Mandatory submission of patient identifiable information to third parties: FGM now, what next?

The government has done much to tackle female genital mutilation (FGM),1 2 3 but the planned rollout of FGM Enhanced Data Collection across the NHS in October 2015 is ill considered. All healthcare professionals will be legally obliged to submit highly sensitive, patient identifiable information on every woman with FGM attending the NHS for whatever reason. A woeful consultation preceded the ministerial direction, which also says patient consent is not needed. While stating that confidential data will not be released to third parties (such as police, Crown Prosecution Service), the reassurance is inadequate and not future proofed.4 5 6 The legal responsibility for communicating that this information will be collected, where it will be sent, and what may happen to it is devolved to frontline clinicians.7 8 The push to implement an electronic infrastructure and opt-out that is not fit for purpose will bring already compromised patient confidence closer to breaking point.9 10 The initiative has no evidence of benefit, wastes precious clinical time, and will profoundly damage trust in health professionals who will either collude or ignore the imperative.

Correspondence with the minister of public health and civil servants remains unanswered. The Department of Health seems wilfully unaware of the wider ramifications of breaching confidentiality and the impact on the human and healthcare rights of already disadvantaged women and their families. Rather than tackling FGM, this measure is likely to be counterproductive and hinder eradication strategies.

Confidentiality is not absolute, but it underpins the doctor-patient relationship.11 Without reiterating countervailing ethical and professional duties, the GMC recently emailed all doctors about their obligation to breach confidentiality if the government has made a law compelling them to do so.12 But such law is unnecessary and misguided. The government still has time to reflect and pull back from a policy that wrecks the basic medical promise of confidentiality.