Education And Debate

Secrecy in the NHS

BMJ 1994; 309 doi: (Published 17 December 1994) Cite this as: BMJ 1994;309:1640
  1. Naomi Craft
  1. BMJ, London W1CH 9JR, editorial registrar.

    Seven years ago we collected 20 examples of secrecy surrounding health and the NHS in Britain.1 This month we repeated the exercise, and in three days we have discovered 30 examples. We will be pleased to hear of more.

    Trust contracts

    (1) Paragraph 330 of the Terms and Conditions of Service for Hospital Medical and Dental Staff says that “A practitioner shall be free, without prior consent of the employing authority, to publish books, articles, etc, and to deliver any lecture or speak, whether on matters arising out of his or her hospital service or not.” A growing number of trust hospitals have contracts which have replaced this with a gagging clause.

    The BMA's database records the following trusts as having at some time inserted a confidentiality or conflict of interest clause, or both, into contracts:

    Frimley Park Hospital; Walsgrave Hospital; St Helens and Knowsley Community Health; Mid Staffordshire General Hospitals; North Staffordshire Hospital Centre; Leicester Royal Infirmary; Royal Devon and Exeter Hospital; Ashford Hospital, Middlesex; and Heatherwood and Wexham Park Hospitals. For example, a recent confidentiality clause from a contract given to a consultant working for West Kent Health Authority reads: “In the course of your work you may have access to confidential information which should not be disclosed to any other person unless in the pursuit of your duties or with the specific permission of the employing authority.”

    Hansard reports that in March 1994, Dawn Primarolo (then opposition spokesperson for health) asked the secretary of state for health “what freedom NHS trusts have to vary the terms and conditions for service for hospital medical and dental staff in relation to the freedom of practitioners to publish articles or to speak on any issue without the prior consent of their employer.” The health minister, Brian Mawhinney, replied in a written …

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