HL Deb 04 May 1993 vol 545 cc692-6

8.36 p.m.

The Parliamentary Under-Secretary of State, Northern Ireland Office (The Earl of Arran) rose to move, That the draft order laid before the House on 8th March be approved.

The noble Earl said: My Lords, the purpose of the draft order is to introduce for Northern Ireland provisions corresponding to the Access to Health Records Act 1990, which came into operation in Great Britain on 1st November 1991.

It may be helpful to the House if I say a few words about the provisions of the order. Access to computerised health records is already available under the Data Protection Act 1984. The type of records to which this order relates are manually held health records prepared by health professionals in respect of individual patients. The right of access to these records will be exercisable by the patient concerned or his or her nominee, his or her authorised representative, the parents in the case of a child or other legally-authorised person.

There will be certain exemptions from the right of access, principally where disclosure of information would, in the opinion of the record-holder, result in serious harm to the physical or mental health of the patient or someone else. Information about or provided by some other identifiable individual, other than a health professional, is also exempt. These exemptions also apply under the Data Protection Act 1984 in relation to computerised health information.

The order also provides a mechanism whereby a patient may apply to a record-holder for correction of information which he or she considers to be inaccurate. The record-holder should then make the necessary correction unless it is considered that the information in the record is correct. In this event a note should be added to the record indicating the points in dispute. In either case, the patient should be supplied with a copy of the corrected record or a note of the disputed points.

Where a person seeking access to his or her health records feels that any provision of the order has not been properly applied in his or her case, application may be made to the court for an order requiring compliance. Such application will normally follow completion of complaints procedures which will be set out in regulations to be made by the Department of Health and Social Services under Article 10(2) and (3). We consider that the order will be a useful measure in the extension of people's rights to information, and that it should contribute to improvements in doctor/patient relationships. I beg to move.

Moved, That the draft order laid before the House on 8th March be approved.—(The Earl of Arran.)

Lord Prys-Davies

My Lords, we believe that this order is a very good one. I thank the Minister for explaining its background and principal provisions. It widens individual rights, and I believe that its very existence will tend to ensure that the written record is correct. As the noble Earl so rightly said, the order is based on the Access to Health Records Act 1990. That Act originated as a Private Member's Bill but supported by the Government. I recall with great affection and sadness that it was introduced to your Lordships' House by the late Lady Ewart-Biggs, who, as I am sure your Lordships will recall, was genuinely and deeply interested in the affairs of Northern Ireland and the well-being of its citizens. We are profoundly grateful for her personal bravery and for her contribution to the improvement of inter-community relations in Northern Ireland.

It saddened Lady Ewart-Biggs that the 1990 Act could not be extended there and then so as to apply to Northern Ireland. She could not see why the people of Northern Ireland should be denied for a single day the principle of access to medical records which would be available to citizens throughout Great Britain by virtue of the 1990 Act. I am sure that Lady Ewart-Biggs, had she been with us, would therefore have welcomed the order warmly.

So far as I can see, apart from Article 13, which appears to update the law to reflect the Human Fertilisation and Embryology Act 1990, the order is virtually identical in terms to the 1990 Act, which, as the Minister said, came into operation on 1st November 1991. But this order will not come into force until late summer or, more than likely, early autumn. It will not be retrospective. I accept that. But this raises an important issue. Where proposed GB legislation confers new rights upon the citizen and is seen to be just as relevant for the citizens of Northern Ireland as it is for the people of England, Wales and Scotland, why is Northern Ireland denied access to the legislation for two years and, in many cases, possibly longer than two years?

Having read the record of the discussion on the order which took place in the Standing Committee on Statutory Instruments in another place the other day, I anticipate that the Minister may plead that such delay is inevitably occasioned by the need for consultation in Northern Ireland. I suggest that that explanation would beg another question. Is there any good reason why the appropriate Northern Ireland department cannot commence consultation at a much earlier stage, possibly while the proposed GB legislation is still on the drawing board and when the GB authorities are consulting in England, Wales and Scotland? I wonder whether the department in Northern Ireland can give consideration to that. It is a simple reform which could and should be built into the system. Otherwise, people in Northern Ireland can justifiably point to a denial of important rights.

Finally, perhaps the Minister can confirm that the terms of the order are as extensive as the 1990 Act. That appears to me to be the case but I could have missed a point or two. I shall also be interested in the comments of the noble Lord, Lord Holme of Cheltenham, as I believe that he has a very special interest in the question of access to records and official information. With those few reflections, it gives me pleasure to support the order from these Benches.

Lord Holme of Cheltenham

My Lords, this is one of those happy occasions when there is sunny unanimity on all sides of the House. We all support the order, although, like the noble Lord, Lord Prys-Davies, I regret that something so valuable has taken so long to reach the people of Northern Ireland. I thank the noble Earl, Lord Arran, for the terms in which he introduced the order and I should like to associate myself with the remarks of the noble Lord, Lord Prys-Davies, about the late Lady Ewart-Biggs, who was such a good friend of the people of Northern Ireland and who was a doughty fighter for freedom of information. I am sure that the noble Lord in turn would acknowledge that the original source of the Bill was as a Private Member's Bill in another place. It was introduced by my honourable friend Mr. Archy Kirkwood, who, if I recall, won the freedom of information award for his role in introducing the Bill.

On these Benches we think that the order is desirable not just on general grounds of freedom of information, to which there has been a long commitment on these Benches, but also specifically because mistakes can be made in records which need to be brought to light for the benefit of the patients concerned. The Northern Ireland citizen's advice bureaux told me that in a recent case there was confusion over diagnosis and a shuffling of cards. As a result one patient was told quite incorrectly that he had liver cancer and was treated accordingly for two years before the doctors finally became aware of the mix-up in the medical records. That kind of thing, as all of us know, can happen. Fortunately, it does not happen too often, but patient access to records is prudent in the interests of better medicine. I believe that patients are almost invariably better trusted with their own medical secrets rather than being kept in the dark about them.

I should like to ask the Minister a question. Article 4 of the order, under the definition of professionals, does not include social workers, although, interestingly, it includes, for instance, music and art therapists. I know that this is a point on which the British Medical Association in Northern Ireland has corresponded with the noble Earl. Since this is very specifically his area of authority and expertise in the Province, I wonder whether he would be good enough to tell us what conclusions he has come to about the role of social workers in this matter. With that one question we are pleased on these Benches to support the order.

The Earl of Arran

My Lords, I am grateful for the careful and thoughtful way in which this order has been debated. I say to both noble Lords that I well remember the dedication and devotion of the late Lady Ewart-Biggs in such matters, particularly those relating to Northern Ireland.

The order has its origins in pressure from people who wanted access to their health records and from health professionals who recognised the benefits of open relationships with the people they care for and attend.

The noble Lords, Lord Prys-Davies and Lord Holme of Cheltenham, asked about the reason for the delay in introducing the order. The Access to Health Records Act came into operation on 1st November 1991. There were a number of delays in preparation of the draft order, including some caused by the general election and by the extended consultation period necessary for the proposal. The proposal attracted some 25 replies, and consideration of those replies and other matters gave rise to a number of minor amendments to the draft order, none of which affected the fundamental principle of the patient's right of access. Having said that, we are always very anxious indeed to ensure that Northern Ireland legislation reaches the statute book with the minimum of delay following the comparable GB legislation. I can certainly confirm to the noble Lord, Lord PrysDavies, that the order is as extensive as the 1991 Act.

The noble Lord, Lord Holme of Cheltenham, asked about social workers. Statutory rights of access to manually held social services records and personal health information contained therein are subject to the provisions of the Access to Personal Files and Medical Records (Northern Ireland) Order 1991 but Part II of the order which provides for such access is not yet operational, pending the making of regulations setting out the conditions under which access may be given. Regulations are currently being drafted under the order and are expected to be made during 1993. As soon as those are in place Part II of the order will be brought into operation. Although the statutory right of access to social services records has yet to be given effect, administrative procedures are in place within each Health and Social Services Board which allow for client access to social services records under conditions broadly comparable to those to be contained in the proposed regulations.

Finally, I should just make clear that this order does not introduce major changes of policy for health bodies or professionals; rather it extends the established principles and procedures of patients' access to cover all health records.

On Question, Motion agreed to.