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Court Emphasises Importance of Patient Confidentiality

trainA consultant psychiatrist employed at a high-security hospital who has been accused of breaching confidentiality by leafing through a patient’s medical notes on a crowded train will face an internal disciplinary panel after the Court of Appeal underlined the gravity of the allegations.

Unbeknown to the consultant, sitting across the aisle from her during the train journey was a senior civil servant from the Department of Health, who raised concerns in a letter to the NHS Trust that runs the hospital, saying that she could read the patient’s name and other details as the pages were turned.

The trust decided to convene a disciplinary panel to consider allegations of gross misconduct against the consultant, who also faced claims that she had dictated patient notes during train journeys and discussed patients with her PA during telephone calls made in public. However, the proceedings were subsequently halted by a High Court injunction which was issued on grounds, inter alia, that the trust had wrongly refused to invoke the full rigour of its ‘fair blame’ procedure.

Allowing the trust’s appeal and setting aside the injunction, the court stressed the importance of patient confidentiality and described the allegations against the consultant as ‘potentially serious’. Although ‘considerable mitigation’ was available to the consultant, including her heavy workload and glowing references, the court ruled that the threshold for a disciplinary hearing had nevertheless been crossed.

The court concluded, “Patients’ right to confidentiality is fundamental in the health service and must be respected by doctors and other staff. The breaches alleged…were such that a decision to convene a disciplinary panel was justified. The court should not in my view intervene to prevent it.”