The Government has outsourced duties for awarding benefits claims to ATOS. It has also outsourced the handling of “big data” from NHS GPs to ATOS. Medicine and law maintain that safeguarding against conflicts of interests is essential for preserving integrity of the professions (for a comparative approach, see here). The Solicitors Regulation Authority (SRA) for example have produced full guidance in chapter 3 on this matter in their Code of Conduct. However, chapter 4 on confidentiality and disclosure also provide important information, particularly in relation to the mandatory requirement O 4.4 for “information barriers” to safeguard against breach of confidentiality (click on the picture to see an enlarged view).
These are currently the details of contracts awarded for the GP Extraction Service (“GPES”). ATOS are very open about their “GP Extraction Service” (details here).
Peter Oborne from the Telegraph, and many others, have warned against the portrayal of “benefit cheats” being misleading (see for example his article here, Nonetheless, professional monitoring and surveillance services, for example “George Osborne must correct his claims about benefit fraud. And his portrayal of the poor as mean-minded and cheating” Specialist private investigator firms such as Boothroyds do exist, which have some focus on benefits claimants. This has been a war waged in the popular media, for example on the BBC website and one from ITN news about a “crippled man winning a motorcycle race”:
The issue here is whether the patient has given “implied consent” for the “lawful transfer” of data from NHS to outside agencies. I have previously written about this issue under the present legislation. ATOS have previously denied that they operate any targets regarding benefits. Quoted in an article by Amelia Gentleman in the Guardian, an ATOS Healthcare spokesperson said: “It is simply and absolutely untrue that there are targets for the number of people to be assessed as fit-to-work; neither set by the Department for Work and Pensions nor Atos Healthcare. Every person we see is assessed individually with a focus on the facts of their own case.” The GMC will be mindful that their code of conduct, “Good medical practice”, cites conflicts of interest specifically in paras. 74-76:
Margaret McCartney has previously elicited from the GMC, the regulatory body for doctors, that “The first duty of all doctors is ‘to make the care of your patient your first concern’. But that is not the only duty doctors must observe. Being open and honest and acting with integrity is also an essential part of medical professionalism.” The full response is here. Indeed, the GMC make it further clear that dishonesty in writing reports cannot be justified by reference to the first duty of doctors. Further advice on disclosing information for employment, insurance and similar purposes can be found in this document.
The legal issue which is most crucial to this is whether there is a legal argument that the importance of disclosure outweighs the importance of confidentiality, and this is an issue for the professional regulatory bodies concerned governing the behaviour of all agents in the situation above. There is a good arguable case that ATOS should have effective information barriers in place. It is unlikely that patients when they have consented for their data to be held by GPs are aware that data can be so easily transferred to outside organisations. This is further complicated by the finding from Nature and Science within the last fortnight that it may be possible to identify the identity of individuals from “anonymised” data.
The response should not be one of “moral panic“, arguably. However, this is the sort of the letter that could produce a legal, regulatory and ethical nightmare:
