Will the government really penalise GPs whose patients opt out of data sharing?

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It seems the government has found a way to dissuade GPs from letting patients opt out of having their medical records sold to private firms – the threat of penalties or even an investigation into the way they run their practice.

Vox Political revealed earlier this month that the government is planning to make a profit from selling the private records of NHS patients in England to healthcare and pharmaceutical firms.

The records are said to be ‘anonymised’, but in fact anyone buying your details will be able to identify you.

The system, originally called the General Patient Extraction Service (GPES), now the Health and Social Care Information Centre, may also be described as the care.data scheme. Health Secretary Jeremy Hunt wants you to think the information will be used for medical research and screening for common diseases, but in fact it could be used by private health companies as evidence of failures by the National Health Service, and could help them undercut NHS bids to continue running those services – accelerating the privatisation that nobody wanted.

Patients have the right to withhold their data, but they must specifically inform their medical practice of their wishes. This is why medConfidential created a web page containing a special opt-out form, along with a form letter in various formats, allowing patients to opt out themselves, their children and any adults for whom they are responsible.

Now GPs are living in fear of reprisals if they don’t deliver enough details to the new system.

According to GPonline.com, Health minister Dr Daniel Poulter failed to rule out penalising GP practices with a higher-than-average proportion of patients opting out of new NHS data sharing arrangements.

In a written answer to Labour MP and health select committee member Rosie Cooper, Dr Poulter also refused to say what level of patient opt-out from the scheme would trigger an investigation.

Asked whether practices would be penalised, who would investigate practices with a high opt-out rate, and at what threshold this would apply, Mr Poulter said: “NHS England and the Health and Social Care Information Centre will work with the BMA, the RCGP, the Information Commissioner’s Office and with the Care Quality Commission to review and work with GP practices that have a high proportion of objections on a case-by-case basis.”

Ms Cooper took this as an admission that GPs were “being threatened and bullied into ensuring patients don’t choose to opt-out”.

Reacting on Twitter, NHS national director for patients and information Tim Kelsey ruled out fines for practices where large numbers of patients opt not to share data. He wrote: “Nobody is going to get fined if patients opt out.”

None of this offers a good reason for you to leave your medical records unprotected – in fact, it gives you more reasons to opt out than before, and might provide GPs with the excuse they need to retaliate.

Doctors have been pushed further and further by the Conservative-led government’s changes to the NHS. For example, they were told they would have a greater say in where the money went, as members of Clinical Commissioning Groups (CCGs), but that was not true – they don’t have the time to take part in such decisions so they have been handed over to firms that are often part of the private companies now offering services to the NHS (for a price).

Now they are being told they may face reprisals if they do not betray the principle of doctor-patient confidentiality.

But you can only push a person a certain distance before they push back.

How will NHS doctors in England respond?

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How can we believe the government’s ‘health tourism’ statistics?

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“It’s my policy and I’ll cry if I want to” – or is Jeremy *unt simply responding to criticism of his bid to climb on the anti-immigration bandwagon?

A speech by Iain Duncan Smith is immediately reminiscent of a wasp negotiating its way through a bulldog’s digestive system; there’s a lot of droning and implied pain, but through it all you know exactly what the outcome will be.

From this starting point, one may liken a speech by Jeremy Hunt to a hippo having an unhappy bowel movement as a result of an unwise dietary choice; much clumsy blundering in the wilderness and a fair amount of distress – which may be transferred to any poor creature unlucky enough to get in the way.

It seems that migrants and visitors from abroad who use the NHS are now facing the full onslaught of the Health Secretary’s metaphorical indigestion, with nary a bucket of Rennie in sight – except in this case the cure would be a set of reliable statistics covering the use of NHS services by our foreign-born friends.

Armed with new reports by independent firms Prederi and Creative Research, the Health Secretary (and well-known misprint) believes ‘health tourism’ is costing the NHS £2 billion every year – and has announced that he plans to claw back around £500 million of that money.

A BBC report states that ministers believe some of the spending is unavoidable but “it would be realistic to save a quarter. Savings would come from deterring so-called health tourism, recovering money owed by other countries and a levy on non-European temporary residents”.

But the cost of health tourism, as set out in the report, is tiny – at a maximum of £80 million it would be four per cent of the estimated total loss – and this is based on evidence which even one of the reports’ authors, Prederi, have admitted is incomplete. On its own, it could not possibly generate the saving demanded by the new policy, nor could it justify the claim that £2 billion is currently being lost.

That is not the point, though. This is about getting the NHS on the anti-immigration bandwagon.

The study has been released to coincide with the Immigration Bill, which (surprise, surprise) includes plans for a £200-per-person-per-year charge for temporary migrants to use the NHS during any stay lasting between six months and five years.

The Conservative-led Coalition government says this could recoup around £200 million per year, but this is clearly nonsense.

Put yourself in the position of a person from abroad, considering an extended stay in the UK. If an extra cost of up to £1,000 for a five-year stay was added to the trip, out of the blue, would you go ahead with it? Or would you consider other destinations?

Alternatively, if the trip could not be avoided, would this not make you more likely to use the NHS, in order to simply get your money’s worth? The trouble with this is that such a person would not know the cost of a consultation. According to Dr Chaand Nagpaul, chairman of the British Medical Association’s GPs committee, the cost of a single hospital outpatient appointment would equal the £200-per-year levy.

And then there is the administration cost. New Statesman revealed that the chair of the Royal College of GPs, Claire Gerada, has warned that the cost of administrating the new system could outweigh the savings, while also increasing public health problems such as TB by deterring temporary migrants from seeking treatment when they first fall ill. This gives rise to the possibility that we are facing another Tory policy that could have deadly consequences for the population.

This is not a plan to deal with health tourism at all. This is an attempt by an increasingly-desperate Conservative Party to claw back some of the voters who have (themselves) migrated to UKIP because of fears that have been planted in their minds by political spin-doctors, rather than any real threat – the phantom problem of immigrants getting benefits they haven’t earned.

Health tourism is not costing the UK £2 billion a year, and the measures outlined by the government will not stop it, or save any lost money. If anything, it will cost the country millions of pounds.

But then, when has Jeremy Hunt bothered with the facts, when he can have his way simply by playing on people’s fears and manipulating their beliefs?

This is why reference was made, at the top of this article, to Iain Duncan Smith – another Tory minister who won’t let thousands of possible deaths interfere with his beliefs.

‘Papers, please!’ Harsher laws for immigrants could mean Nazi-style ID checks for British citizens

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Prove who you are: Theresa May and David Cameron check the credentials of two police officers, to ensure they aren’t illegal immigrants. No, not really – but don’t be surprised if police checkpoints start appearing everywhere with people in peaked caps demanding your papers, just like in Nazi Germany during the 1930s and 40s!

Theresa May has responded to criticism of her policies on immigrants by revealing her plans for the latest Immigration Bill – countering a threat that is perceived to be much worse than the reality.

Experts say this will require a system of identity checks for everyone, requiring British citizens or those with permanent residence to prove that their own presence in the UK is legal.

In a move that seems designed to appease the Daily Mail and its readers, she wants banks to check the immigration status of people applying to open accounts, and private landlords to make similar checks on their tenants.

You will notice that this means the government wants other people to carry out its responsibilities.

The Home Secretary also intends to “streamline” the appeals process in immigration cases. Under the current government, this word generally means “make less fair”, and this is borne out by a passage stating the measures aim to “deport foreign criminals first and hear their appeal later”. In such circumstances, how can we be sure they really are criminals?

There will also be a requirement for temporary migrants like overseas students to contribute towards NHS costs. This is not necessarily a bad thing – although it would be unfair if this money found its way to the private companies now infesting the NHS, rather than the public service itself.

But there will be no tightening of border controls, no “streamline” for bureaucratic deportation procedures, and no measures to tackle forced labour or lack of enforcement of the minimum wage.

Immigration Minister Mark Harper was quoted on the BBC website, saying: “The law must be on the side of people who respect it, not those who break it.” Fine words from the man who was unable to say whether flak-jacketed immigration officers had discriminated against people of ethnic minorities when they carried out their spot-checks at railway stations in August.

The BBC article also quotes Don Flynn of Migrants’ Rights Network, who reiterated that evidence contradicts the view that immigrants are attracted to the UK by benefits and free services; and Dr Richard Vautrey of the BMA, who said a system is already in place for hospitals to recover the cost of treating patients who are not eligible for NHS care – and introducing a system for GPs could be a “bureaucratic nightmare”.

The Guardian tells us the Immigration Law Practitioners’ Association (ILPA) has warned Theresa May her plan, for millions of private landlords to face “proportionate” fines of up to £3,000 if they fail to conduct checks on the immigration status of new tenants and other adults living in their properties, is unworkable.

“British citizens, European economic area nationals and third country nationals alike would be required to produce identity documents at many turns in a scheme that would be intrusive, bullying, ineffective and expensive and likely racist and unlawful to boot,” said the ILPA response.

And the Residential Landlords Association said landlords would need to know about a potential 404 types of European ID documents, in order to operate the scheme – saying some landlords would refuse to house migrants, for fear of falling foul of the new rules – and isn’t that the point of the exercise?

The Guardian quotes Habib Rahman, of the Joint Council for the Welfare of Immigrants, who predicted that “these measures will divide society, creating a two-tier Britain, a return to the days of ‘No dogs, no blacks, no Irish’ and of ill people with no access to healthcare walking the streets of Britain. This bill is a travesty and must be stopped,” he said.

BBC home affairs correspondent Dominic Casciani tells us the ultimate goal is increased public confidence in the system.

But if we are doing all the work ourselves, why should this add up to increased confidence in the government?

Hands off my medical records, Jeremy!*

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The two-fingered salute: Jeremy *unt displays his high regard for the NHS patients whose details he wants to steal and sell to private business.

Conservatives. They think they own everything – including your medical records.

If you live in England, Jeremy ‘The Misprint’ *unt wants your doctor to send your confidential patient record to a national database, from which it will be sold on – sold on to make money for him, mark you – to “approved” private companies and also universities.

The system is called the General Patient Extraction Service (GPES) – although exactly who it serves is entirely up for debate. You may also see it described as the care.data scheme.

He thinks this gross abuse of patient confidentiality is a good idea. But then, he’s a Tory and therefore thinks he has a God-given right to take anything, from anyone, if they have less filthy lucre than himself.

According to the Daily Mail – and you know the Tories have lost the plot when even the Heil weighs in against them – the *unt wants us to believe that the information will be valuable for medical research and screening for common diseases.

And an NHS England spokesman told the paper, “The programme will provide vital information to approved organisations about the quality of health services.”

Oh really?

So in fact this information could be used by private health companies as evidence of failures by the National, publicly-funded, service, yes?

How would it help in screening for common diseases? This information becomes freely available without any data having to be sold – how else would we know when an epidemic breaks out?

And how is this valuable for medical research – beyond the possibility that the now-infamous ‘job offer’ for people to take part in human medical experimentation may be targeted at particular individuals, according to medical records that they thought were only available to their own, trusted GP?

Doctors say Mr *unt and NHS England have failed in their duty to publicise the plan in a proper and reasonable way, that patients are not getting an “informed” choice about the matter, and that patients could be identified from the data with any information other than that on common conditions – which, we’ve already established, becomes public knowledge anyway.

Some Local Medical Committees (LMCs) are already discussing whether to opt out of the system – and this blog would urge all the others to do the same.

If you are concerned about this gross invasion of your privacy, you can contact your own LMC and request that they opt out. Contact details can be found on the British Medical Association’s website here.

*In fact he won’t be able to get his filthy hands on them anyway because I live in Wales. The title is for effect.

Wow! Petition renews the struggle against vicious welfare cuts

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Francesca Martinez, who launched the WOW Petition, is no stranger to political discussion. She is pictured on the BBC’s This Week, discussing how attitudes to disabled people have hardened (thanks – in my opinion – to misleading propaganda organised by Conservative ministers).

A community of the concerned – including people who are sick and disabled, carers, friends, families, and those who are perfectly healthy – has come together to launch a new resistance to the draconian Coalition welfare cuts that are killing, on average, 73 people every week.

The launch of the WOW (it stands for resistance to the ‘War On Welfare’) Petition comes only days after the Conservative Party started a ‘voodoo’ poll on its own website, intending to fool respondents into saying that the reforms already introduced by the Department for Work and Pensions – and soon to be reinforced with even more drastic measures – are fair.

The document on the government’s e-petitions website has been launched by actor and comedian Francesca Martinez. On the Ekklesia website she said we are living in a dark time for disabled people: “Already a third of disabled adults live in poverty. That’s disgraceful and with the new cuts, that figure can only rise.

“It breaks my heart that some of the most vulnerable people in society are being demonised and used as scapegoats. It’s something everybody needs to fight against.”

The petition calls for:

“A Cumulative Impact Assessment of all cuts and changes affecting sick & disabled people, their families and carers, and a free vote on repeal of the Welfare Reform Act.

“An immediate end to the Work Capability Assessment, as voted for by the British Medical Association.

“Consultation between the Departments of Health and Education to improve support into work for sick and disabled people, and an end to forced work under threat of sanctions for people on disability benefits.

“An Independent, Committee-Based Inquiry into Welfare Reform, covering but not limited to: (1) Care home admission rises, daycare centres, access to education for people with learning difficulties, universal mental health treatments, Remploy closures; (2) DWP media links, the ATOS contract, IT implementation of Universal Credit; (3) Human rights abuses against disabled people, excess claimant deaths & the disregard of medical evidence in decision making by ATOS, DWP & the Tribunal Service.”

That may seem a big demand, but the alternative is potentially fatal for hundreds of thousands of people. Esther McVey, the Minister for Disabled People, has announced that, when Disability Living Allowance (DLA) is replaced by Personal Independence Payments (PiPs), more than 300,000 people will have their benefits cut or removed altogether. That is not an achievement.

In addition, anybody who can walk more than 20 metres will not receive the mobility element of the new benefit.

The petition has already won a huge online response, and I strongly encourage you to help build on that. Go to the site and sign the petition. Visit wowpetition.com (the petition’s base website) and join the discussion on the forum. Above all, ask your friends, relatives, work colleagues, or anyone else you think might be interested, to sign the petition.

It’s time to turn the tide against the persecution of the vulnerable.