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The following extract is taken from the 2001 'Health Care Chaplaincy Volunteers' training resource folder offered by the Hospital Chaplaincies Council of the Church of England. This looks like being an excellent general resource, and the following extract (pp.36-41) has material of far wider value about confidentiality in a Health Care setting. To order a full copy, visit the CHP website....|
THE JOINT COMMITTEE FOR HOSPITAL CHAPLAINCY
A Statement of ConfidentialityDated July 1982
Administrative changes in the National Health Service make this an appropriate time for Hospital Chaplains (both Whole- and Part-Time) to be reminded that they are employees of their Health Authority and thus subject to rules covering all employees, especially in preserving the confidentiality of patients. There is increasing pressure on the National Health Service to ensure that the confidentiality of patients is observed.
A Chaplain should never disclose information about a patient when it has been obtained in his capacity as a Hospital Chaplain, to anybody, except staff directly concerned with the treatment of the patient, unless explicitly permitted by the patient to do so. Needless to say, a Chaplain is never under any obligation to disclose information given to him by a patient or about a patient.
For many years, it has been mistakenly assumed that the admission of a patient to hospital is not confidential. Chaplains must be aware that this is not the case; the information that a person is a patient is regarded by the Department of Health and Social Security as confidential. As an employee of the NHS, the Chaplain is bound to observe confidentiality, even where he might feel it his duty as a clergyman to break it. Furthermore, no Chaplain should give an interview to the press or the media on any matters relating to his Chaplaincy without the knowledge of the hospital administration.
An experienced Chaplain will immediately recognise that there is no real difficulty here, except that sometimes patience and time are needed in order to work within the framework of these rules. All the above applies to the appointed Chaplain, but there are some consequences for other clergy visiting hospital who are not Chaplains. Thus, only Chaplains have a right of access to admission lists; and any records which are kept in the Chaplains' office are personal and confidential.
The appointment of deputies to Chaplains, especially where the staff at a clergy house share the duties at a hospital, needs careful attention. Hospital administration should always be consulted in whatever arrangements are then made for access to admission records. It needs to be emphasised that deputy and locum Chaplains are bound by the same rules of confidentiality as are all employed Chaplains.
Other clergy making pastoral visits should remember the need for discretion. Patients and public, as well as hospital staff, may not always understand the distinction between appointed Chaplains and other visiting priests and ministers.
Any suggestion that Hospital Chaplains might feel themselves less strictly bound by rules of confidentiality than other members of staff would only serve to undermine their position as Chaplains and could cause distress to patients and other staff.
Issues in confidentialityFor further reading on the issue of confidentiality see the article by Robert Clarke, Chief Executive of the Hospital Chaplaincies Council and Chaplain to the Queen, in Ministry Today, February 1996 (full details in bibliography).
... Is any among you sick? Let him call for the elders of the church;
Yes indeed! But what then should we make of the outsized banner headline in the
Church Times of 2 June 1995, following lead stories in the Sunday press of the previous week? -
A new ban on local clergy seeing patient lists and visiting the wards ...
Has something so dramatically changed in our society that, in some way and for some reason, the National Health Service (NHS) now feels the need to protect its patients from the Churches?
This question has both yes' and no' answers, and it is vital that every official representative of any church, congregation or group visiting any hospital, or indeed any sick person in their home, should now be fully aware of the importance of confidentiality and privacy for the benefit of all patients.
Let us first look at the yes' and try to identify some of the reasons behind it.
Circumstances and attitudes have changed and are changing in our society. Among the more welcome and positive developments is the increasing concern of the NHS for the total wellbeing of its patients. The Guidelines (HSG/92/2) issued by the Department of Health to all NHS Hospital Trusts in 1992, when read alongside the Patient's Charter, highlights the importance for each and every Trust to provide all patients of all faiths, all races and all traditions with ready and easy access to the spiritual and religious care which is appropriate to the particular history and needs of the patient.
Such formal recognition of the importance of spiritual and religious care' is a significant advance in our liberal democratic society and should be warmly welcomed by all faith communities. In most hospital trusts there is now the provision of a team of officially selected and appointed hospital chaplains. These are people who are specially trained for work with patients, staff and relatives in the complex world of the modern hospital setting. In the case of the larger religious traditions the chaplains are contracted and paid by the NHS for their work. All major faith communities and minority groups as well as the main Christian traditions are included among the lists of Official Chaplaincy Appointments to the Trusts.
In many instances the provision of official Christian hospital chaplains as full members
of the hospital/trust staff pre-dates the introduction of the NHS in 1948. The recent
more formal arrangements with all faith communities, together with a remarkable
increase in numbers (now 350 whole-time and about 1800 part-time hospital
chaplains), has come about as the result of management changes in the NHS linked with a changed understanding of the significance and value of spiritual and religious care for the total wellbeing of the patient. With a better trained and selected total chaplaincy of all traditions, the NHS has set new standards and duties for all staff
chaplains which include undertaking more responsibilities in the work-place in the
interests of both patients and employing trusts.
Perhaps a few recent examples of local practice and professional standards which have failed to be up to the highest expectations of the NHS, society and the law, will serve to highlight the pastoral implications of this problem.
The economic recession of recent years has meant that many employers large and small are unwilling to employ those who they think may have a bad sickness record now or in the future. For example, when a manager of a small Midlands company attended a service at his local church and heard the prayers, using the full name, for a person in the town who was, in the words of the Bidding, seriously ill and needing further major investigations', he mentioned his genuine concerns for the sick person to the company personnel officer. Rightly or wrongly the sick person came to the view that the only reason for having been made redundant in the down-sizing of the company a few months after his/her return to work, was that the company might have to pay for very expensive sickness payments in the changed arrangements of National Insurance, which would be financially to the company's disadvantage - a serious matter in the light of the recession. When detailed inquiries were made, it became clear that the name had been put on the prayer list not at the request of the person concerned but in response to information given by a 'concerned member of the church' who had picked up the news while visiting her husband who happened to be in the same ward. The prayers of the faithful greatly disadvantaged both patient and family in this case!
Another recent example is that of a concerned minister. Having been told of the serious illness of a lady's husband, and from the best possible motives, he made a home visit. Regrettably the information had come not from the patient, but from an official sick visitor' in the congregation. This visitor had made an official visit to another patient in a distant hospital who happened to be in the same ward as the husband. The visitor had recognised the husband/patient as a member of the congregation, and had gone straight back to tell the minister that this man was in hospital for cancer tests. The fact that her husband was in hospital at all was news to the wife, and came as such a shock when the minister told her, that her already fragile mental and nervous condition gave way to a total breakdown leading to her immediate admission to the local acute psychiatric clinic. It transpired that her husband, aware of his wife's delicate condition had arranged to go away on business for a couple of days' rather than worry her with the truth that he was to undergo preliminary cancer investigations. In law he was entitled to expect that the fact that he was a patient was itself confidential information. He had the right, whatever others might think of his approach, to protect his wife in what seemed to him the best manner possible. His caution seems to have been justified by the fact that she required prolonged treatment following disclosure of his real situation. Thinking that the breach of confidentiality was made by the hospital, he began legal proceedings against the health authority, which he withdrew only when the true source of the breach was identified. Both husband and wife are now alienated from all worshipping communities.
Additional examples can be cited in cases of HIV and AIDS patients. Regrettably these conditions give rise to strong and often irrational adverse and confrontational attitudes in the judgments of many in our society. Christians included. Once confidentiality about a patient's condition is breached, there may be and often are more damaging results for patient and family in relation to employment, insurance and bank accounts, pension schemes and mortgages. A moment's reflection will confirm that it is not only in the best interests of the patient but also of society as a whole, that privacy and confidentiality are fully respected. Only then can patients be expected to come forward in time to receive the treatment and counselling which they and their families need and which is in the interests of the community as a whole. Terminations, mental illness, genetic counselling and a whole host of other conditions could be listed: for all alike, it is imperative that the health care professional can provide privacy and confidentiality, so that vulnerable, sick and troubled people may feel secure in seeking help, information and care.
As the Law and the NHS attempt to set standards which will ensure for everyone the best possible climate of security in which to make the right choices for themselves, their families and society, it seems wholly right that they should expect the understanding and support of all faith communities which, above all else, are concerned to speak of the meaning, the dignity and the purpose of humankind.
We have taken some space to show how and why some things have changed. The no
change' part of our answer arises out of the simple theological truth that God does not
change and therefore the individual and collective responsibilities of his people in their relationships with their fellows do not change. In the changing medical, technological, social and legal situation of our complex society, there remains the duty of the church,
ministers and the faithful people of God, to pray and care for the sick and those who
are involved with them. But we do need to look at what are the most appropriate and
professional ways of providing that care and witness.