Overseas visitor patients are entitled to the same high level of medical confidentiality as any other patient.
There is a public interest in preserving the trust patients have that the information they disclose to their doctor will be kept in confidence. Without this they may be discouraged from accessing the treatment that either they or their dependents need. This may lead to patients not accessing services until after their condition has deteriorated and requires emergency care. In cases where patients may have a communicable disease, this represents a public health risk.
This concern is particularly acute with respect to patients who may fear that information will be passed to immigration officials. Asylum seekers and refused asylum-seekers may also have experienced abuses at the hands of the state in their country of origin and may lack trust in state authorities. Therefore, they may already be reluctant to disclose personal information, including to the NHS.
The BMA receives queries from GP practices about requests for patient information from organisations like the Home Office. Requests can often be for information about a patient’s treatment or referrals, and administrative information, such as the dates they registered with a practice.
All personal information provided by patients to their doctors is confidential, regardless of whether it is demographic or clinical data. As with all requests for confidential information, the general rule is that consent should be sought in the first instance. Where consent is withheld or cannot be sought, doctors should ensure they follow General Medical Council guidelines on the exceptional circumstances in which it is justified to disclose confidential information without consent in the public interest, for example for the prevention of serious harm or the prevention or detection of serious crime.
Data-sharing between NHS Digital and the Home Office
In January 2017, NHS Digital and the Home Office signed a memorandum of understanding (MoU) that formalised a long-standing information-sharing arrangement, whereby NHS Digital passes confidential demographic information to the Home Office "in the public interest" to trace suspected immigration offenders. The MoU applied to demographic information held by NHS Digital only.
In May 2018, the government announced a fundamental change to the MoU with immediate effect. NHS Digital's data-sharing with the Home Office is now limited to the tracing of an individual who is being considered for deportation having been investigated for, or convicted of, a serious criminal offence, or where they present a risk to the public. It is estimated that the change to the MoU will exclude some 95% of previous Home Office requests. This change will be reflected in a revised MoU, which is forthcoming.