|Previous Section||Index||Home Page|
In some existing national health service information technology (IT) systems, detailed care records are already available outside the immediate locality. Under the National Programme for IT (NPfIT), detailed care records are potentially available to the other organisations within the technical environment on which that particular IT system has been deployed, typically across local health communities. These are generally referred to as a deployment instance and can be as small as a single organisation or as wide as the NHS defines within the geographic area of a supplier. Access to records is tightly controlled, however, so that only those who are involved in a patients care may have
access to that patients clinical information and even this access can be prevented by patients who dissent from information sharing.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what assessment he has made of the circumstances in which an opt-out from the summary care record under section 10 of the Data Protection Act 1998 could be overridden; and if he will make a statement. 
Mr. Bradshaw: Requests made by patients under the provisions of section 10 of the Data Protection Act 1998 must be considered on a case by case basis. The Act makes it clear that a section 10 request should only be overridden where the purpose served by processing the data is sufficiently important to warrant doing so even where it is accepted that substantial harm or distress is being caused. We do not expect there to be many, if any, circumstances where this would arise in the case of an individual who is competent to make decisions. However, there may be circumstances, for example, where there are serious child protection concerns, where a doctor might feel that a parents request to opt a child out of having a summary care record is not in the best interest of a child.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what representations he has received from law enforcement organisations on (a) access to the secondary users database and (b) provision to law enforcement authorities of the identities of individuals with specific information on their medical records; and if he will make a statement. 
Mr. Bradshaw: Law enforcement organisations are not permitted to directly access data held within the secondary uses service or any other patient information held centrally, and no representations have been received to do so.
Data are only disclosed to law enforcement organisations in accordance with the Departments publication Confidentiality: NHS Code of Practice (2003), copies of the code are available in the Library. This limits disclosure to circumstances where the overriding public interest outweighs obligations of confidentiality, for example, when immediate action is required to prevent or support detection of extremely serious crimes, where there is statutory authority, or where the courts have made an order requiring disclosure.
Mr. Stephen O'Brien: To ask the Secretary of State for Health which categories of staff other than those based at the surgery at which a medical record was created will be able to override a patients wishes expressed through sealed envelope software. 
Mr. Stephen O'Brien:
To ask the Secretary of State for Health for what reasons Connecting for Health obliges patients to sign documents that invoke the provisions of section 10 of the Data Protection Act 1998 before they opt out of the summary care record;
and what guidance he has issued on the compatibility of accepting an instruction to opt out of the summary care record with (a) common law confidentiality provisions and (b) the fair processing requirements of the Data Protection Act. 
Mr. Bradshaw: Decisions about whether or not to agree to an individuals request to opt-out of a summary care record rest with individual general practitioner practices. Provided that patients are informed about the summary care record and access to that record is appropriately controlled, the Department believes that the provisions of common law and the fair processing requirements of the Data Protection Act 1998 are met in full.
Where these requirements have been met, section 10 of the Act still applies and provides a framework for considering requests while recognising that there may be circumstances, for example for child protection purposes, where an opt-out request should be turned down.
The Government believe that the summary care record is an important component of the care that the national health service should provide in the future. It is in the interest of both doctors and their patients to ensure that any opt-out request by a patient, agreed to by the doctor, be clearly documented in the event that future medical or legal consequences should call the matter into question. NHS Connecting for Health has provided general practitioners with a simple pro forma for that purpose.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what scenarios his Department has established for the release of identifiable patient information from NHS care records to third parties without the patients consent; and what the (a) data source, (b) destination, (c) nature of the information, (d) legal justification, (e) data controller and (f) professional role of the individual providing approval in each scenario is. 
Mr. Bradshaw: The release of identifiable patient information from NHS Care Records must be in accordance with the provisions of the Data Protection Act 1998, common law confidentiality requirements and any other pertinent legislation. These limit the release of information without consent to circumstances where the public interest that would be served by the release of information outweighs an individuals right to confidentiality, or where legislation or the courts require or permit the release. These circumstances are described and explained in more detail in the Departments publication Confidentiality: NHS Code of Practice (November 2003) copies of the Code are available in the Library.
Dorset county hospital in Dorchester is managed by Dorset county hospital NHS foundation trust, and the Royal Bournemouth hospital is managed by the Royal Bournemouth and Christchurch hospitals
NHS foundation trust. The information requested is a matter for these foundation trusts.
We have written to Robin SeQueira CBE, chair of Dorset county hospital NHS foundation trust, and Sheila Collins, chair of the Royal Bournemouth and Christchurch hospitals NHS foundation trust, informing them of the hon. Member's inquiry. Copies of the replies will be placed in the Library.
Mr. Peter Ainsworth: To ask the Secretary of State for Health how many litres of bottled water were purchased by his Department in each of the last three years; and if he will make a statement. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health what guidance he has issued on the classification as sensitive of a patient's name and address when stored in conjunction with a record of (a) attendance at a health facility and (b) consultation with a particular clinician; and if he will review the provisions for recording sensitive information in the audit trail of records accessed on the Patient Demographic Service database. 
Mr. Bradshaw: The Code of Practice, Confidentiality: NHS Code of Practice, published in November 2003, provides guidance on the required practice for those who work within or under contract to national health service organisations. In addition, the specific guidance issued in support of the Personal Demographics Service (PDS) draws attention to this wider guidance and states explicitly that each health care organisation is responsible for ensuring that health care professionals are aware that inappropriate use of the PDS could result in disciplinary proceedings against them.
The information held within the audit trails associated with the PDS can be sensitive, though clearly not as sensitive as a full clinical record, and the content is covered by the code. Access to audit trail information is restricted to a small number of individuals authorised by their organisations to investigate the use and potential misuse of systems, and to access the minimum information necessary to undertake this work. There is no evidence of abuse of these arrangements but NHS Connecting for Health continues to monitor and review as necessary.
|n/a = Not available.|
Revenue resource limits for strategic health authorities (SHAs) and primary care trusts 2005-06 and 2006-07.
Gross expenditure reported in the national health service summarised accounts of SHAs 2005-06 and 2006-07.
Mr. Bradshaw: Government planned funding for the national health service for the next three years 2008-09, 2009-10 and 2010-11 is set in Figure A.l of the Department of Health Departmental Report 2008, copies of this publication are available in the Library.
Mr. Bradshaw: The information requested is shown in the following table. Information on administration is not available prior to 1991-92. The latest year for which information is available is 2006-07.
|Administration costs (£ million)||As a percentage of total NHS expenditure (Percentage)|
| Note: Figures for 2004-05, 2005-06 and 2006-07 exclude data for foundation trusts. Source: Annual financial returns (unaudited) for primary care trusts, (strategic) health authorities and national health service trusts 1991-92 to 2006-07. NHS total expenditure (England) 1991-92 to 2006-07.|
Tim Farron: To ask the Secretary of State for Health what the NHS surplus was for 2007-08; and how much was spent in that year on prepayment of suppliers for services to be provided in years after 2007-08. 
NHS accounts are prepared in accordance with the United Kingdom generally accepted accounting practice (UK GAAP) framework as required by HM Treasury and set out in guidance for the NHS by the Department. Each NHS organisations accounts is subject to a full audit to ensure that they are complying with this framework.
Under UK GAAP rules, a prepayment would not impact on the surplus because expenditure is recorded on an accruals basis. This measures resources as they are consumed rather than when cash is paid. Therefore any prepayments made in 2007-08 would have no impact on the expenditure recorded in the NHS for that financial year, and consequently would not affect the level of surplus.
|Next Section||Index||Home Page|