Forced consent?

I meant to put this up ages ago, sorry for the delay.

 

It would seem that in order to get patients to ‘consent’ to having an electronic record that will in the future be linked up to a national system, some a mental health trust in London has decided to withhold medical treatment from patients. The trust claims that providing care without it going on such a system is not safe. Why they think it is safer to withhold treatment is any ones guess.

 To me, this seems yet another example of how the public are being forced, and even having their life’s put at risk, if they refuse to roll over and give ‘consent’ to this sort of data sharing.

 As always, some links below

E-Health Insider

ComputerworldUK

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  

Termination rights

Having not said anything for a while, I thought it was about time I did and I thought I would go with something controversial.

 

There has been talk about a woman’s right to have a termination without having to get permission from 2 GPs and some people really hate that idea.

 

Being a bloke, I do not think I am in a position to say what is definitely right or wrong however I do think I can raise questions that people should be asking.

 

If a woman wants a termination and does not get approval from 2 GPs (20% GPs want terminations stopped and 25% refuse based on their own ethics), will she simply find anther way? For example she could force a miscarriage or go to a backstreet abortionist.

 

Should we not be doing more to avoid unwanted pregnancy in the 1^st place? This is where a lot of people seem rather 2 faced. Some people are completely against the idea of a termination but at the same time do not approve of contraception. In other words, they think you should only have sex if you are prepared to have children. If the result is you getting pregnant and giving your child away, then they would rather have that. Sorry to be blunt, but if that is your attitude, you really need to wake up and get in the real world with the rest of us.

 

There is also the issue of sexual assaults. There are people that think even if you get pregnant by rape you should be forced to have the child. Should someone that was raped be told what to do with her own body after having that right taken away from some sick pervert? What happens to those who get raped but do not want to rport it, ether because they do not want others to know or because they see reporting it a waste of time (the conviction rate for rape in the UK is embarassingly low)?

 

Then there is all those with access to the fact she had a termination. Accesse to such info is a large subject (see some of my previous notes), but would others knowing be yet another reason for a woman to go to the backstreets?

 

I do not think getting a termination is something any woman would find easy, but the way the current system works is not helping and is probably making things far worse. There is no reason why a woman can not book directly with a clinic where she can get advice, sources of help and some counselling before she makes up her mind.

 

http://news.bbc.co.uk/1/hi/health/7674361.stm

 

http://www.dailymail.co.uk/news/article-452318/One-GPs-wants-ban-abortion.html

 

http://www.pharmj.com/editorial/20000715/news/bpas_contraception.html

 

http://www.peopleandplanet.net/doc.php?id=1912

 

http://www.medic8.com/medicines/Morning-after-pill.html

 

http://www.prochoicemajority.org.uk/

 

http://prolife.org.uk/

More access to health records?

It is not long since people like me warned about the increasing access to our medical records and now the NHS seems to be confirming our greates fears.

Bellow are links to stories about how there are plans to increase the amount of people with access to our records. It is bad enough a patient cant tell their GP something without having to let every doctor and nurse they see at the practice know about it despite there usually not being a ‘need to know’ basis, It is bad enough reception staff are getting access to our records and knowing our test results and what medications we have been issued, now they want to social care, voluntry orgs, private firms, researchers and never ending list.

 

Will doctors defend the patient right to privacy? Dont bank on it!

http://www.ehiprimarycare.com/news/3915/access_to_nhs_care_records_may_be_widened

http://www.ehiprimarycare.com/news/3947/data_sharing_review_has_messages_for_the_nhs

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.