Health and Care Bill

Debate between Lord Lexden and Lord Hunt of Kings Heath

Lords Hansard - Part 1 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, my amendment concerns patient data. I want to probe the meaning of new Clause 14Z61, proposed by Clause 20(2), which relates to the permitted disclosure of information by integrated care boards. It sets out, on page 27 of the Bill, a number of conditions under which disclosure can be made. They include when

“the information has previously been … disclosed to the public”

or

“the disclosure is made in accordance with any enactment or court order”.

That seems perfectly sensible. However, proposed new subsection (1)(f) contains a catch-all condition under which a disclosure can also be

“made for the purpose of facilitating the exercise of any of the integrated care board’s functions”.

That seems remarkably open-ended. My amendment seeks an assurance that this power excludes the personal data of patients.

We have already had one go at the issue of data and digital transformation, and I have told the House that I am right behind the efforts of the NHS and the Minister’s department to encourage the digital transformation of the NHS. The potential is clearly enormous. However, public confidence depends on the integrity of the system and having embedded in it a guarantee that every use of data will be consensual, safe and transparent.

The recent Laura Wade-Gery review, on which a number of noble Lords have commented, acknowledged some of those concerns. As she said:

“The field of data science is undergoing a revolution as new tools such as machine learning transform our ability to gain insights and improve outcomes. These advances, combined with the explosion of new data driven commercial business models, have caused citizens to be concerned about the privacy of their individual health data and the controls in place over its dissemination and use.”


There may be situations where a patient does not want a doctor—by the way, just for the Chief Whip’s reassurance, I have not spoken for 37 minutes as the clock says—to tell another doctor something about them, yet this can be ignored by those who want to copy records across a lifetime. Modern communications have created the capacity to copy medical records on a scale that can shatter medical confidentiality.

The experience of Care.data is surely a lesson for us. The decision to axe the scheme followed the publication of two reports that supported far greater transparency over what happens to the information, and opt-outs for patients who want their data seen only by those directly caring for them. A review by the late Dame Fiona Caldicott, and a second by the Care Quality Commission, recommended tougher measures to keep people’s medical information confidential. The Caldicott review said that there needs to be much more extensive dialogue with the public as to how their information can be used. As she said:

“Citizens have a right to know how their data is safeguarded. They should be included in conversations about the potential benefits that responsible use of their information can bring. They must be offered a clear choice about whether they want to allow their information to be part of this.”


This was brought home to me recently by NHS England’s announcement that it is to give trusts, as employers, access to the Covid and flu NHS vaccination records of their staff. I am fully behind the vaccination drive and sympathetic to the Government’s mandating of vaccines, but the announcement said:

“To assist Trusts with understanding the vaccination status of their workforce, we are providing a solution for Trusts to view the vaccination status of staff who are on the Electronic Staff Record … system. To do this, we are undertaking an exercise on Trusts’ behalf, to match ESR data, using NHS numbers, with vaccination data held in the National Immunisations Management System … which includes data drawn from all point of care vaccination systems. Following a successful import of ESR data into NIMS, a dashboard will be provided to each Trust detailing their workforce Covid and Flu vaccination uptake, drilled down to employee-level.”


Let me be clear: I support the vaccination drive, as I said, but am I the only one to worry about the access to confidential data that is being given? I recognise that we are talking here about electronic staff records as opposed to electronic patient records, but the principle of releasing patient data is the same.

I would like to hear some assurance from the Minister about the use of this clause and the open-ended nature of new Section 14Z61(1)(f), because, as I think we will shortly hear from the noble Baroness, Lady Brinton, such an open-ended disclosure provision in other legislation would be looked at with very great concern. Having said that, and having taken up 44 seconds, according to the Clock, I beg to move.

[The Deputy Chairman of Committees (Lord Lexden) (Con)]

My Lords, I have failed in my duty, and not for the first time. I should have stated before calling Amendment 145 that the noble Baronesses, Lady Brinton and Lady Harris of Richmond, will be taking part remotely. May I apologise, and invite the noble Baroness, Lady Brinton, to speak?

Medicines and Medical Devices Bill

Debate between Lord Lexden and Lord Hunt of Kings Heath

Committee stage & Committee: 7th sitting (Hansard) & Committee: 7th sitting (Hansard): House of Lords
Thursday 19th November 2020 Grand Committee

[The Deputy Chairman of Committees (Lord Lexden) (Con)]

My Lords, I have received no requests to speak after the Minister, so I call the noble Lord, Lord Hunt of Kings Heath, to conclude the debate on his amendment.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I think this has been an excellent debate. I fully accept, as my noble friend Lady Thornton said, that my Amendment 122 covers a much wider area than Amendment 123, which focuses on the specific issues relating to the report of the noble Baroness, Lady Cumberlege.

My Amendment 122 was definitely a probing amendment, because the current situation in relation to clinical negligence is wholly unsatisfactory. It combines the bureaucracy and slowness which the noble Baroness, Lady Bennett, referred to in relation to Windrush and she is absolutely right to draw parallels. It combines a hugely frustrating process for patients and their relatives with a system that increasingly becomes ever more expensive for the NHS. The noble Lord, Lord Bethell, was not going to be drawn on these wider considerations, but the noble Lords, Lord Lansley and Lord O’Shaughnessy, have both dealt with these—we know that it is a very complex issue, but surely, at the end of the day, we have to recognise that the current system simply is not working.

Health Protection (Coronavirus, Restrictions) (North East of England) Regulations 2020

Debate between Lord Lexden and Lord Hunt of Kings Heath

Monday 12th October 2020 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, thank you. Surely, the Minister was right to open by emphasising the gravity of the situation, but here we are again debating regulations that have already been superseded, which serves to underline the unsatisfactory nature of how we are dealing with local Covid lockdown regulations. I do not want to go over the grounds of my PNQ on Friday, but, when Mr Speaker called for the most significant of these regulations to be debated in Parliament at the earliest possible point, I think he spoke for the great majority of parliamentarians.

As the Minister has said, the Government propose to introduce a new tiered system of restrictions for local lockdowns, and, whatever the justifications for them—the noble Lord is right about the evidence that we are facing—they involve a serious reduction of people’s liberties and, of course, put many businesses in jeopardy. I am in no doubt that this House should be asked to approve them before they come into force, just as the Commons is likely to do. My understanding is that that is now likely, and, if so, this is very welcome.

Of course, the relationship between government and local authorities is highly relevant to this and the regulations the noble Lord spoke to today. Right from the start—going back to March—the Government seemed to exclude local bodies from the key part that they could have played in helping to combat and manage the virus. Public health directors were ignored, NHS and university lab capacity was overlooked and, as the Institute for Government has pointed out in its analysis of government decision-making:

“The decisions on lockdown and school closures were taken and introduced swiftly, and with little consultation and planning for how they would work in practice.”


I was very struck by a comment made by the Newcastle City Council leader Nick Forbes a few days ago. He said that confusion over the latest restrictions was deeply unhelpful and that they were very difficult to enforce and had left dangerous conspiracy theories to fill the void. We know that a frequent complaint of many leaders is that local authorities were often given little notice of when local regulations were to be made.

In parallel to the new regulations that we will debate later this week, it has been reported that the Prime Minister wants local leaders to help shape the package of local lockdown measures. Clearly, as a principle, that is welcome. Does the Minister agree that, generally, evidence shows that, globally, countries that rely on a central approach are not as effective as those that use trusted local bodies? Does he also accept that local authority test and trace services seem to have a much higher rate of contact, both for complex and non-complex cases, than the national scheme, which faces so many problems? Can he also expect to see the ending of decisions on lockdowns being leaked in advance of local leaders being told what is in them?

It is clearly important that the rules are complied with. Will the noble Lord say something about compliance rates? I do not know whether he has studied the recent report of the C19 National Foresight Group, which has been looking at the communications the Government have with the public over these restrictions. It concluded:

“National Integrity and Trust is Being Eroded”


because of the

“style, pace and timings of communications”.

It says:

“This mostly focussed around rhetoric, over-promising and timing (where late night national announcements created negative impacts on the relationship with the public). Apparent conflicting activities (where two announcements seem to contradict) and stating ambitious targets that are then not achieved were aligned to eroding trust with the public.”


Regarding local bodies, the C19 group went on to say:

“The lack of trust in the local structures from ministers and government departments… also impacts on their ability to feel included as part of a greater UK wide management”


of the pandemic. Does the Minister recognise this, and will this be considered as part of the recasting of the relationship between the Government and local authorities?

[The Deputy Speaker (Lord Lexden) (Con)]

My Lords, I apologise again, particularly to the noble Lord, Lord Hunt, and the noble Baroness, Lady Thornton. I was looking at the list for the next debate. I call the next speaker for this debate, the noble Lord, Lord Greaves.