Intended for healthcare professionals

Education And Debate

Injury surveillance programmes, ethics, and the Data Protection ActSharing data to prevent injuriesPotential problems for tenantsThe legal positionEthical viewpoint

BMJ 1999; 319 doi: (Published 07 August 1999) Cite this as: BMJ 1999;319:372

Injury surveillance programmes, ethics, and the Data Protection Act

Public health is the arena in which clinical medicine, epidemiology, management, politics, and the law all meet—or perhaps more accurately, collide. Often there seem to be conflicting imperatives. Even within a department colleagues may disagree on policy. Such disagreement can be productive if as a result important policy issues are explored. The case described here raises important issues about the legal and ethical basis of the government's injunction to health authorities to work with other agencies, which is central to the current green papers on public health. A consultant, a director of public health, a health authority lawyer, and an ethicist present their views.

Sharing data to prevent injuries

  1. Ronan A Lyons, consultant in public health medicinea,
  2. Jo Sibert, professor of community child healthb,
  3. Michael McCabe, clinical director of accident and emergency medicinec
  1. a Iechyd Morgannwg Health, Swansea SA1 1LT
  2. b Department of Child Health, University of Wales College of Medicine, Cardiff CF64 2XX
  3. c Morriston Hospital, Swansea NHS Trust, Swansea SA6 6NL
  4. Iechyd Morgannwg Health, Swansea SA1 1LT
  5. Bevan Ashford Solicitors, Waterloo House, Fitzalan Court, Cardiff CF24 0BA
  6. Bioethics Centre, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand

    The purpose of the NHS is to improve the health of the population. This guiding principle was first laid down in the Strategic Intent and Direction for the NHS in Wales: “Working with others, the NHS should aim to take the people of Wales into the 21st century with a level of health on course to compare with the best in Europe.”1 This was subsequently taken up by the Health of the Nation and Our Healthier Nation initiatives in England and Better Health, Better Wales, the most recent green paper in Wales.14 In England, the prevention of injury is one of four areas for health gain in the population and in Wales it is one of 10 areas for health gain. Both old and new English and Welsh documents identify the need for injury surveillance systems and that the NHS needs to work with others to prevent injuries. Thus, the Welsh Protocol for Investment in Health Gain for Injuries sets targets for health authorities, among which are “working with others, each health authority purchasing team and local authority should develop a multidisciplinary, multiagency strategy for addressing injury prevention, based upon targeting …

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