NHS Digital bosses have refused to rule out sharing confidential patient data with the government in future benefit fraud investigations.
The organisation currently passes information to the Home Office - including addresses - to help with immigration enforcement as part of a ‘memorandum of understanding’ with the government, which experts say puts people off seeking potentially life-saving medical treatment.
MPs on Parliament’s health select committee want the controversial practice to be paused while a full investigation into its impact is carried out by Public Health England.
But bosses have so far refused and on Thursday did not rule out similar arrangements with other government departments in the future.
“What happens when people start asking you about whether people are co-habiting?” asked committee chair Sarah Wollaston, a former GP.
“What if the Department for Work and Pensions start approaching you and asking for data? Having established this [sharing data in immigration cases] is alright, how can the public have confidence you won’t start sharing their addresses if the government wants to start looking at benefit fraud?”
Wollaston said the health service was clearly prepared for future requests as it had already surveyed public opinion on information sharing to assist in investigating “other crimes”.
NHS Digital chief executive Sarah Wilkinson and chair Noel Gordon said the current sharing system had been put through a rigorous “public interest test” and that any requests from other departments would be subject to the same process.
“We have an obligation under the Health and Social Care Act to provide, on a lawful and proportionate basis, information of an administrative kind. When we provide information to the Home Office it is under lawful conditions,” Gordon said.
He added that the decision to allow data sharing in immigration cases had been set against “Parliament’s clear intention to control immigration offences” and that he would not expect future asks to come from other government divisions.
Labour MP Paul Williams, who still practices as a GP to retain his medical licence, said clamping down on offences including tax evasion and benefit fraud had also been identified as key priorities by Theresa May’s government.
“We have heard very clearly that people’s health-seeking behaviour has changed as a result of this,” he added.
Doctors of the World, an organisation that helps socially excluded people access healthcare, told MPs at a previous committee session that they had seen evidence of people putting off seeking medical help for fear of being deported.
One of their GPs, Dr Peter Gough, told HuffPost UK: “As a doctor, the idea that my patients address should not be treated as confidential is nonsense. For many of the patients we see in the Doctors of the World clinic, their home address is actually the most sensitive part of their medical records.
“The idea that NHS Digital shares patient information with the Home Office is deeply concerning. As GPs we are seen as the custodians of patient information, and this data sharing arrangement takes control of our patients information away from us.”
Wollaston described the response by NHS Digital - which did not seek external ethical advice before agreeing to the memorandum of understanding - as “dismal”.
“You have been told very clearly by Public Health England that there is a risk,” she added.
“Why would you not apply a precautionary principle on this and at least suspend data sharing until they have completed their review?
“You do not have a legal obligation - you have a legal power - to share this, but it does not necessarily mean it is the right thing to do.
“The public are supposed to trust you to be custodians of their information...I do not think you understand the principles of confidentiality at all.”
Wilkinson and Gordon said they would be willing to reassess the system should Public Health England’s study provide “robust evidence” of an impact on people seeking medical help.