HL Deb 15 July 1991 vol 531 cc6-7

2.50 p.m.

Lord Ennals asked Her Majesty's Government:

Whether they are satisfied that the operation of the contract system in the NHS provides sufficient safeguards for patient confidentiality.

Baroness Hooper

My Lords, the National Health Service has an excellent record in protecting patient confidentiality. Staff are aware that breaches are a serious disciplinary matter. Health authorities have been told to put in place safeguards which are to the satisfaction of their senior medical staff. Action is in hand to strengthen further the security of personal health data in contracting.

Lord Ennals

My Lords, I am most grateful to the Minister for her reply. Does she accept that the new NHS billing system is creating an open breach of confidentiality? NHS finance officers are now well acquainted with information, for example, about abortions or people with diseases which are sexually transmitted. In consequence, many doctors are now refusing to provide the information that is requested of them in order to protect the confidentiality of the information about their patients. Did the noble Baroness notice that confidentiality was one of the series of complaints made by 600 consultants who stated their views about the NHS reforms clearly in the Observer yesterday?

Baroness Hooper

My Lords, there is a need for named data to facilitate the new contracting arrangements. However, the examples quoted by the noble Lord are already taken care of. Statutory regulations are in force which do not permit the use of named contract data in some areas, including sexually transmitted diseases and AIDS. The abortion regulations of 1991 also restrict the disclosure of information provided to the CMO. Thus, steps are being taken to ensure that the anxieties that have been expressed are not valid.

Lord Tordoff

My Lords, is it not the case that the BMA believes that the present system which collates information in Liverpool, or at any rate on a centralised computer, contains people's names in plain? However, the BMA would greatly prefer some kind of coding system to be introduced so that extraneous people could not look at the documents.

Baroness Hooper

My Lords, as I said, all National Health Service staff have a duty to maintain confidentiality. Where it is essential within the contracting process for the identity of the patient to be known, this information should only be disclosed to authorised persons on a need to know basis. Any dangers of the information being widely disseminated are being taken into account.

Lord Ennals

My Lords, I am sorry to return on the matter, and I am grateful to the noble Baroness, but does she recognise that if names and addresses are always given then the breach has already taken place? Following the point made by the noble Lord, Lord Tordoff, will her department examine the coding in order to give that protection which does not exist even for the types of condition to which she referred?

Baroness Hooper

Yes, my Lords. Perhaps I may go further in answering the previous supplementary, as well as that of the noble Lord. All contract minimum data set items other than name and address must be in code. This is of special importance for diagnoses and operations where free text is not permissible. For computer medium and fax machines, the practicalities of encryption of name—that is, scrambling the data in a coded manner—are being studied. Advice on the introduction of these techniques will be issued as soon as practicable.

Lord McColl of Dulwich

My Lords, does my noble friend agree that having the names of patients in a computer is much more confidential than the systems we have had in the past?

Baroness Hooper

My Lords, that may be so, but clearly we must ensure that safeguards are in place.

Lord Tordoff

My Lords, surely that depends on who has access to the computer records. Whereas in the past access to the records was limited, it may be much more widespread now.

Baroness Hooper

No, my Lords. I have already said that it is only on a need to know basis.