people can find out-list bellow) and it seems even calling crimes stoppers will be recorded and made available to others. If you call people that provide ‘confidential’ help for rape/abuse, emotional problems, dug/alcohol addictions, battered partner or anything else, that too will be kept. So will calls to your doctors, GUM clinics and sex therapist if you have one. The content of such things will not be recorded, but the fact we called a sex therapist means you will in effect be telling everyone you have a sexual problem. Who will have access to this? How long have you got? It’s a big list (795 public bodies and quangos all with varying degree of access). I would love to give the complete list but I can’t find a copy BUT here are some of them: Police, Security services, 475 local councils, Food Standards Agency, Department of Health, Immigration Service, Gaming Board, Charity Commission, Royal Navy Regulating Branch, Atomic Energy Authority Constabulary, Department of Trade and Industry, NHS Trusts, Ambulance Service, Fire Service, Department of Transport and the Department for the Environment.I wonder if NHRC are on the list. ThinkPolice will need approval of a superintendent or inspector (like they will say no!). Council officials will only need permission from the authority’s assistant chief officer. Thousands of staff in other agencies will need to get approval from a senior official. In other words, our telephone privacy is screwed! There is no mention of court orders/warrants and the government decided to not consult on this in parliament (they did not need to, they can alter some laws anytime they feel like it).Think you have nothing to worry about? Last year the voluntary arrangement that was in place untill this law allowed 439,000 searches of phone recordsFrom 2008 (not sure of exact date) the same will apply to websites we access and who we email.More info about it can be found at http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=484752&in_page_id=1770&ct=5 

Some examples

Below are just 5 examples of moral/ethical questions that need to be asked about medical privacy.

I decided to do this as a separate thing so that people who have an interest in such things, can see some basic questions that I have.

There are loads of examples, including the example of identifiable data being released from GUM clinics in England without patient consent that I could have put in, but I thought it best to start with the basics

It is because of these examples and the fact most patients are not aware of what is being shared (one patient pointed out that talking to a doctor was like talking to priest) that I get my back up. Informing patients does not take long. It can be as simple as printing off what the receptionist can see and showing that to the patient. Some patients might not be that bothered, but others would be. Some patients might not be that bothered about who sees their referral letter, test results for things like STDs/STIs (cervical smear test results are now held on one national database in Scotland without the informed consent of patients and despite the fact this database is not as secure as it should be) or who knows that they are on Viagra but others would be. It takes seconds to tell a patient that you dictate to a secretary who will know who you are and what is wrong with you, yet doctors and nurses seem to hate the idea of telling patients the truth. They give the impression that they keep info private, yet this is far from reality. Telling your doctor/nurse or any other health worker is far from ‘confidential’. 

Example 1

A girl becomes sexually active but does not want anyone other that her GP knowing. In most practices, that would not be allowed. The girl then become pregnant but wants a termination. She is now faced with 3 choices.
1) Tell the GP and allow her (or him if they chose not to see a female doctor) to share the data.
2) Try and force a miscarriage and not report it.
3) Go to a back street abortionist which may not be done safely and she runs the risk of being abused.
I for one think the latter 2 choices are dangerous and I find it appalling that the health profession seem to think these are 2 viable options.

Illegal abortions still take place in the UK. What has to be asked, yet the health profession refuse to ask, is, are illegal abortions taking place in the UK because the health profession refuse to allow access for legal abortions unless the woman agrees to inform others? If the answer is yes, then the health profession can/should be held responsible for illegal abortions. In other wards, the buck stops with the health profession. 

Example 2

Parents decide to take out insurance, including insurance for their children. As part of the application the applicants must disclose medical data. One of the children says no and as a result the application is refused. The parents then use presure on the child and the child decides to say yes. Is that consenual? I don’t think it is. Whilst it is unlikely that a 4 year old will be able to make a informed choice, what about a 14 year old? 14 year olds can make life changing choices, so why can they be forced to realease data? If there is something they don’t want their parents or others to know, then they don’t have much chance of keeping it from them and should they be forced to tell others? Don’t chiildren have rights?If the parents want to make a claim for an injury but the child refuses to allow the GP to release some info and again parents apply pressure getting the child to change their minds and say yes, is that consenual?What if it was a case of a man/womans partner wanting the other to share data? Saying no to this could cause a breakdown in the relationship, which could involve children. Is that consensual?

What about children being lead to think that telling insurance compaines and evrybody else, such as employers is normal because that is what they have been lead to belive. I know this is a phylisophical question, but it is something that I have felt needs to be considered by doctors as they are often the only people standing in the way of people gaing access to our records (although with the new natuional databse, something that is to be removed with the introduction of a national database (it is interesteing to note that children seem to have been excluded from the national databases that ministers and doctors cliam will save lives and saying no will cause harm to pateints).

Example 3

A man is arrested for sexual abusing children, or ay other crime. The man is arrested and then questioned at which time he admits the crime. The only evidence the police have is the mans confession. The man is then charged and brought before the courts. At this point it is discovered that the man had not been read his rights after being arrested and had not been told he was under caution. He had also been lead to believe that what he had said before being arrested would ‘go no further’. Because his rights were breached, what he had said in the past could not be used as evidence, he then walks free.A patient. tells a doctor/nurse something under the impression that nobody else will know and unaware of the fact that the data would be used by others, such as for insurance or to determine if the idividual broke the law. The patient then finds out data latter date about this and the doctor then simply tells the patient this is the case and the patient can do nothing to stop it. If that means the patients would not have disclosed data or be examined, then that is tough luck, the patient has fewer rights than the criminal. If the patient happened to be a victim of the above crime and had sought help due to this, then that raises one big question. Why is it the patient has less rights? Their attacker walks free for not being told the truth, the patient simply has this back dated to allow data to be shared and accessed.I for one find that imoral, yet it gets done almost every day in the health profession.

Example 4

If I was to lead someone to believe that I was a doctor so that I could carry out an intimate examination on them, would it be an assault/ sexual assualt even if they agree to me touching them? I would say yes.If a patient was to allow a doctor to carry out an intimate examination because of they thought tht only the GP would know why they were there and what was wrong with them but the info was then known by others (ether from reading the info or from thr doctor dictating the info to them), would that be a assault/sexual assualt? Again I would say yes.A lie to touch is still alie no matter what your profession. This sort of assualt goes on almost everyday in the health profession, yet it goes un-punished