With this it will be convenient to discuss the following amendments: No. 167, in clause 40, page 17, line 30, leave out subsection (5).
No. 168, in clause 40, page 17, leave out lines 32 to 35 and insert—
‘(6) Section 36 does not permit the disclosure by the Board of any information received under this section.’.
No. 169, in clause 41, page 18, line 14, leave out subsection (5).
These are probing amendments through which we are attempting to understand the data flows through the system and to probe what information is required. Amendment No. 166 would delete subsection (3) and replace it with the provision stating that information about NHS registration can be passed but that it should not
“include any information which would allow the identification of an ‘individual’”.
The amendment would reduce the detail of the information supplied in order to protect confidentiality.
I have a question about the amount and detail of the data supplied. Subsection (3)(d) will allow information about the history to be transferred. With reference to amendments Nos. 167 and 169, will the information be used for any purpose other than the production of the mid-term population statistics? Such statistics—in particular Slough’s problems estimating mid-term figures—have been a feature of debates in Committee and were a feature of the Second Reading debate.
I shall support my hon. Friend’s amendment unless the Minister can provide me with a little comfort about a concern that I have. I understand the Government’s objectives and the reasons for their proposals, but the Bill should not conflate statistics, which try to identify general trends, and personal information, which might identify individuals. I hope the Minister will reassure me that that will not happen.
I, too, support the amendment, because subsection (3) ranges extremely widely. The Minister tries to ensure that information about registrations between general practices—people moving from one general practice to another, or from one health authority area to another—is properly captured. The explanatory notes describe the process as the creation of an information gateway; I think they mean the creation of a power to ensure that the board still receives the information.
In subsection (3)(d), which the amendment covers, the information to be provided as part of the measurement of flows of people from one general practice to another includes the reasons for an individual’s cancellation or re-registration. There may be many reasons why one cancels one’s registration with one’s general practitioner, and they may have nothing to do with one’s relocation to a different part of the country. One may be unhappy with the performance of the general practice, for example. I am not sure that it is appropriate for the board to start piling up information about why people have moved. Surely the board needs only the statistical information that an individual has moved or has changed GP. I should be grateful if the Minister could explain why subsection (3) must go so far as to cover, in paragraph (d), the reasons for people registering or not registering.
Clauses 40 and 41 provide for the Secretary of State for Health, public authoritiesor Welsh Ministers to share patient registration information with the board for the production of population statistics. To be clear, clause 40(4) makes it explicit that patient registration information does not include any information about the health, care or treatment of individuals.
Patient registration information is information about persons who are or who have been registered in any place in England or Wales as persons to whom primary medical services are provided. That may include, but is not limited to, information such as a person’s address, their date of birth, their gender or their NHS number. The provisions replicate the current data sharing arrangements within the Office for National Statistics.
It may be helpful to the Committee if I explain exactly what happens to such information. Patient registration information is collated and held in the national health service central register, which is currently maintained at the Office for National Statistics and is used primarily to manage the transfer of medical records between GP practices and between the NHS and the armed forces’ medical services. Statisticians in the ONS have access to that information, and that access enables the ONS to derive and estimate migration within England and Wales and between England, Wales, Scotland and Northern Ireland.
The data covered by the clause will therefore allow greater monitoring and analysis of migration and population movements—something in which the Committee has taken an interest, as the hon. Member for Fareham said. I think that all Committee members want there to be better quality, more up-to-date data to assist in some important areas of policy-making.
Amendment No. 166 would prevent the Secretary of State or another public authority from disclosing tothe board any information that would allow the identification of an individual. That would mean that all information would have to be in an anonymised, non-identifying format. I hope that the hon. Member for Braintree will understand that the distinction he tried to draw between statistics on general trends and data on registration represents a conceptual difference, but in practice it is important to bring them together.
I understand the hon. Gentleman’s concern. Although information will be processed at an individual level by the statistics board, only aggregate statistics will be published. The Bill introduces legal provisions to maintain the confidentiality of information and will penalise any breaches of those provisions.
It is interesting to see the way in which the debate is going because it illustrates the importance of having absolute clarity about the tension between having the quality of information at the most local level and ensuring that confidentiality is protected in the way set out by the Minister. That is important because if one errs too far in one direction, one may find, as we did in the past, that information simply does not pick up what happens at the most local level, particularly in rural areas. The protection must be there so that we can be assured that data are used in an appropriate way to ensure that the interests of every area are properly analysed and understood.
My right hon. Friend is right. In dealing with concerns about understanding flows of population, it is necessary for statisticians to have access to the data. The important question then is whether that takes place in circumstances that sufficiently safeguard the confidentiality of certain types of data and the uses to which they may be put. That is the essence of the debate that we are having this morning.
The reason is that, just like the ONS at present, the board will need to have access to identifiable information if it is going to continue to produce—let alone improve— useful and meaningful population statistics. Such statistics require the ability to identify all moves where an individual has registered a change of permanent address, thus enabling the board to identify which individuals should be counted as migrants and in what data periods, areas and population sub-groups. Individual records are required for matching and tracing migrants between separate reporting periods; research into understanding, for instance, patterns of migration by linking recent and older records is possible only if the two types of records can be matched individually.
It has become increasingly important for policy makers to be well informed about migration, both to monitor the pattern and trends in flows and to respond to changes in the position and impact of migrants within society and the economy.
This aspect of the data caused some of the problems in Slough which I spoke to the Minister about, and part of the failure to estimate mid-year populations accurately is to do with such things. For example, young men in particular do not necessarily have a health record, as they tend not to register with GPs. Therefore, connecting all the pieces of information has significance, if only to statisticians, who can work out whether particular classes of people not registering and so on. That might help to improve the accuracy of some of our poor counts, with results in respect of the failings in our current population counts.
My hon. Friend has become something of an expert in the field. She has powerfully made the case for the provisions, which we continue in clause 40. The clause is drafted to create a statutory gateway that will allow the board to continue to have access to patient registration information for the production of population statistics.
Amendments Nos. 167 and 169 would widen the scope of clauses 40 and 41 so that the patient registration information could be used by the board for any purpose. The clause would, therefore, not restrict how the information might be used by the board—although, clearly, when taken with amendment No. 166, the usefulness of the information for the board would be limited.
I have explained the Government’s intention, as part of the reforms, to transfer the national health service central register from the Office for National Statistics. Given that, placing the long-standing data-sharing arrangement on a statutory footing is necessary, so that the board can continue to use patient registration information for the production of important population statistics. I hope that that assures hon. Members.
I am grateful to the Minister for the way in which he has talked through how the information can be used, but I still wonder whether there is any way in which less detail could be provided, while still achieving the objectives that the hon. Member for Slough referred to.
I was also struck by the Financial Secretary’s comments on subsection (5), which restricts the use to which the data can be put. The restriction is very clear. I am not sure that I would wish to remove it, but it is a tight restriction compared to the broad ability in clause 36(4)(a) for any enactment to be used to share the data. On the one hand, we have provisions that enable broad use, subject to legislation, and on the other, some tightly worded subsections restricting the use of data. There is a contradiction, which we need to explore later. I beg to ask leave to withdraw the amendment.