NHS is harming patient confidentiality by sharing data for immigration purposes, say MPsBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1676 (Published 15 April 2018) Cite this as: BMJ 2018;361:k1676
All rapid responses
“Is the government back-tracking on its promise to respect the confidentiality of GP data?"
Recently you reported on the effort of Dr Sara Wollaston MP, chair of the Health Select Committee and Professor Helen Stokes-Lampard, chair of the RCGP to persuade the government to amend its secret “Memorandum of Understanding” between the Home Office and NHS digital, whereby the Home Office could obtain GP data. This data was registration data given by patients to GP practices . This data sharing was without the knowledge or consent of the GPs or, naturally, the patients concerned. Drs Wollaston and Stokes-Lampard successfully argued that this data sharing would make people with an irregular migration status, of whom there may be half a million in the UK, reluctant to register with a GP. This would be detrimental to their own health and have wider public health consequences. It also broke numerous policies on data protection. Their argument was eventually accepted by the government .Digital Minister Margot James MP made a statement to this effect in the House of Commons.
As a result, GPs may have felt able to reassure patients with irregular migration status that the information they share with their GP is confidential. They would, unfortunately, be giving false reassurance. The current position, as given in a letter from my MP quoting a government source is “that an immigration exemption [ to the Data Protection Act 2018 will be introduced] so that day to day operations to tackle illegal immigration are not obstructed unnecessarily.” “. I take this to mean that the Home Office is intending to use the immigration exemption clause of the Data Protection Act 2018, passed in May 2018, to obtain the information they used to obtain under the “Memorandum of Understanding”. Indeed, the implication is that new internal regulations are now being drafted. That this is the case can be confirmed by a letter on the Health select committee website . Until these new regulations are drafted, and here we are looking at a process that has already taken four months and will take some more, we are reassured, by the same letter, that “each request will be reviewed by a manager in the Home Office.”
Where patients are reluctant to register because of their concerns that their information may be shared with the Home Office, GPs may, under current regulations, register the patient with the practice address as their home address, as is also be done for homeless people.
Immigration regulations are now so complex that many people are unsure of their status, and this uncertainty goes way beyond the “Windrush generation.” The quantity of legislation is so great that even a legal expert has difficulty in determining status. In cases where the Home Office makes a ruling, there is no longer a right of appeal, nor is it possible to obtain from the Home Office the basis for their decision .
In the statemen made by Digital Minister Margot James MP withdrawing the “Memorandum of Understanding”, she stated that information would only be sought in cases of “serious criminality”. The letter I received speaks simply of “immigration matters.” The “Memorandum of Understanding” excluded children; will this exclusion be carried on under the new arrangements?
Can I appeal to the Home office and NHS digital to publish as soon as possible the regulations under which they will share information? If they simply use the immigration exemption clause of the Data Protection Act 2018 they will potentially be able to obtain more information than they did under the “Memorandum of Understanding” thus break the undertaking made by Ms. James on 14/04/2018.
Dr Gervase Vernon
09/05/2018 Sarah Wilkinson, chief executive at NHS Digital
““We welcome the Home Office’s response to the concerns expressed by the Health Select Committee and its willingness to adapt its tracing requests to better align with established codes of practice within the clinical community.
“The narrowing of the tracing service to only those individuals convicted of more serious criminal offences, or who represent a risk to public security, circumvents the difficulties which have arisen as a result of conflicts between existing legislation and case law and the long-established Codes of Confidentiality of the GMC and various Colleges.
“We understand the Home Office will limit its requests immediately. Likewise, we will immediately only process requests which meet these revised criteria.
“As soon as is practically possible, we will amend the Memorandum of Understanding between ourselves, the Home Office and the Department and Health and Social Care which describes this tracing service, and publish the updated version openly.”
letter from Sara Wollaston to NHS digital on 29/01 2018
memorandum of understanding revision plan as of 13/06/2018
Mirror 14/04/2018 https://www.mirror.co.uk/news/politics/home-office-stop-using-nhs-12508018
The Government has u-turned on forcing NHS to share data with the Home Office to track down illegal immigrants.
Labour say the practice was "yet another example of Theresa May’s heartless ‘hostile environment’".
It follows strong criticism from charities and the Health and Social Care Committee whose chair Dr Sarah Wollaston, put forward an amendment to the Data Protection Bill.
In today’s debate the Government accepted the principle of that amendment which restricts the occasions when NHS Digital has to share data relating to criminal investigations to serious offences only.
Furthermore, data in such cases can only be shared with the police.
This means that NHS Digital can no longer share data with the Home Office on migrants alleged being investigated for immigration offences to have committed immigration offences. Dr Sarah Wollaston proposed the amendment
This data sharing of migrants’ patient information has been going on for many years and was most recently formalised in a Memorandum of Understanding (MoU) between NHS Digital, the Home Office and Department of Health and Social Care.
Most recently the Health and Social Care Committee published a report strongly criticising the MoU and the immigration tracing service, demanding that it end immediately.
Digital Minister Margot James told MPs that a previous memorandum of understanding between the departments had been narrowed so that records could now only be shared in cases "involving serious criminality".
The move came after Tory MP Dr Sarah Wollaston, who chairs the Commons health select committee, put down an amendment to the Data Protection Bill which would seek to do just that.
Ms James said: "The Government has reflected further on the concerns put forward (Dr Wollaston) and as a result, and with immediate effect, the data-sharing arrangements between the Home Office and the NHS have been amended."
She added: "The bar for sharing data will now be set significantly higher, by sharing I mean between the Department of Health, the Home Office and in future possibly other departments of state, no longer will the names of overstayers and illegal entrants be sought against health service records to find current address details."
Ms James told MPs that the data would only be used in future "to trace an individual who is being considered for deportation action having been investigated for or convicted of a serious criminal offence".
full report of the Health and social care committee 2018
“Health and Social Care Committee. Oral Evidence - Memorandum of Understanding on
Data-Sharing between NHS Digital and the Home Office, 2018.”
current status of the health committee; awaiting response
correspondence 3/07/2018 between Sra Wollaston and powers that be 03/07/2018
“during the transition period, any such request “will be reviewed by a manager in the Home Office”. “23/06/2018
Competing interests: No competing interests