Clause 41 - Compulsory disclosure of documents for purposes of counter fraud or security management functions
Health Bill
5:45 pm
Andrew Murrison (Shadow Minister, Health; Westbury, Conservative)
I am rather confused. We are nearly there and can tick off the minutes until 7 o'clock, draw a deep breath and go for the final furlong. There is not a great deal in chapter 3 with which we would take issue. Nobody can possibly object to the protection of any part of the service from fraud and unlawful activities. We would certainly support the Government's intention to ensure that lawfulness obtains to the NHS and that we remove fraud wherever we find it. That said, the devil is always in the detail.
When eschewing unlawful activity, there is a danger that we trample over sensitivities that are important, particularly matters to do with confidentiality. As we go through the list of clauses, I will be pressing the Minister to assure the Committee that confidentiality is maintained as a high priority, while respecting the need on occasion to divulge information to appropriate bodies. Where that happens, it needs to be done in a controlled and measured way.
We know from various bits of the public service that when the reins are loosened, sooner or later, because of the size of the public service, we lose control to an extent over that information. That is wrong in itself, but it also gives the public the impression that the system is not copper-bottomed, not—to use another metaphor—watertight. That is to be regretted.
We can think of the incident regarding the Driver and Vehicle Licensing Agency, reported some two or three years ago now, when a rogue individual was able to put information into the public domain and the difficulty that that caused. There have been many other episodes, fortunately mostly minor. That of course was by commission. If we loosen the reins, mistakes will be made. That is inevitable, and material will get to where it should not be, by default. That seems likely as a result of the measures because they give us less of a hold over sensitive information than we had previously. We have to make a judgment as to whether that is acceptable, given our need to ensure that what goes on in the national health service and elsewhere in the public sector is lawful, and to clamp down on fraud, which we understand to be substantial. I would like to hear from the Minister a brief exposition on the extent of the problem that she has identified and requires addressing in chapter 3.
We have just dealt with a chapter in which we suggested that the Government had identified a problem that did not exist and had come up with seven clauses to solve that problem. I am not going to level that accusation at the Government here—broadly, clauses 41 to 52—because we are content that there is fraud within the NHS. We hope that fraud is not rampant, but we accept that there is some in the system. The Government, as a responsible one, will wish to reduce that and to ensure that we get efficiency from our service and that those who are miscreants are brought to book. We will support the Government in that, in a way that we would not necessarily support them in the clauses discussed hitherto. What is important is that we have an assessment of the scale of the problem before we consider whether the remedy proposed, in terms of disclosure, is worth the cost, to put it bluntly.
There are a number of ways in which confidentiality in the NHS is being challenged and threatened all the time. Briefly, we mentioned Connecting for Health—what used to be called NPfIT—and the potential that that has for challenging a guarantee of patient confidentiality. I imagine that the use of Connecting for Health would be considered as part of the measures that the Minister will bring forward to combat fraud and unlawful activities within the NHS. What would be useful in the course of the discussion of the clauses is if the Minister gave us a description of how NPfIT or Connecting for Health might be used or abused in the course of such activities.
In summary, although I broadly welcome the intention behind this set of clauses, I sound a cautionary note. I hope that the Minister will be able to tell us what the problem is and the extent of it, and how by addressing that problem we will not unacceptably damage confidentiality in respect of how sensitive patient records are dealt with.