INDEX
Introduction Page 1
History of Confidentiality Page 2-3
Statutory Provisions Page 4
Data Protection Act 1998 Page 4-6
Other important statutes Page 6
The Public Health (Control of Disease) Act 1984 Page 6
Abortion Act Page 6
Road Traffic Act 1988 Page 7
National Health Service (Dental Services) Page 7
The NHS Confidentiality code of practice Page 7
H M Revenue & Customs (HMRC) Page 7-8
Births, Deaths Registration Act 1953 Page 8
Human Fertilization and Embryology Act 1990 Page 8
Terrorism Act 2005 Page 8
Access to Health Records Act 1990 Page 8-9
Access to Medical Records Reports 1985 Page 9
Access to Health Records Act 1990 Page 9
Disclosure in the Public Interest Page 9-11
Children and confidentiality Page 11
Freedom of the Press Page 11-12
Conclusion Page 12-13
References Page 14-16
Bibliography Page 17-19
ABBREVIATIONS
BDC British Dental Council
GDC General Dental Council
GMC General Medical Council
HMRC H M Revenue & Customs
PACE Police and Criminal Evidence Act
PCTS Primary Care Trusts
INTRODUCTION
It is the duty of dentists and their staff to respect confidentiality. They have a legal, ethical
and statutory obligation to keep their patients information in any form, private.
General Dental Council, Maintaining Standards(2005) al. 3.5
‘The dentist/patient relationship is founded on trust and a dentist should not disclose to a
third party information about a patient acquired in a professional capacity without the
permission of the patient’
As stated by Dental Protection Advice Sheet ‘Confidentiality’ 2011
‘The obligation extends to all members of staff’. This duty of confidentiality also extends to all
employees, contractors, students and other associated healthcare workers.
The GDC Standards for the dental team details in Standard 4
‘Maintain and Protect Patient’s Information’
4.2 of the GDC also provides guidelines relating to confidentiality which the dentist and the
team must understand
4.2.1 Confidentiality is centred to the relationship and trust between you and your patients.
You must keep patient information confidential
4.2.2 You must ensure that non-registered members of the team are aware of the
importance of confidentiality
4.2.3 You must not post any information or comments about patients on social networks or
blogging sites
4.2.4 You must not talk about patients or their treatments in places where you can be
overheard by people who should not have access to the information you are discussing.
It is also the responsibility of the practice to ensure that all records are kept secure and
registered under the Data Protection Act (1988).
Living on a small island of 84,497 (Isle of Man Census Report, 2011). The reassurance of
the patient of confidentiality and trust is paramount for the growth of a business and practice
and discussed as well.This is discussed in general terms in
Trust in the dentist relationship, Jacques (2005)
In conclusion, ‘Trust is the foundation of a successful patient-dentist relationship as with all
other relationships.’
In reviewing and researching the topic of patient confidentiality I immediately became aware
that I, staff and also patients would benefit from an educational resource which will reinforce
and re-educate individuals on the subject of confidentiality and the issues surrounding the
subject.
History of Confidentiality
The original basis of confidentiality extends back to the Hippocratic Oath some 2400 years
ago. The principle of confidentiality confirms that patients can trust healthcare professionals,
not to publicize patient’s information.
The original source states;
‘Whatever in connection with my professional practice, or not in connection with it, I see or
hear in the life of men, which ought not to be spoken of abroad. I will not divulge, as
reckoning that all should be kept secret.’
However, if we analyse this quote ‘Which ought not’ we can assume that this was not an
absolute and hence depended on the discretion of the doctor.
The Declaration of Geneva 1947 removed this ‘discretionary’ power and recited on absolute
duty in the form:
‘I will respect the secrets confided in me, even after the patient has died.’ This important duty
is demonstrated in Bluck v Information Commissioner (2007)
In general any information that is obtained in confidence should remain so. The duty
however is not an absolute one. In general any information obtained in confidence can be
disclosed if:
- The patient provides consent
- The information is in the public interest – see cases discussed
- Disclosure of interest is provided by statute
- The data cannot identify the individual, RV Department of Health exp Source
Informatics Ltd. (2001)
Early case law (although not medical) clearly demonstrates a duty of confidence.
Fraser v Evans (1969) 1QB 341 Lord Denning stated;
‘The jurisdiction is based not so much on property or on a contract as on the duty to be of
good faith. No person is permitted to divulge to the world information which he has received
in confidence.’
The same principle was reiterated in Hunter v Mann (1974)
‘In common with the professional men the doctor is under duty not to disclose without the
consent of the patient, information which he the doctor has gained in his professional
capacity, save….in very exceptional circumstances.’
However, due to the doctor failing to provide this information ‘under public interest’ he was
fined. The same basic principle has been illustrated many times.
W v EdgeII (1990) This case involved a psychiatric patient who requested relocation and
long term discharge. The doctor Edgell produced a report based on his findings that he
should not be relocated or discharged due to his continued interest in firearms.
In conclusion W. V. Edgell (1990) withdrew his application and applied for an injunction
against the doctor from disclosing the report. Edgell brought a case under a breach of
confidence and an action of breach of contract.
In this case there was no doubt a duty of confidence by the doctor, however ‘the breadth of
that duty’ was carefully considered. The court held that the defendant Edgell had not
breached equitable duty of confidence and referred to General Medical Council (GMC)
guidelines as this time.
General Medical Council Rule 81 states:
‘Rarely, disclosure may be justified on the grounds that it is in the public interest which, in
certain circumstances, for example an investigation by the police of a grave or very serious
crime could override the doctors’ duty to maintain his patient’s confidence.’
The obligation to keep the information provided to the healthcare professional is not absolute
as discussed in case law and this assignment there are cases where:
- The law obliges the healthcare professional to breach confidentiality, there is a duty
to give the information freely.
- The law allows the health care professional to breach confidentiality
The law in general obliges the health care professional to maintain confidentiality but may
disclose in public interest only or if they consider disclosure to outweigh confidentiality of the
individual. No breach of confidentiality will occur if the patient provides consent or if in the
information provided the individual cannot be identified. R v Department of Health ex parte
Source Informatics Ltd (2001)
3
The healthcare professional under the Data Protection Act 1998 is obliged to fairly and
lawfully process patient data.
Statutory provisions
There are some statutory provisions which the dental team and management must consider
and may require positive disclosure of confidential information. These will be discussed in
detail within this literature review.
Data Protection Act 1998
The Data Protection Act 1998 controls how personal data is processed and used
electronically or manually. It replaces the original enacted Data Protection Directive
95 146/EC. This personal data includes medical/dental and health records including x-rays
and images. It does not include verbal communications which have not been physically
recorded. The act applies to identifiable living individuals who can be identified from that
information. The act does not cover information relating to someone who has died. This is
covered by the Access to Health Records Act 1990.
The Act introduces eight data protection principles that detail standards for processing data.
The data as by the act must be;
Fairly and lawfully processed
Processed for limited purposes
Adequate, relevant and not excessive
Accurate and not kept for longer than necessary
Processed in line with the data subject
Secure
Not transferred to countries outside the E.U. without adequate protection
The Data Protection Act 1998 now should be read with the Freedom of Information Act 2000
which includes elements of the Data Protection Act 1998. The Act replaces the Access to
Health Records Act 1990. The Act by virtue of S 68(2) a health record is defined as one
which:
- a) Consists of information relating to the physical or mental health or condition of an
individual
- b) Has been made by or on behalf of a health care professional in connection with the care
of the individual
The Data Protection Act provides legislation whereby if a breach is found section 55 (11)
makes it a criminal offence and under such circumstance 55 (A) a financial penalty payable
to the Data Protection Commissioner can be imposed which can then be enforced via the
civil courts. Compensation can also be made to the patient or person who has suffered
distress as a result of the breach.
The Data Protection Act 1998 provides individuals with access to their medical records,
however case law demonstrates that there is no absolute right of access to all medical
records.
R V Mid-Glamorgan Family Health Service Authority ex Parte Martin (1995)
The case highlighted the fact that the health authority can deny a patient access to their
medical records if it is in the best interests of the patient to do so.
This case involved a patient who had a background of psychological problems who had
repeatedly requested access to his medical records all of which were prior to 1991.
Sir Robert Parker rejected at appeal that at common law the medical professional had an
absolute right to a patient’s records whilst rejecting that a patient had an absolute right to
access them.
The court held that in considering medical records there was no common duty of access and
the health authority could refuse disclosure if it was considered in the best interests of the
patient.
Roberts vs Nottinghamshire Health Care Trust (2005)
A patient at a high security psychiatric hospital who was suffering from mental illness was
not entitled under the Data Protection Act 1998 to full disclosure of a report to be used in a
mental health review.
On review of the reasoning behind this it was found compelling not to disclose and no
injustice had been caused at the patient had opportunity to present his own psychological
evidence.
Two cases which demonstrate the approach which The European Court of Human Rights
have considered are:
1) MS v Sweden (1997) this case involved the release of medical records to an insurance
company without the patients consent. As a result of the medical information being provided
no compensation was provided.
However, it was found that article 8 of The Human Rights Act was not breached. The court
explained that the protection of the economy by ensuring compensation was only paid in the
correct circumstances and the staff to whom the information was disclosed had their own
duty of confidentiality. Here no case of confidentiality was breached.
2) Z v Finland (1998) where Z applied for relief to the European Courts of Human Rights that
her privacy was violated after her HIV status was disclosed during her husband’s criminal
trial. One of the critical issues in this trial was in fact her husband’s HIV status.
The court rejected Z claim that her medical records and the court ordering her doctor to
provide evidence was in breach of article 8 of the Human Rights Act as disclosure of the
medical records outweighed her right to confidentiality.
Other important statutes
Statute creates an exception or justification to the obligation of confidentiality. In specific
cases of Disclosure a court order can be made. The healthcare professional can object to its
disclosure but the final decision of the judge is binding. There are several statutory laws
which require full disclosure.
The Public Health (Control of Disease) Act 1984
This act informs the healthcare professional that they must notify a local authority officer if
they believe a patient has a notifiable disease.
Notification of a number of specified infectious diseases is required under The Public Health
(Infectious Diseases) Act (1988) and The Public Health (Control of Diseases) Act (1984).
New (amended) regulations for clinical notifications came into force on 6 April 2010.
An updated list can be found at https://www.gov.uk/notifiable-diseases-and-causativeorganisms-
how-to-report
The act excludes HIV and AIDS. This is so that patients with HIV and AIDS must not feel at
risk of reporting their illness or seeking help.
Abortion Act 1962
All abortions must be recorded providing the name of the woman and address of the woman
concerned. Regulation 5 of this act ensures that all of this information is kept confidential.
Road Traffic Act 1988
Section 172 of 1988 Road Traffic Act obliges that all people including dentists and
healthcare professionals must provide the police with the name and address of any
individual who they suspect have committed a traffic offence.
National Health Service (Dental Services) Contract regulations 2006 in England and Wales
Although my practice in Isle of Man is not NHS based we do refer to NHS doctors and other
practices. Under this act the dentist has the duty to disclose any dental records the board
may request within 14 days.
The NHS Confidentiality Code of Practice
This code of practice sets out clearly confidentiality procedure which health services, NHS
trust, PCTS and other bodies must comply with. A copy can be read at www.dh.gov.uk
H M Revenue & Customs (HMRC)
The Taxes Management Act (1970) section 19A may make an application for patient record
cards, copies of NHS schedules and other confidential associated material.
In Guyer v Walton (2001) the persons were required to provide dental record cards and
other documents to the HMRC. The issues considered were, if the requested documents
were necessary for such an investigation, did a duty of confidentiality exist and preclude the
disclosure, was the document precluded by legal privilege and would the above contravene
the Human Rights Act 1998 Sch 1 Part 1 Act 1 or Data Protection Act 1998.
Judge Brice dismissed the appeal and found that the documents were reasonably required
and hence the duty of confidentiality was overwritten.
However, a recent case Long v Revenue and Customs Commissioners (2013) involved the
request of appointment diaries for assessment. In a letter dated 7th May 2013 HMRC stated:
‘The appointments diary will help me check your income and expenditure.’
Following review and appeal the courts found that the diaries consisting of two A4 sized
pages with no financial information was not a reasonable request. The patient’s
confidentiality was upheld and Dr. Long did not have to produce the business diaries to the
HMRC.
It is worthy to note that all financial matters relating to patients should be recorded if possible
on a separate sheet to clinical records. Where a request by HMRC is obtained, advice
should always be requested and clinical details of a confidential matter concealed in all
circumstances.
Births, Deaths Registration Act 1953
Parents have a legal duty to register the birth details of all children born in the UK within 42
days of the birth.
Human Fertilization and Embryology Act 1990
The Act regulates the control of embryos and all doctors must provide the names of the
patients who register.
Terrorism Act 2005 and PACE 1984
This Act provides a legal obligation of all individuals including dentists to provide information
that may help in the act of terrorism. The Police and Criminal Evidence Act (PACE) (1984)
provides the core framework for police in order to investigate, detain and interview people.
Under this act a dentist may be ordered to provide evidence. Further discussion is found
later under ‘Disclosure in Public Interest’.
Access to Health Records Act 1990
There is no clear confidentiality and legal obligation in death. However in the interests of all
patients confidentiality is believed to be held in death. GDC” Standards For the Dental Team”
(2013 ) states
“You must keep patient information confidential even after patients die “
Maintaining confidentiality in death also protects blood relatives and third parties in some
circumstances. Bluck v Information Commissioner (2007), this case involved a mother
requesting disclosure of her deceased daughter’s medical records.
The Epsom Trust had already admitted liability and damages had been awarded. The
mother wished to disclose the deceased daughter’s records but the trust under section 41,
Freedom of Information Act (2000), argued the duty of confidence continued in death.
The Information Commissioner agreed with the hospital refusals to disclose the deceased
records and at tribunal came to the decision that confidentiality was valid and upheld. Duty
of confidentiality survived the patient’s death.
However, access to the deceased medical records can be allowed to a limited group of
people through The Access to Health Records Act (1990). Disclosure should always be
made promptly and it is up to the data controller to ensure that the person is the patient’s
personal representative.
The Department of Health (2010) guidance indicates that access to the deceased medical
records can be made in the absence of a statutory provision if it is believed to be in public
interest.
Lewis v Secretary of State for Health and another (2008), related to a case involving nuclear
power workers at Sellafield who had knowingly consented to have their tissues sampled
upon death 1962-1991. However, it was also noted by the Secretary of State that tissues
from workers at other nuclear establishments had also been taken. The Redfern Inquiry into
human tissue analysis was confidential, yet it was unclear if consent had been obtained from
these patients prior to removal.
The judgement found that the public interest in the disclosure of the material outweighed the
public interest in maintaining confidentiality of medical records. The court also emphasised
that any disclosure be on strict terms of confidentiality and no information would be made
public.
Access to Medical Reports Act 1988
This act gives the patient restricted access to a medical report produced for employment or
insurance purposes. If a medical report or dental report is produced for an employer,
insurance party or third party it is still a contentious point if implied consent to be examined
allows disclosure. Kapadia v London Borough of Lambeth (2000). At the court of appeal it
was found that the medical report ‘could be disclosed by the doctor to the employers.’
However, today, ethically the doctor could and would have breached confidentiality. In all
cases advice should be obtained from medical, dental or healthcare regulators in such
circumstances. The Patient can ask you not to send a report .
Access to Health Records Act 1990(section 3)
This now relates to the deceased records only. The deceased family may apply under this
act for disclosure records.
Disclosure in the Public Interest
As discussed, consent should always be asked of the individual first however, if it is believed
that the person is a victim of neglect SDC guidelines say, ‘Where a patient puts their health
and safety at serious risk or if you think that you have confidential information which would
help prevent or detect serious crime or abuse, the dentist or healthcare professional should
disclose the facts to the relevant authority. It should be done so with the patient’s best
interest at heart.’
If an individual has contracted a disease or is at risk to an individual or to the public then
advice and help from Dental Protection or dental advisor should be taken. The public interest
to disclose must outweigh, ‘both the public interest in maintaining confidentiality and the
obligation of confidentiality to the individual.’
Serious crimes such as, case of suspected child abuse, rape, treason, a patient is putting
their own health and safety at serious risk, murder, crimes for financial gain or loss,
terrorism, road traffic accident.
Court orders are normally required to disclose such information. A dentist who fails to do so
may be found in contempt of court. However, in the case of Gaskin v Liverpool City Council
(1980) it was found that Liverpool City Council should not be found to produce confidential
9
files of club. This again demonstrates that it is possible to contest orders but in general
would not apply to a dentist.
The General Dental Council v Savery and other (2011) involved disclosure of 14 patient’s
records. Out of the 14 patients 10 objected to their disclosure whilst four failed to respond. In
conclusion a court commented:
‘The fact that the patient’s in question object to disclosure, or do not consent to it, does not
affect the position. The reason the GDC is given statutory authority to make use of patient
records in this way is because of public interest.
The case of W v Egdell (1990), also reinforces this concept that the duty of confidentiality
can be overridden in the interests of protection of the public.
In Hunter v Mann (1974), the case involved a doctor who had treated drivers of a suspected
accident who had subsequently left the scene. In court Dr Hunter argued that the absolute
privilege not to disclose confidential information was guarded under the duty of
confidentiality. The courts found in favour of the doctor and stated:
‘In common with other professional men, the doctor is under duty not to disclose (voluntarily)
without the consent of the patient, information which he, the doctor, has gained in his
professional capacity. Boreham, J (1974).
Today a dentist’s duty of confidentiality is outlined by the GDC. It is a complex area that
involves the law, professional ethics, the Data Protection Act (1998) and the Human Rights
Act (1998), Health and Social Care Act 2001 and acts relating to terrorism and war.
In conclusion information may be disclosed in public interest if;
- Disclosure is made only to them whom it is necessary to disclose (i.e. not to everyone)
- The risk must be a ‘real risk’
- The risk should involve physical harm to the public
Children and confidentiality
Heathcare professionals owe a duty of confidentiality to the parents of a child but case law
also demonstrates that all clinical situations are different and the subject of confidentiality
and the young adult must always be considered. Those aged 16/17 years old are assumed
to have the capacity to consent and hence have the same duty of confidentiality as adults.
The same should apply to a Gillick (1986) competent child under 16 years of age.
Care should be considered in providing all young adults with advice and treatment as it is
best practice to encourage the child to discuss the condition with the parent. Although the
healthcare professional should not do so without the consent of the competent child.
We must consider however that confidentiality can be breached if a healthcare professional
believed the competent child in refusing life threatening treatment. In the case of RE v A
minor (1990), the court considered a case whereby a practising Jehovah Witness (aged 15)
refused transfusions. The local authority made the child a ward of court and the court
authorised the transfusion on the fact that the patient had no realisation of the full process
that lay before him.
Freedom of the Press
Another interesting concept to investigate is the Freedom of Expression in the media and
public interest. Case law details many cases such as X v Y (1998). This case involved a
newspaper who wished to release the name of two doctors who had HIV. Although
potentially the information could be in the interest of the public, consideration was given to
the probability and risk the patients were place in due to the disease. The courts found that
this was minimal and hence the paper was refused disclosure.
Campbell v MGN (2004), in this case the model Naomi Campbell was photographed leaving
a narcotics meeting. She pleaded ‘breach of confidence’ arguing that her confidential
information had been disclosed. The House of Lords ruled that the Mirror newspaper was
liable.
Lord Hope stated:
‘The right to privacy had to be balanced against the right of the media to impart information
to the public and the right of the media to impart information to the public has to be balanced
in turn against the respect that must be given to private life’.
In this case, the court concluded there was little public interest in the story and Campbell
had a right to have her privacy.
Conclusion
Confidentiality is a duty based perspective of dental practice life. The relationship between
dentist and patient is based on the understanding that information divulged will not be
provided without patient consent. It involves not only the dentist but also all those associated
with dental practice. Confidentiality is the building block of great patient relationships
whereby the patient should be confident that all information disclosed in the practice is
provided in confidence and will be kept that way even in death.
Breaches of confidentiality tend in general to be in advertent and complaints usually brought
before the professional regulators rather than the courts. The British Medical Association
(2008) states that ‘public interest can only be determined definitively by the courts.’ Records
should never be given to solicitors, insurance firms, police or any other third party without
the consent of the patient. Public Interest and Disclosure of records or information should
really be justified after seeking advice from the regulators or defence organisation first.
On review of our own confidentiality procedures and workflow it was noted that the last 15
years we have never had a complaint relating to confidentiality although after review of all
risks relating to confidentiality it was considered a review of ‘Confidentiality and Risk
Assessment’ would be produced as a matter of practice improvement. As a group of 5
practices we also noted that we had never been approached or even considered disclosure
in ‘public interest’ or in fact under any other act.
This immediate practice has been halted as a result of this literature review and assessment.
- Call centre and electronic records:
On review of confidentiality and our electronic computer system we noted that the medical
history and in fact all the clinical notes were accessible by all clerical staff. On review and
discussions with R4 (Kodak) the suppliers we were able to limit access to clinical notes and
medical information hence ensuring that only essential information was shared in house in
order to improve patient confidentiality.
- Reception
Often questions which contain confidential information are discussed at reception. All staff
have been reminded of their duty and should request that such information is discussed
away from reception.
As a member of a caring profession ‘Dentistry’ confidentiality in my opinion should always be
maintained. I expect my personal confidentiality to be maintained and I believe my patients
should expect this also.
Confidentiality, personally and as a dentist is an ethical duty which is a core attribute to great
patient care which I believe should always be adhered to. As stated by the Care Quality
Commission Essential Standards of Quality and Safety March 2010.
Outcome 1: Respecting and involving people who use services
People who use services: Have their privacy, dignity and independence respected.
In conclusion areas whereby confidential information may be requested or required should
always be considered in depth prior to release of such information. Guidance from dental
advisors, GDC or BDA should always be sought.
Prior to disclosure and full appraisal of the situation assessed. Confidential information
should as defined be kept confidential in the majority of circumstances and the staff, practice
and practitioners at all times should respect this.
REFERENCES
Abortion Act (1962), Regulation 5
Access to Health Records Act (1990) S68 (2)
Access to Medical Records Reports 1985
Boreham, J (1974), Hunter v Mann, QB 76
Births, Deaths Registration Act (1953)
Bluck v Information Commissioner (2007) 98 BMLRI
Campbell v MGN (2004) 2AC 457
Care Quality Commission Essential Standards of Quality & Safety, March 2010
Data Protection Act 1988
Data Protection Act 1998
Data Protection Directive 95 146/EC
Denning, L (1969) Frazer v Evans, 1 QB 341
Dental Protection: http://www.dentalprotection.org (accessed 18th December 2014)
Department of Health (Feb, 2010)‘Guidance for access to health records request’
Freedom of Information Act (2000) Sec 41
Gaskin v Liverpool City Council (1980)
General Dental Council (May,2005) ‘Principles of Patient Confidentiality’
General Dental Council v Savery and other (2011) EW HC 3011
Gillick v West Norfolk and Wisebech Area Health Authority (1986) AC112
Guyer v Walton (2001)
H (Healthcare worker) v N (Health Authority) (2002) EWCA CIV 195
Health and Social Care Act (2001)
Human Fertilization and Embryology Act (1990)
Human Rights Act, (1998) Sch 1, Part 1, Act 1
Hunter v Mann (1974) 2WLR 742 (1974) 1QB 767
Isle of Man Census Report (2011)
Jacques, J (2005) Trust in the dentist relationship, UCLA
Kapadia v London Borough of Lambeth (2000) 57 BMLR 170
Lewis v Secretary of State for Health and another (2008) A11 ER 90
Long v Revenue and Customs Commissioners (2013)
MS v Sweden (1997) 45 BMLR 133 ECHR
RE v A minor (1990) 9BMLR1
Road Traffic Act (1988), section 172
R v Department of Health ex parte, Source information Ltd. (2000) 1A11 ER 786
RV Department of Health ex parte, Source Informatics Ltd. (2001) QB42
R V Mid-Glamorgan Family Health Service Authority ex Parte Martin (1995) 1 WLR 110
Roberts vs Nottinghamshire Health Care Trust (2005) EWHC 1934 QB
Terrorism Act (2005)
The Declaration of Geneva 1947 amended at (Sydney, 1968; Venice, 1983; Stockholm,
1994; 2005)
The Police and Criminal Evidence Act (PACE) (1984)
The Public Health (Control of Disease) Act (1984), Infectious Diseases Act (1988) updated
list [online] https://www.gov.uk/notifiable-diseases-and-causative-organisms-how-to-report
Accessed 18 December 2014
The Taxes Management Act (1970) section 19A
W v Edgell (1990) 2WLR 742 (1990)1 A11 ER 835 (1990) CH359
Z v Finland (1998) 25 EH RR 371
X v Y (1998) 2 A11 ER 648
Legislation Cited
Commissioners for Revenue and Customs Act 2005 (c.11) s.19
Finance Act 2008 (c.9) Sch.36
Finance Act 2008 (c.9) Sch.36 para.1
- v Inland Revenue Commissioners Ex p Taylor (No2)
[1990] 2 All E.R. 409; [1990] S.T.C. 379; 62 T.C. 578; CA (Civ Div); 1990-03-22
Taxes Management Act 1970 (c.9) s.49C
Taxes Management Act 1970 (c.9) s.9A
Tribunal Procedure (First-tier Tribunal) (Tax Chamber) Rules 2009 (SI 2009/273) r.39
BIBLIOGRAPHY
A-G Guardian Newspapers Ltd. (1990) AC109
BDA Advice Sheet B1 Ethics in Dentistry (March, 2009), London British Dental Association
Coco Engineering v An Clark (Engineer) (1969) RPC 41
Dental Advice Series: Confidentiality London
Duchess of Argyll v Duke of Argyll (1967) 1 Ch.302
Medical Law (Samantha & Samantha) (2011)
National Health Service (Dental Services) Contract regulations 2006 in England and Wales
The NHS Confidentiality code of practice [online] http://www.dh.gov.uk
Palmer v Tees Health Authority (1997) Lloyds Reports 351
POLICE AND CRIMINAL EVIDENCE Act 1984 – http://0-
login.westlaw.co.uk.brum.beds.ac.uk/maf/wluk/app/document?
&srguid=i0ad82d080000014a6b9d94e9312b6da8&docguid=IC64CD2E0A91F11E2B7A5FE
7C22DD236C&hitguid=IC64CDR2E0A91F11E2B7A5FE7C22DD236C&rank=1&spos=1&ep
os=1&td=4000&crumb-action=append&context=86&resolvein=true Accessed December
2014
R v Mid-Glamorgan Family Health Services Ex parte Martin
Roberts v Nottinghamshire Healthcare NHS Trust, Queen’s Bench Division, (01 August
2008)
Stephens v Avery (1988) 1 Ch449
Tarasoff v The Regents of the University of California (1976) 17 Col 3d 358
Thomas Marshall v Guinle (1979) 1 Ch.227
Unlocking Medical Law & Ethics (Carr) Hodder Education 2012
Legislation Cited
[1] Brazier M. Medicine, Patients and the Law, 3rd Ed. Ch 3. London: Penguin 2003
[2] GMC. Confidentiality: protecting and providing information. (2004)
[3] Mason J K, McCall Smith R A, Laurie G T. Law and Medical Ethics 6th Ed. Ch 10.
London: Butterworths, 2002.
[4] W v Egdell [1990] 1 All ER 835
17
[5] GMC. Good Medical Practice. (2001)
[6] GMC. Serious communicable diseases. (1998)
Websites
http://www.dentalprotection.org/docs/librariesprovider4/dental-advice-booklets/
confidentiality—excluding-scotland.pdf?sfvrsn=10
http://www.cdsbc.org/~ASSETS/DOCUMENT/CDSBC_Dental_Recordkeeping_May2013.pdf
http://dentiststudybuddy.org.uk/wp-content/uploads/2011/10/ethics-in-dentistry-advisorysheet.
http://en.wikipedia.org/wiki/Electronic_health_record
http://en.wikipedia.org/wiki/Medical_record
http://www.gdc-uk.org/Dentalprofessionals/Standards/Documents/
PatientConfidentiality[1].pdf
http://www.gdc-uk.org/Dentalprofessionals/Standards/Pages/default.aspx
http://www.gdc-uk.org/Dentalprofessionals/Standards/Documents/
PatientConfidentiality[1].pdf
http://www.gmc-uk.org/static/documents/content/Confidentiality_-_English_0914.pdf
http://www.gov.im/media/207882/census2011reportfinalresized_1_.pdf
https://ico.org.uk/for-the-public/health
http://www.jyi.org/issue/trust-in-the-dentist-patient-relationship-a-review/
Long vs Revenue and Customs Commissioners http://0-
login.westlaw.co.uk.brum.beds.ac.uk/maf/wluk/app/document?
&srguid=i0ad82d080000014a6b816dd8909acb2a&docguid=I3DBE00F0A01011E3BC05B4D
D38067CDB&hitguid=I3DBE00F0A01011E3BC05B4DD38067CDB&rank=2&spos=2&epos=
2&td=13&crumb-action=append&context=16&resolvein=true
http://www.inbrief.co.uk/employees/employer-access-to-medical-records.htm
http://www.magicandmedicine.hps.cam.ac.uk/on-astrological-medicine/further-reading/
history-of-medical-record-keeping
http://www.medicalprotection.org/uk/resources/factsheets/england/england-factsheets/ukeng-
access-to-health-records
http://mymedicalapp.com
http://www.nasbhc.org/atf/cf/%7BCD9949F2-2761-42FB-BC7A-CEE165C701D9%7D/
TA_HIT_history%20of%20EMR.pdf
http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Documents/
PatientGuidanceBooklet.pdf
http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Documents/
PatientGuidanceSummaryA4.pdf–
http://www.nmc-uk.org/nurses-and-midwives/advice-by-topic/a/advice/confidentiality/
https://www.princeton.edu/~achaney/tmve/wiki100k/docs/Declaration_of_Geneva.html
http://www.sciencedirect.com/science/article/pii/S0267364912000209
http://www.tuc.org.uk/workplace-issues/employment-rights/health-and-safety/sicknessabsence/
confidentiality-and-medical–
http://ukhumanrightsblog.com/2010/05/28/medical-records-not-as-private-as-may-firstappear-
under-human-rights-law/
http://www.wpro.who.int/publications/docs/MedicalRecordsManual.pdf
Back to blog