The NHS should protect patient confidentiality | Letters

The agreement of the NHS to hand over patient information to the Home Office immigration authorities (Report, 25 January) fills us with anger and dismay. Patient confidentiality is one of the cornerstones of an ethical and effective healthcare system. That is why, in the absence of a court order, the NHS does not share even the address of a patient with the police or any other public body, except in the most serious cases of harm to the person, involving murder, rape or manslaughter.

There is an obvious asymmetry in adding immigration offences as the one further category where such information can be shared. It marks the intrusion of a political agenda into how our medical records are kept and safeguarded. It shows that NHS Digital cannot be trusted with our confidential information. While this decision affects only a small minority of patients, such an erosion of rights always begins with someone else but ends up affecting us all.

We are especially worried at the impact on trust in the NHS among migrants. They include people who have been tortured, or trafficked, people who have serious communicable diseases, people who have vulnerable dependents including children. The migrants affected by these measures retain the right to access a wide range of NHS services perfectly lawfully. But doctors can no longer provide the assurances of confidentiality they once thought they were able to. This is a further obstacle to confident healthcare access and will in our view cause harm both to individual and public health.

The review leading to this agreement was initiated in response to concerns some of us raised, but we were never given the chance to comment and discuss any proposed process of information sharing, its legal basis and its possible impact. A full consultation and proper scrutiny of this agreement are now needed urgently. We call on NHS Digital to suspend this service to the Home Office until a transparent and public review of its merits has taken place.
Leigh Daynes Doctors of the World
Yusef Azad National Aids Trust
Elizabeth Carlin British Association of Sexual Health and HIV
Chloe Orkin British HIV Association
Natika Halil FPA
Martha Spurrier Liberty
Genevieve Edwards Marie Stopes International
Phil Booth Medical Confidential
Fizza Qureshi Migrants’ Rights Network
Jim Killock Open Rights Group
Sally Daghlian Praxis
Gus Hosein Privacy International
Judith Dennis Refugee Council
Ian Green Terrence Higgins Trust

• If illegal immigration is such a serious crime that the government feels entitled to break the confidentiality of medical records, what about benefit fraud or driving when taking certain medicines, or being employed while suffering from certain mental disorders, or even being treated surgically if obese? Doing something about these could all be “in the public interest”, but the main effect would be to make very many people regard doctors as government agents rather than friends they can have confidence in. Immunisation and breast screening rates have already been affected in immigrant communities, and the road to hell is well known to be paved with good intentions. Perhaps doctors will have to go back to writing illegible notes on cardboard medical records if they are to be trusted by their patients in future?
Dr Richard Turner
Harrogate, North Yorkshire

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The NHS should protect patient confidentiality | Letters