Volume 1

The Electronic patient record : sixth report of session 2006-07 / House of Commons, Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee
Date:
2007
Catalogue details

Licence: Open Government Licence

Credit: The Electronic patient record : sixth report of session 2006-07 / House of Commons, Health Committee. Source: Wellcome Collection.

    36/122 (page 32)
    _..we have to come back to whether or not an individual patient has the right to say, “I do not want information handled in a particular way”, and I was very disturbed to hear the sort of argument that says 98% of people are going to come round, therefore these other troublesome people should be swept aside.'” 79. Ethical objections to the opt-out consent model were expressed by clinical as well as patient groups. Amongst those advocating an opt-in or explicit consent approach were the British Medical Association (BMA), the Royal College of Psychiatrists and a number of individual GPs.'° The BMA stated that: ...it is for patients to decide, in discussion with a healthcare professional where appropriate, the extent to which their clinical information is placed on electronic systems...The BMA’s policy is for explicit consent to be obtained before any healthcare information is uploaded onto the system.” 80. Dr Paul Cundy argued that an opt-in or explicit consent approach would be a more effective way to build patient trust in the new system. He suggested that consent could be gained by GPs during routine consultations: When the patient next comes to see their GP you can discuss whether you want something going on [to the SCR], you can do it slowly over time, and in taking that approach, which is a default opt-in approach, you slowly build the system and that allows time for trust in the system to be developed.’ 81. However, officials expressed clear objections on 26 April to the use of an opt-in consent system. Harry Cayton argued that an informed consent system would be impractical, estimating that “100 years of GP time” would be required to offer informed consent to every patient in the country.’” He also thought that an opt-in system would tend to disadvantage vulnerable groups: ...if you have an informed consent to be part of the system, then large sections of society, particularly some of the most vulnerable people in society, do not take part. They do not take part because they do not know how to give informed consent, they do not take part because they do not understand what is being asked or offered and they do not take part because of physical immobility. ..1°’ Subsequent plans: a hybrid consent system 82. In spite of these comments, the Department of Health subsequently outlined more detailed consent proposals for the Summary Care Record, which included the addition of a significant opt-in element. A supplementary memorandum, received on 12 June 2007, explained that: 102 Q116 103 See Ev 41, Ev 103, Ev 137, Ev 149 and Ev 186, respectively 104 Ev 42 105 Q118 106 Ibid 107 Q59