The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Save the Bays e-mail controversy has further spooked doctors already worried about provisions in the draft National Health Insurance (NHI) Bill that seemingly jeopardise patient confidentiality and data protection.

Dr Duane Sands told Tribune Business that the disclosure of private e-mails in the House of Assembly by Cabinet ministers and MPs showed that confidentiality concerns over NHI “need to be addressed in a very robust way”.

He added that the Save the Bays ‘leak’ had exacerbated concerns over the draft Bill’s section 34, ‘Power to require information’, which allows the NHI Authority “at all reasonable times” to demand records from doctors and insurers without any seeming checks and balances.

Warning that the episode had further undermined the medical profession’s trust in Government, and how it might exploit medical record access via NHI, Dr Sands called for ‘confidentiality’ concerns to be addressed both in the legislation and in practice.

“It speaks volumes about the issue of confidentiality,” the FNM’s Elizabeth candidate said of the move by two Cabinet ministers, Jerome Fitzgerald and Fred Mitchell, to disclose private e-mails under cover of Parliamentary privilege.

“It has reaffirmed what we have been talking about; that there needs to be protection for the software, the data, the medical records [under NHI].

“It needs to be very clear who has access to it, what they can do with it, and how they should get it, as opposed to someone walking in and saying: ‘Open up the computer’. That is what is included in the current legislation,” Dr Sands added.

“We have always said it needed to be strengthened regardless of the general protection that applies in the Bahamas. Certainly, when you talk about patient confidentiality, it is of the utmost importance.

“We would have been thinking about it independently of last week’s events, but they go to highlight why it is so important. It is to protect everybody.

“Given that privacy has bene shattered to pieces, clearly this is something that needs to be addressed in a very robust way with this [NHI] legislation but also in practice.”

Dr Sands previously told Tribune Business that section 34 gave the NHI Authority, the scheme’s proposed regulator and overseer, “unbelievably sweeping powers that are so general” when it came to demanding information from doctors and insurers.

He said at the time: “You are basically saying that the Authority has God-like powers over practitioners, and in the absence of schedules and regulations defining what they can ask for, and who can see it.”

Another doctor, speaking on condition of anonymity, told Tribune Business yesterday that the disclosure of Save the Bays’ e-mails had shattered the medical profession’s trust in Government.

“We all had the concern to start with, but this just brings it to light,” the doctor said. “Our number one issue with NHI, right at the top of the list, is data security and protection of patient confidentiality.

“We’re all talking about it. When we read it in the papers, we couldn’t believe the man did that. If this Bill goes through, the Government will have access to everyone’s health records at any time.

“Look at what they’d do to their perceived enemies; they’d go after them. I wouldn’t trust the Government with any of our data because of this. No way. It is very scary.”

Dr Sands yesterday said the draft Bill had “been so heavily weighted in favour of the NHI Authority, with very little concern about the most important person in this whole thing, the patient”.

He added that the Save the Bays-related e-mail leaks, and subsequent House of Assembly disclosures, raised the spectre of MPs and others “doubling down” and releasing information on topics such as a patient’s HIV status or sexuality, which could have been obtained by an NHI Authority employee.

“We have a lot of work to do when you’re talking about a national electronic medical platform that can be accessed by hundreds of individuals,” Dr Sands told Tribune Business.

“We need to have a watertight security system, and know who is accessing it; what they are doing with it; whether they are taking a screen shot of it; and on and on. We haven’t seen the hardware and software platform put in place yet.”

Dr Sands said the House of Assembly disclosures had “turned upside down” the attorney-client relationship, which he argued had always been “sacrosanct” in the Bahamas.

Fearing that medical/patient confidentiality could be next, he added that the House of Assembly disclosures had “thrown the baby out with the bath water”.

“It demonstrates how you can destroy an industry, destroy confidentiality and confidence, in one sweep,” Dr Sands told Tribune Business.

“Last week set us back, and it is going to have to be addressed... The damage done to this jurisdiction in a week by a stupid, ill-conceived presentation in the House of Assembly may have led to immeasurable damage to the Bahamas.”