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Lord Winston: My Lords, before the Minister sits down, perhaps I may raise one point. It seems to me that there is something of a paradox here. The Government supported the notion of protection of confidentiality for in vitro fertilisation and still regard that as useful. I wonder whether the Minister could briefly address the issue that troubles me and probably others also. There is one set of patients who seem to be legislated for but people going through other medical treatments are not so treated. Would she address that paradox? It seems to me to be an important principle in consideration of this whole matter.
Baroness Cumberlege: My Lords, quite frankly, there is something of an anomaly. The noble Lord will know that the Human Fertilisation and Embryology Act 1990 regulates the circumstances in which disclosure of specified information is permitted and that centres are licensed. It is a very draconian Act in some ways. As the noble Lord said earlier, it has brought us some difficulties. We are aware of that. Because we shall be subject to the EC directive, it seems to us inappropriate now to bring in more legislation which may land us in the same kind of difficulties as did the 1990 Act in the case of human fertilisation and embryology. Although we do not rule out legislation for ever and a day, the timing is not right. We should want to reconsider the matter when we have had a chance to build it into the EC directive.
Lord Walton of Detchant: My Lords, I am very grateful to all those who have chosen to speak in what has proved to be for me an extremely interesting debate. In particular, I echo the congratulations which have come from all parts of the House to my noble friend Lord Kilpatrick on his sensitive and moving maiden speech, in which he painted a vivid picture of some of the everyday dilemmas of clinical practice that face all doctors in this very difficult area of confidentiality, based on his own personal clinical experience.
I was grateful to the noble Lord, Lord Winston, for his qualified but warm support for the principle of the Bill. I was grateful to him also for drawing attention to some of the problems that already exist in relation to the confidentiality of medical records and of the difficulties which arise in many medical records departments in the NHS. I thank him too for the points he made in regard to the problems with the media; they are extremely difficult. They are problems that might arise if the Bill progressed further, because the question would be: under law, who would be liable to a criminal prosecution? Would it be the media that used the
I thank the noble Lord, Lord Milverton, for his talk from the standpoint of a priest and his willingness to support the view that we should close gaps in existing provisions. I express my gratitude to my noble friend Lord Attlee for his support and for drawing attention to the important matters relating to the stance of the insurance industry. That is an issue which may need to be further examined, though my belief is that the Access to Health Records Act and the existing recognition that a patient may give valid consent to the disclosure of personal medical information would meet most, if not all, the anxieties expressed by the insurance industry.
I am grateful to the noble Baroness, Lady Robson, for her welcome for the Bill. I was glad to hear that she feels that legislation is needed and that the guidelines alone must ultimately be reinforced by statute.
I thank the noble Lord, Lord Carter, for his cautious welcome and note that he would wish, if the Bill proceeds to Committee stage, to introduce some probing amendments. There is no doubt that he is right in saying that something must be done to protect the private sector, which is presently under common law duty. Those of us who have looked carefully at the issue do not feel that the existing common law provision is sufficient to protect confidentiality of sensitive information in that area. I can reassure the noble Lord that the intention of the Bill is to cover all areas of medical practice.
Scotland and Ireland are excluded because the laws in those two countries are somewhat different. If the Bill were to succeed, one would hope that, ultimately, similar statutes would be introduced in those two
As usual we heard a carefully considered, thorough and characteristically sympathetic response from the noble Baroness, Lady Cumberlege. She is right in saying that real progress has been made. The noble Baroness drew our attention to the many statutes and provisions which protect confidentiality as matters stand at the moment. There is no doubt that the department's guidance is valuable. But I cannot do other than stress yet again that gaps exist in the guidance. There is little in it about the principle of informed consent on the part of patients. Above all, there is a lack of overarching statutes and provisions to cover all parts of the private sector, and that is a significant deficiency in the guidelines.
I would have wished to see the Government giving qualified support to the Bill, even with the provision that they might wish to introduce amendments at Committee stage to meet the points raised by the noble Baroness. Nevertheless, I was reassured by her comments that, in view of the European data protection legislation, whatever is done and in whatever way the guidelines are applied, a statute will be required by 1998 at the latest.
In the light of the assurances given by the noble Baroness I shall certainly consult widely upon what action will be necessary in the further consideration of this Bill. Nevertheless, I feel that the government guidelines, as they exist at the moment, are insufficient and that that crucial area of patient confidentiality will require statutory examination and control in the interests of the health of the nation and, above all, in the interests of our patients.
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