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Thursday, 24 January, 2002, 11:44 GMT
Doctors say 'keep treatment confidential'
The disclosure of patients' information is controversial
The disclosure of patients' information is controversial
Doctors are outraged at politicians' divulgence of confidential information in the case of 94-year-old Rose Addis, whose family complained about her care in an NHS hospital.

The head of the British Medical Association is writing to party leaders to emphasise the importance of keeping details of cases confidential.

BBC News Online looks at the issue of confidentiality - and what effect such high-profile criticism has on doctors and nurses working in the NHS.

Doctors' leaders are furious at how details of patients' cases have been banded about in the political arena.

Dr Ian Bogle, chairman of the BMA, is writing to the leaders of the main political parties. demanding that information about treatment must continue to be treated as confidential and only be divulged with the patient's consent.

He will also ask that issues related to the treatment or care given to an individual by the NHS are not raised without having checked the facts.

Dr Bogle said: "We call upon the party leaders to sign up to these principles, to ensure that debate is conducted in a way that respects the confidentiality of patients and is based on fact."

If the patient or their family go and talk to the papers and release information about elements of the patient's care, then those elements can be discussed

Dr Richard Nicholson, Bulletin of Medical Ethics

Dr Evan Harris MP, Liberal Democrat health spokesman, and a member of the BMA Medical Ethics Committee, said MPs needed guidance on raising medical concerns of their constituents.

"Confidential medical information must be sensitively handled by relatives, medical staff, the media and MPs.

"Handbags at five paces over the Despatch Box helps nobody - clear guidelines will."

Nigel Edwards, acting chief executive of the NHS Confederation said: "This story has turned into a political slanging match. 

"The sort of coverage we are seeing does not help the families address their concerns, nor does it help the hospital to deal with the complaints that have been made.

He added: "NHS organisations that find themselves in the middle of this type of problem must be allowed to defend themselves." 

Professor Sir George Alberti, president of the Royal College of Physicians president, said: "However, the RCP fully supports the right of doctors and NHS Trusts to reveal details of individual patient care, when they are subjected to totally unreasonable public criticism by the media and families."

Discussing care

Dr Vivienne Nathanson, head of science and ethics at the BMA said there was no difference between practical details of care, and medical results of tests in terms of confidentiality.

What was crucial, she said, was what a patient had brought into the public domain.

"We expect doctors to look very carefully at this and to do their best to avoid releasing any more information than the patient has."

She said that applied to details of how often a patient had been bathed as much as the results of X-rays.

Handbags at five paces over the Despatch Box helps nobody - clear guidelines will

Dr Evan Harris, Lib Dem health spokesman
Dr Richard Nicholson, editor of the Bulletin of Medical Ethics, said the general rule is that hospital authorities, politicians and others should not make any information about a patient's care public without the permission of the patient or their representative.

He added: "If the patient or their family go and talk to the papers and release information about elements of the patient's care, then those elements can be discussed.

"But it would not be appropriate to discuss other parts of that patient's medical care.

"So if Rose Addis had been in hospital 10 years ago for something different, it would be totally inappropriate for the hospital authorities to start talking about that."

Patient groups are also concerned about the revelation of medical details.

Mike Stone of the Patients Association told the BBC: "Confidential medical information about one's medical history should not be released by anyone."

'Seek patient consent'

The General Medial Council (GMC) advises doctors information must not be given to others unless the patient consents or they can justify the disclosure.

It adds patients have a right to expect that information about them will be held in confidence by their doctors.

The GMC says patient's consent for the disclosure of information must be sought wherever possible.

Rose Addis : her care is at the centre of a political debate
Rose Addis : her care is at the centre of a political debate
In the case of Rose Addis, Michael Walker, Unison's Greater London nursing officer, says confidentiality has been broken, but that it was the family who made it a public issue.

He told BBC News Online: "If the staff had kept quiet, and not responded to the individual allegations, then it would have been said they were covering up or not answering the questions.

But he added: "It should have been the hospital and not the politicians who spoke."

Staff 'not being heard'

The exposure of details of Mrs Addis' care have also brought the actions of NHS staff into the spotlight.

Tom Sandford, London officer for the Royal College if Nursing added: "People have been really disappointed about the way the issue has been presented.

"I do think its been stressful for staff. It's hard to go to work and find yourself slagged off in the media."

Michael Walker, who has spoken to staff at the Whittington Hospital, says this kind of criticism can seriously undermine staff and damage morale.

"They feel totally that their side of the story is not being heard."

But he said they were very confident about the decisions they had taken.

Dr Ian Bogle, BMA Chairman
"We have to be clear about confidentiality"
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