The problem of Patient Confidentiality


The rights of the perpetrator appear more important than the needs of victims’ families

Killer’s consent
At the start of any homicide inquiry, one of the first things the inquiry panel has to do is to get the killer’s permission to see the medical records.

Under the current system of Patient Confidentiality medical records being cannot usually be examined by anyone not directly involved in delivering care. For any independent homicide inquiry to proceed, the patient has to give consent for their records to be disclosed.

This means the inquiry has to ask the killer for consent before they can investigate the death.

The patient can refuse permission. In such cases the inquiry team has to go to court to get permission from a judge to see the files.

See Philip Theophilou Inquiry p.4

Judge’s rarely refuse such permission, (as it’s matter of public interest), so the whole exercise is pretty pointless and just leads to further unnecessary delay.

Confidentiality or Cover up?
In some cases Mental Health trusts refuse information to the families of victims on the grounds of ‘patient confidentiality’

Sometimes it emerges that the withheld information actually has little to do with personal medical history but rather more to do with systemic problems and failures in the system.

The fact that a patient’s records are in a complete mess won’t disclose any personal information about the patient, but it is hugely embarrassing for the professionals charged with keeping good and accurate files, particularly in an area where a patients previous history is so vital to their future treatment.

There is no independent review of information deemed to come under ‘patient confidentiality’. Such material is also not subject to the Freedom of Information Act.

Families, Friends and others who need to know
In some cases members of the patient’s own family, friends or other agencies worried about a persons deteriorating mental state, have not been told important information out of misplaced concerns for patient confidentiality.

Sometimes this failure to pass on information can have devastating consequences. (eg the case of Glaister Butler & John Bryceland)


SOURCES

Obtaining consent from perpetrator before investigation from: National Patient Safety Agency. Independent investigation of serious patient safety incidents in mental health services. Good Practice Guidance, February 2008. p 13 & 35
http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60156&
type=full&servicetype=Attachment

Department of Health: Confidentiality NHS Code of Practice http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en
/documents/digitalasset/dh_4069254.pdf

General Medical Council – Guidance on Confidentiality
http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality.asp

NHS West Midlands
Report of the Independent Inquiry into the care and treatment of Mr Glaister Earle Butler (2009) p35ff
http://www.westmidlands.nhs.uk/cms/portals/0/repository/21/Independent%20
report%20into%20the%20Care%20and%20Treatment%20of%20GEB.9b8a2cc6-
7810-432e-9213-7ec92c28a519.pdf

See also
Case of John Bryceland who murdered his partner Jacqueline Hughes, in Glasgow in August 2007. (She pleaded to section him, MH services said they couldn’t discuss it with her, he killed her days later).