DATA PROTECTION AND ACCESS TO PERSONAL HEALTH INFORMATION (Hansard, 7 May 1993)

§ Mr. Malcolm Moss (Cambridgeshire, North-East)
I beg to move, That the clause be read a Second time.
The proposal is a straightforward one. The Access to Health Records Act 1990 gives patients a right of access to their health records. It applies to records relating to the physical or mental health of an identifiable individual compiled by a health professional in connection with care and treatment. "Health professional" is defined without reference to osteopaths, and records compiled and held by an osteopath are therefore outside the scope of the Act.
As the main purpose of my Bill is to introduce a statutory registration scheme for osteopaths, to place the profession on the same footing as the other key health 392 professions, it seems logical for individuals who have received treatment from an osteopath to be given the legal right of access to the records of that treatment.
The definition of "health professional" is the same across the whole range of legislation that deals with the individual's right of access to information about his own health. For the sake of consistency, it is again logical to include registered osteopaths in all the various legislation—that is especially important in respect of the Data Protection (Subject Access Modification) (Health) Order, as the Access to Health Records Act applies only to records compiled in a written form. An individual's right of access to information held in computerised form is provided by the subject access provisions of the Data Protection Act 1984.

§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville):
Scanning the horizon for good news this morning, I am happy to light upon the excellent Bill introduced by my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss).
This new clause is an important proposal, which the Government strongly support. For many years, we have openly supported the principle that patients should, as a matter of course, have the right to know what has been written about them. The new clause extends to individuals who receive treatment from osteopaths the existing rights of patients to have access to their health records.
People have had a legal right of access to personal health information for some time now. Health records kept on computer are accessible to patients by means of section 21 of the Data Protection Act 1984, although certain information is exempt by virtue of the Data Protection (Subject Access Modification) (Health) Order 1987. Those exemptions are necessary to protect the subject from serious harm to his physical or mental health and to protect the privacy of other identifiable individuals.
In 1987, the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) successfully piloted on to the statute book the Access to Personal Files Act, which gave individuals the right of access to records not held on computer—usually described by the rather unsophisticated term "manual records"—but that right extended only to those manual records held by local authorities and local social services for the purposes respectively of their housing and social services functions.
Health records were excluded from the Access to Personal Files Act 1987 because, at that stage, the Government wanted to reach an agreement with the medical profession, which had reservations about the idea of a legal right of access to health records. The profession was concerned about the potential effects on patient care of patients being handed that right, and argued that arrangements for access should involve appropriate safeguards for patients, doctors and other health professionals. It recognised that, in any case, many doctors had long practised voluntary disclosure to patients of their personal records, and argued that legislation was not necessarily the right way in which to deal with the issue. Therefore, the Government undertook to enter into talks with the medical profession to see what could be achieved.
After discussions, which extended over two years, with representatives of the profession, a draft code on non-statutory access to health records was produced. That document was circulated widely for comments. The only reservations about the principle of access were raised by 393 the medical profession itself. For that reason, the Government concluded that agreement could not be reached on a non-statutory code which would match the expectations of the public and which would have the unequivocal support of the medical profession.
When the hon. Member for Newcastle upon Tyne, North (Mr. Henderson) presented his Access to Health Records Bill in 1989, the Government decided to support it, subject to necessary safeguards because its provisions were entirely consistent with my Department's policy on access to records. The issue is not just letting patients see their own health records. Medical records are maintained for patient care and are used by doctors and other health professionals to help them in the diagnosis of patients. Records are thus used to record and advise other health professionals on the progress of care and treatment.
However, the primary purpose is to record what is in the best interests of patients and what is in the record may not always be in the best interests of the patient to know. For example, there may be circumstances in which the uncontrolled disclosure of information may cause harm or distress.
Therefore, the problem has been to ensure that information for patients is recorded properly, while providing safeguards for patients against the risks that some disclosures may bring. Some doctors are fond of using phrases and medical jargon in records which many people find incomprehensible. That is why the legislation provides that the applicant should be given a simple and clear explanation of the meaning of the record by a relevant health professional, whether or not the applicant requests clarification.
A right of access to records can be reassuring to patients who know that they may see their records at any time. If patients ask to see their records and detect misleading or inaccurate information, they can request that that information be corrected. The Access to Health Records Act 1987 specifically provides for that. One of the advantages of the right of access is that it forces those who compile records to think rather more carefully about what they write. Openness therefore acts as a safeguard against possible casual, ill-considered personal comments which are sometimes found on health records.
In paying tribute to hon. Members who have successfully introduced Bills that have given individuals greater access to records, I must also acknowledge the work of the Campaign for Freedom of Information in raising public consciousness on this issue. The campaign has argued with much success that people should have the right of access to information that affects them and to information that enables them to take decisions about their lives. Those principles lie at the very heart of the Government's policy on openness.
The patients charter has highlighted the existing right of access to one's own health records. That, coupled with the right to be given detailed information on local health services, enables patients to make more informed decisions and illustrates the development of a more patient-centred health service taking account of the wishes of patients. With access to information, patients are empowered to play a greater role in decisions that affect them.
The issue of patients' access to their own health records is part of the wider issue of the provision of information to 394 patients. Before legislation, there was a great deal of evidence that patients were not given as much information about their condition as they would like. For example, a survey of patients' satisfaction in general practice found that lack of information concerning treatment was the most frequently reported deficiency in the service provided.
Access to health records has provided an important new freedom to people, particularly because we should all be encouraged to take more responsibility for our health. We increasingly want to know what to do to keep ourselves healthy and what we can do to improve our chances of a quick recovery when we are ill. We want to be able to discuss our treatment with doctors and the other health professionals involved in caring for us, to understand what we are being asked to consent to and to know the risks, alternatives and chances of success.
Of course, access to the written record is not an alternative to discussion with professionals. However, I am sure that being able to see and understand what has been recorded about one helps to make that discussion more informed and equal and it will therefore become a more natural process between patient and professional.
The Government welcome and support the new clause. Given the enhanced status that the Bill gives to the profession of osteopathy in the field of health, extending patients' rights of access to the records of a registered osteopath seems the natural and logical progression.

§ Ms Dawn Primarolo (Bristol, South)
We welcome and support the new clause. As the Minister said, in a Bill that is designed to protect patients' rights and access to osteopaths in terms of training and the quality of service that patients receive from osteopaths, it is entirely right that they should have access to their own records and protection in that way.
I sincerely hope that the positive way in which we have started our discussion on the Bill today is a sign that we shall be able to progress speedily through a Bill which should have been on the statute book a long time ago and which has the support of all parties—although representatives of one party are absent from the Chamber today.
9.45 pm
I expect that the Liberal Democrats are still celebrating, and we would not want to take that from them after their spectacular victories against the Government—[Interruption.] I could recount all the shire counties that were lost—

§ Mr. Deputy Speaker (Mr. Michael Morris)
Order. A general reference to that may be acceptable, but we do not need to explore the depths.

§ Ms Primarolo
I was encouraged by some sedentary comments, and I stand corrected, Mr. Deputy Speaker.
I can think of no better basis from which the Government can look to the horizon to redeem themselves than to improve and develop the national health service and to take the message from the electorate yesterday that they expect the Government to do that and that they have not approved of the Government's progress thus far. I therefore hope that we shall be able to support all the proposals in the Bill and conclude our business in good time so that we can return to our constituencies and continue the work that we were doing yesterday.