My Lords, I declare my interest as a vice-president of the Local Government Association. I have signed Amendment 83A, tabled by my noble friend Lord Scriven, and will come back to that. I am very grateful for the help of the General Medical Council and the British Medical Association.
My Amendment 81A in Clause 17 is a probing amendment to understand the information that the Secretary of State may require from local authorities, including health information, and registered individuals looking after an unaccompanied migrant child. Clause 17(2)(b) refers to
“such other information as may be specified in regulations made by the Secretary of State”.
That is so general that it could include requests for a migrant child’s health data. I can see some eyebrows being raised on the Front Bench, but I am particularly pleased that the Chief Whip is in her place, as she may feel a sense of déjà vu. The previous Home Secretary demanded similar access to information held by certain public authorities, including doctors and local authorities, which included patients’ confidential personal data, during the passage of the Police, Crime, Sentencing and Courts Bill. This then reappeared in the Bill that became the Health and Care Act of last year. Both Bills were amended, and satisfaction was given by the Minister at the Dispatch Box, who made it absolutely plain that the Home Secretary and the Home Office could not demand any information that overrode the confidentiality rules that doctors and other registered professionals must follow.
The General Medical Council, in its regulation of doctors, sets ethics frameworks by which they and only they can release confidential data without the consent of the patient, usually at the request of the police or some other body because somebody else’s life is at risk. The problem with how it was framed in the Police, Crime, Sentencing and Courts Bill was that it was so general. When I probed, it could have related to witnesses at scenes of crimes, or to somebody connected, but not to somebody who was just suspected of a crime. So I was really grateful to the then Home Office Minister for her assistance in making this happen.
The difficulty with Clause 17 is that we must protect the data of that patient—in this case, the migrant child —as confidential to them and to the healthcare professionals who look after them, for example the child’s social worker or the care worker where they are residing, since all three of them may have access to shared care records. I am sorry that the noble Lord, Lord Markham, is not in his place, because shared care records are very important in the improving of services to looked-after children, to ensure that all those who need to know have access to the relevant information. We are moving into a world where we have social workers, the social care providers who are looking after looked-after children, the doctors and, imminently, pharmacists, because they too will be able to provide some medical care under changes that are happening.
All of those professionals are bound by confidentiality rules. The problem with the text at the moment is that there is no boundary on any information that the Secretary of State might demand. Can the Minister tell us whether the corporate parent—the local authority—or the child’s social care provider currently has any discretion on whether and when to share personal information? Obviously, I am asking particularly about health-related information, but I suspect it also raises a wider issue about the non-health information held in a child’s shared care record.
There is another perspective to this too. Social workers, in a similar way to doctors and other health professionals, depend entirely on establishing a relationship of trust with their clients, and they may owe them a common-law professional duty of confidence. If this is the case, the provision could undermine that relationship
of trust and interfere with these duties, which would be highly problematic. It would place social workers in a very different position to health professionals, because social workers work for the local authority, and it is the local authority that the Secretary of State is asking for that information.
At present, shared care records are controlled by health integrated care boards. However, this controllership and the composition of ICBs is naturally subject to change, depending on the will of government—it seems to change about every two years at the moment. As such, we want to take steps to ensure that, as far as reasonably possible, patients’ data is protected, unless it is given up by a doctor who has consulted the GMC framework and then come to their own decision. Will the Minister agree to have a meeting with me, the General Medical Council and the British Medical Association? I know that a number of civil servants in the Home Office are familiar with this argument. The Information Commissioner’s Office may wish to be present as well: it was at two sets of meetings in the course of the other Bill. This is a very serious matter. It may seem outwith the scope of this Bill, but because of the powers that the Home Secretary is giving herself, it is absolutely not.
I move extremely briefly to Amendment 83A, which is after Clause 20 and picks up a point that is also reflected in Amendment 82 from the right reverend Prelate the Bishop of Durham. It is designed to ensure that, where there is any transfer of a child between different authorities and any relevant partners interacting with that child, the child is protected from maltreatment and from impairment of their mental and physical health and development and to ensure their well-being and, most importantly, safeguarding.
There is a particular relevance to the issues we were discussing earlier this evening, when we discussed how Kent does not have on its books any of the children who arrive in Kent. They have been allocated all over the country, and the Afghan children, in particular, are now sometimes being moved to their third local authority, but the first local authority they were booked with remains responsible for their care; that does not transfer. As a result, there needs to be something explicit about the work of any other agency and partners looking after these children in their area, as they will be. Perhaps the Minister could respond to that as well.