Clause 59 - Control of patient information
Health and Social Care Bill
10:00 am
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
We have had a useful opening debate. With your permission, Mr. Maxton, I should like to set out the Government's position on several issues in the clause because a number of the amendments range across various aspects of the clause. I welcome the hon. Member for Woodspring to one of his passing appearances in the Committee. He has shown an all too infrequent interest in the proceedings, but we are pleased to see him here this morning.
It is interesting also that both Conservative and Liberal Democrat Members have advanced the argument that while people have nothing to fear from a Labour Government, we should be worried about what Ministers of other persuasions might do with the legislation. I assume that they are thinking of what they would be obliged to do if they were given the powers. It is a purely hypothetical circumstance, but we are all in favour of the precautionary principle, however remote the risk might be.
It is right that there should be a detailed debate about the provisions in the clause. We are inevitably dealing with fundamental issues of privacy and patient confidentiality and it is important to go through all the matters involved. I believe that much of the speculation and concern that has been expressed this morning and over the last couple of weeks is misplaced. I hope that the amendments that we tabled ahead of the debate today have assuaged some of those concerns and that my remarks will provide further reassurance.
The clause has two main parts and three main purposes. Subsections (1) and (2) provide powers to regulate the disclosure and processing of patient information or information derived from such information. Our amendments limit those powers to commercial purposes. The Government believe that this is a new and much needed protection against the use of patient information for purposes that run contrary to the interests of the patient and the NHS. I will say a little more about that in a moment.
Subsections (3) to (9) provide for the Secretary of State to make regulations to require the flow of patient information in prescribed circumstances. That will enable us to achieve two aims. First, patients will receive more information about their own clinical care, in accordance with the commitment in the NHS plan. Secondly, it will be possible to safeguard the continued operation of essential services that currently rely on patient-identifiable information.
The clause does not outlaw independent reports on NHS services and it is not an attempt to restrict medical research. A fundamental point is that it does not signal any change to the Government's view about the importance of patient consent. That is a key point in today's debate. Informed consent is crucial to the Government's view of how a modern NHS should work. We cannot move to a patient-centred service if patients are not informed, consenting participants in the services they receive.
As we all know, the NHS does not always operate in the way that I have described. Much of what is done in the NHS relies on implied consent. That is sometimes appropriate, for example when information is shared within a hospital to ensure that a patient receives appropriate care, but at other times the definition of implied consent is pushed too far. We are determined to deal with that, but it is no small task. Not only the relevant legislation, but the culture of the NHS will have to change radically as we move away from past habits into practice based on real consent.
The professions have recognised the need to change the current approach to consent. The General Medical Council issued guidance last year making clear its view that informed consent is the only secure legal and ethical basis for disclosing patients' confidential information. They too recognise how great a change in culture and systems will be necessary to bring this about, and they will not attempt to enforce their guidance until October.The Data Protection Commissioner has also drawn attention to the need to improve the way in which the NHS seeks consent for the use of patient information and we have made a commitment to her that we will do so. We are tackling the relevant areas of concern and a comprehensive implementation strategy dealing with all aspects of consent for the use of patient information in the NHS will be ready by October.
My right hon. Friend the Secretary of State has made it clear that the provision has implications for more than the use of information. His remarks have been mentioned in Committee this morning. The NHS can no longer assume that the benefits of science, medicine or research are somehow self-evident regardless of the wishes of patients. The relationship between patients and the service today has to be based on informed consent. That will require changes in practice and policy.