GPs’ concern over patient confidentiality
New legislation regarding Health Insurance could potentially result in breaches of doctor-patient confidentiality, according to some GPs.
The GPs expressed concern that because of broad wording, the legislation could give the Bermuda Health Council access to private health information, but the Ministry of Health responded saying the authority to request the information has already been in place and privacy has never been compromised.
In a press release issued yesterday, Dr Joanna Sherratt-Wyer said she had been asked to speak on behalf of GP's after the Health Insurance Amendment Act 2012 was passed in the House of Assembly.
“The legislation includes a major shift in the regulatory authority for the insurance companies towards the Bermuda Health Council, which gives the council authority to request information from health insurance providers,” Dr Sherratt-Wyer wrote.
“The legislation is worded such that the council can now request 'any other relevant information required by the council for the purposes of health systems analysis, planning and management.
“The GPs are extremely concerned that this wording is too broad, and has the potential to jeopardise an individual's right to have their personal information kept confidential.”
While by entering into an agreement with a health insurance company patients agree to share information when appropriate, such as in order to process claims, Dr Sherratt-Wyer said they have not agreed for the information to be passed to other organisations.
“This affects everyone in Bermuda who has local health insurance,” Dr Sherratt-Wyer wrote. “Patients have an inherent right to doctor-patient confidentiality.
“Any legislation that could potentially jeopardise this is of serious concern to the GPs acting on behalf of their patients, and we would be very keen to see this clause reworded or removed before it becomes law.”
During a debate on the legislation in the House of Assembly, One Bermuda Alliance members expressed similar concerns about the legislation, saying that in a country as small as Bermuda it takes relatively little information to identify someone.
Responding to the statement, a spokeswoman for the Ministry of Health said that the amendment builds on the authority that is already in place under the Health Insurance Act 1970.
“The Bermuda Health Council has produced a raft of seminal reports and analyses on health system performance, and it requires relevant data continue to do its work as the health system watchdog,” the spokeswoman said.
“The work of the Council focuses on system-wide trends and not on individual patient care, so there is no foundation to the claim that patient confidentiality would be compromised.
“It has not been compromised to date although the authority to request such data is already in the law and it will not be compromised in the future.”
Bermuda Health Council CEO Jennifer Attride-Stirling echoed the Ministry's statement, saying that the council has never requested patient-identifiable information from any organisation.
“We collect data for monitoring purposes and without it we could not produce reports such as the National Health Accounts, Health in Review or the Adult Health Survey,” she said.
“The types of analyses we conduct do not require patient information and there are no plans to request any such data. Any data we require of insurers is anonymised and used for monitoring health system trends in health status, utilisation and expenditure.”
The Bermuda Health Council issued a statement this morning. It said:
The CEO of the Bermuda Health Council, Dr. Jennifer Attride-Stirling, clarified today that BHeC has never requested patient-identifiable information from any organization. The Bermuda Health Council (BHeC) seeks to correct allegations in today's Royal Gazette front page story GPs' concern over patient privacy.
The power for the health insurers' licensor to request any relevant information from insurers has long been in place in the Health Insurance Act 1970, and patient confidentiality has never been compromised.
BHeC collects data for monitoring purposes and without it reports such as the National Health Accounts, Health in Review or the Adult Health Survey could not be produced. These reports have generated seminal information for the public and health system stakeholders, and are available on BHeC's web site (www.bhec.bm).
The types of analyses BHeC conducts do not require patient information and there are no plans to request any such data. Any data requested from insurers is anonymised and used for monitoring health system trends in health status, utilization and expenditure.
In addition, the public and stakeholders should be aware that the power to request such information is already in legislation, and the amendment builds on existing powers. Section 28(5) of the Health Insurance Act 1970 currently states that:
“The Minister of Finance shall have the power at any time to require a licensed insurer to produce any documents and answer any questions which the Minister of Finance may consider relevant.”
Therefore the authority to request any relevant information from licensed health insurers is already in legislation, and it is not newly introduced by the current amendment. The amendment simply adds it to the licensing regulations.
Although this authority has long been in place, patient information has never been requested and it is not needed to conduct the health system performance monitoring with which the BHeC is charged in the Bermuda Health Council Act 2004.
It should also be noted also that the transfer of authority to grant health insurance licenses is in line with the Bermuda Health Council Act 2004, which states in Section 4(2) that:
“In pursuance of subsection (1) where there is any inconsistency between this Act and any Act dealing with health professionals or health service providers, this Act shall to the extent of the inconsistency prevail over that Act.”
Most health insurers are aware of these aspects of the legislation and will vouch that patient identifiable information has never been requested by BHeC, and that doctor-patient confidentiality has never been breached.
We are working closely with insurers to create the new data request in a manner that protects patient confidentiality, and the majority of insurers support the change. In fact, the new data format was proposed by an insurance representative.
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