Threats to privacy
There are 1.3 million people working in the NHS as well as a huge number of temporary agency staff – not just doctors and nurses, but managers, administrative staff, IT staff and contractors. So a massive centralised database poses a huge threat to medical confidentiality.
Although there is supposed to be an audit trail (read Helen’s story for more information) it is highly unlikely that NHS employees will be sacked or disciplined if they claim to have inadvertently called up the wrong patient details. And the Personal Demographic Service will hold everyone’s name, address, NHS number, GP details, ex-directory phone numbers and mobile phone numbers – this information forms the basis of each NHS Care Record.
The Personal Demographic Service will be available to all NHS employees, including high street pharmacies. It will let NHS employees trawl 50 patients at a time using variations on your name, surname, address and date of birth to try to find the correct patient. Hence any NHS employee could find anyone purely by claiming to have legitimately called up the wrong patient details. Added to this, if they work in A&E they will be able to access clinical information – including the information in “sealed envelopes” that have been put there by the patient or doctor to protect the patient’s confidentiality.
Additionally high street pharmacists are arguing that they should not only be able to access your name, address, ex-directory phone number and GP details on the Personal Demographics Service but that they should also be able to access your ‘Summary Care Record’ – as well as edit or amend it, and add medical and clinical details to it.
Your Summary Care Record is part of your NHS Care Record. The plan is to ultimately make it available to anyone in the NHS with a ‘need to know’ – this would includes pharmacists, ambulance staff, District Nurses, staff in community clinics such as Family Planning Clinics, Sexual Health Clinics, hospital staff including nursing staff, physiotherapists, occupational therapists, dietitians, mental health teams… and anyone else the NHS thinks may find your information useful.
Anything you disclose to any doctor, nurse, midwife, health visitor, health professional, NHS employee, pharmacist, at any hospital, surgery or clinic will be stored on this massive central government database. This could include sensitive issues such as sexuality, ethnicity, genetics, mental health issues, illicit drug use, abortion, contraception, impotence, paternity, infertility, HIV, sexually transmitted diseases, infidelity, personal relationships, emotional problems, test results, domestic violence, rape and sexual abuse.
All of this highly personal information would also then be used for ‘secondary purposes’, as detailed in Hidden uses of medical records.