It has been far too long since I updated this blog.
It has been reported that as many as 140,000 non medical staff are able to access patient medical records without consent.
The Mail Online (link at the bottom) story ran on the 26th March 2010. Part of it stated “As many as 140,000 non-medical staff, including porters and housekeepers, have access to sensitive NHS patient files, it emerged last night”.
The mail also went on to say “Government guidelines say only staff involved in ‘providing and supporting patient care’ should have access to confidential information.
But trusts are interpreting the rules so widely that administrators, porters and IT staff are all cleared to potentially delve into a person’s medical file.”
This news comes as no surprise to those of us that have paid any attention to who has access to our information. The thing that gets me about this story is the hypocrisy. It might be the reporters lack of knowledge that just gives me that impression, but you would think they would have done some background searching first. What caused me to say such things? First of all it should come as no surprise that receptionist have access. As it can be seen from previous posting I have made, reception staff in medical practices often have access to the point that unless you are willing to let them know you are on medication for impotence or a termination, then you simply don’t get help.
The other thing that caused me to have the opinion is something I can understand the reporter not mentioning, after all very few people know about it as it is. It was reported some time ago that “The woman in the case did not have to show a wilful publishing or release of data, it said. A failure to keep it secure was enough to breach the Convention” In other words, simply telling staff not to access the data is not enough t comply with the Human Rights Act.
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
I came across this bird brain idea the government has come up with to ‘help’ alcoholics. The idea is that if you are an alcoholic you must get help or have your benefits cut.
So what is the problem? First of all, how do you show the person is an Alcoholic? Are they going to randomly spy on people to see how much they buy or are they going to have doctors/nurses and other health workers spy on patients for them? Will they go through the patients electronic record held on a national database to see how many units of alcohol people admit to drinking or to see if they have problems that could be associated to alcohol? Will they check phone records to see who has been calling Alcoholics anonymous?
This is yet another example of where the government says it wants to help people, yet at the same time simply ignores the underlying problems people have and the fact that people that have problems can not easily gain access to a truly confidential service. If you tell your GP then you in affect allow every doctor/nurse you see know, admin staff get to find out, it gets put on a national database, insurance companies will find out (… the ombudsman sided with the company, when an applicant rightly declared she did not drink alcohol on an application form, but neglected to state that she was receiving psychiatric help for a drink problem, nor that she had formerly attended Alcoholics Anonymous). if you want to work with children you might have to declare it and then there are things like the child Index which could see the information shared with Social Services and Schools if someone thinks there is a ‘concern’.
To make things worse, there is the issue of what if they are wrong? We all know doctors see themselves as Gods who are always right and even if you do get to prove they are wrong, the original claim that you are an alcoholic is kept on file and is a stigma that will follow you around for the rest of your life. What if it gets lost? If the goverment realy cared about helping people with problems, they would spend money on allowing them access to a truly confidential and barriers, such as insurance companies being able to find out, would be removed. Instead they have decided to take another step into making the UK a surveillance society.
It seems that some people, or rather NHS trust, are still determined to share patient data. Not only have they decided to go with the implied consent model to share patient data, they have only given patients 15 days to opt-out of it. The idea is to make some patient data available to nurses working for BUPA as ‘health coaches’. The idea is patient data will be sent to BUPA so that their nurses can help patients with long term health problems such as diabetes, asthma and heart disease. It does not stop their however, the service is being offered to everybody in the West Kent area in an attempt to reduce unnecessary attendance at GP practices and at A&E departments (I thought that is what NHS Direct is for). There is no doubt that it would benefit some patients if they were referred to a ‘health coach’ but to send patient data to others without seeking consent (implied consent has been shown to be unreliable) is, in my view, just another step in the NHS plan to make people get used to the idea of sharing private information with other people to the point we will know no difference. As always, relevant links below
It has been a while since I last posted, so I thought I should post something and it is good news!
The government have dropped something called clause 152 of the Coroners and Justice Bill. This clause had caused a lot of controversy when it was spotted because it was designed to make it easier to share medical information across Whitehall.
More information /related articles below (no set date order, sorry).
It has been reported that the ECS of patients in Scotland has been accessed without patient consent. It is not kwon how many patients have been affected and when I was listening to the news last night it seems the NHS trust in question (Fife) do not know when the records were accessed or why they were accessed.
As usual, here are a couple of links about it.
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.
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
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.
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.
It would seem the government have agreed to allow academics access to hundreds of millions of medical records without patient consent or knowledge. I would try and pretend to be shocked, but that would require acting good enough to get me an Oscar, so I think I will give it a miss.
Computer weekly wrote “The transferred records contain patient-identifiable information on nearly every stay by patients in hospitals in England, and visits to an accident and emergency department. Also within the transferred records are 215 million confidential files on visits to outpatient departments.”
So who got the information? First of all the data was sent to BT (they run a service called the Secondary Use Service) who then passed this information to the Dr Foster unit.
Computerweekly.com also points out “The Dr Foster Unit has received for research purposes 500 million health records, which includes 180 million inpatient and day cases. The unit has 285 million files which include patient-identifiable information”.
We are constantly told by the NHS, the government and researchers that patient privacy is something that is taken seriously, yet hundreds of millions of records are shared without patient consent.
With the government (along with backing from researchers) determined to make everyone’s record available via a national database accessible the police, researchers and countless others, things can only get worse.
As always, please follow the links for more information:
Dr Foster Unit:
BT (sorry, SUS)
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 1st 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.
Just in case anyone reads this and thinks I’ve gone away, I’ve not. Been a bit busy latley and promis to update the blog soon.
In meanttime, here are a couple of sites you might want to look at.
It seems the goverment have finaly confirmed that the police are to be allowed to access the national child database.
First of all the people who are allowed access to this information (teachers, social workers and health workers to name but a few) steal information about children and their families so as to invade their privacy, now they are wanting to share the information with the police long after the child has turned 18.
With information being stolen from the childs and family Summary Care Record, it is easy to see how doctors/nurses are nothing short of agents for the state.
Link to story:
Although I am pleased there has been such a rulling I think it needs to ne looked at very carefully.
Paul Thormton mentions that it was about un-otherised access and about the nurse not having a role to play in the patients health care.
It should not be forgoten (and this is what makes this ruling less effective for those against the national database) the amount of aurthorised userers and ligitmimate access and use has been increasing over the years and doctors/nurses have refused to do anything about it (most have even been caausing the increase and have co-operated with those invading our privacy)). It is also up to GP practices (not individual GPs) who will have a legitimate need to access the data. This last ssue is also where the likes of TBOO and loads of doctors fall down and are shown to have double standards. If a nurse in an asthma clinic has a ‘need to know’ had an abortion, sexual problem, rape/abuse and everything ales in the patients record they can not then complain if a consultant at A&E were to access the same information especially where it is a matter of life or death.
It would also be hard to stand your ground and demand a receptionist at A&E should not have access to a patients record whilst at the same time allowing their own reception staff the same level of access.
I have been in practices where doctors can withhold medical treatment if the patient says no to data sharing, even if this causes harm or death to the patient or others. I think if GPs are allowed to do such things with the aproval/backing of the GMC, BMA, NHS, the ICO and Calldicott Gaurdians, it is hard, if not impossible, to say a consultant/nurse at the hospital can not do the same thing. If have been in practices where staff have accessed records without patient consent and as I found out from the ICO when complaining about Lancashier And South Cumbria Agencey in Preston, a patient has no right to stop access even where the person accessing the record has alterd an access request to gain access to the record.
You can jump for joy at this rulling if you want, but chances are you will hit the floor hard when reality sets in.
Other links about this story (soory they are so long):
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!
“Health bosses have ordered a data amnesty after an employee lost personal information of 137 patients. NHS Lothian launched the campaign to ensure all 28,000 staff understand the rules on storing sensitive data – and own up if they lost files themselves.
The move comes after a worker admitted losing a computer memory stick with copies of letters sent to Edinburgh GPs by NHS Lothian over two years.
The letters cover details of patients in the central Edinburgh from 2006″.
This is something I sort of think is good. I believe that if someones loses patient data they should get in serious trouble or even sacked (right now most people get a slap on the wrist) but at the same time I think it is important to try find out how much data has been lost, I guess this is one of the best ways but it also means letting some people off the hook. It does say a lot about how worried some NHS trust are when they need to have this sort of thing.
- child rights
- data rape
- data security
- drug test
- health access
- Human rights
- lamp post
- medical exam
- patient rights
- strip search
- victim rights