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Audio recording your consultation with NHS doctors

Esther12

Senior Member
Messages
13,774
The evidence before the Panel is that Dr Singhal was working on a daily basis with patients from a very deprived area, with a high rate of drug and alcohol abuse, who could be difficult, abusive, aggressive and manipulative. In the Panel’s view, it is likely that the threat to commit suicide was of a kind that the doctor would have heard before. Therefore, it is quite possible that in the doctor’s mind this particular exchange with Patient A was not material.

Patients from a deprived area? I know they sort. They can be difficult, abusive, aggressive and manipulative.

Can doctors be difficult, abusive, aggressive and manipulative too though? Should that be mentioned?

Some medical stuff reminds me of satire from the 60s - the sorts of attitudes that don't even get made fun of any more.

I've not read that whole report yet, and need to get off-line now, so maybe there is some good evidence in there to justify this sort of profiling. Thanks for posting the report @nolegion it's always nice to read these sorts of original documents every now and again.
 
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I wonder if I may seek to enlist some aid here.

The Care Quality Commission has spent a year failing to produce 'guidance' on what the US calls 'granny cams' i.e. surveillance cameras installed usually by the relatives of the vulnerable elderly in care homes and the like.

And now, in fact, it has become clear that the 'guidance' is not going to be confined to such cameras in care homes. It will apply to any sort of recording, overt or covert, of any sort of medical 'service provider' - which means that it will extend to e.g. audio recording of pretty much any clinical encounter, too.

The last draft documentation – which fortunately was thrown out at the CQC's board meeting earlier this month - included the suggestion the service providers might introduce 'policies' forbidding recording on the grounds of STAFF privacy.

There is no foundation in UK law for this, and, as I say, the documentation as it stood was not approved. But the CQC executives now have the board's authority to issue revised documentation without seeking further board approval, and that, it seems to me, is potentially a recipe for disaster.

For those with time (and the stamina!) who would like to see the detail, perhaps I may refer you to the text of some of the draft documentation and the links to videos of the relevant meetings etc. in the thread golden was kind enough to link at the beginning of this one, rather than repeat all that here. There is still time to send in criticism via the CQC contact details there given. (They didn't think anything would be published this side of Christmas).

Another and easy route for tweeters is the CQC's own hashtag link here.

https://twitter.com/hashtag/CQCcameras?src=hash

The central point, in my view, is that 'service providers' may indeed make 'policy' which protects the privacy of 'service users'. Indeed, I have two very vulnerable relatives in care myself, and I wouldn't want to see another relative filming away in a communal area and posting the results on youtube. There is in fact statutory regulation which confers obligations on e.g. a care home owner to protect my relatives' privacy and dignity.

But that does NOT prevent a relative of mine asking me to install, for instance, a motion-sensitive video camera in her own room, for her own protection. Medical staff do NOT have the same privacy and confidentiality rights as patients. And thank goodness for that, or many of those abusive 'carers' caught on video - I'm sure people will have caught sight of some of the footage from several establishments – would still be at large and abusing, rather than in jail where they belong.

Whether by mail to CQC or by discussion in the twittersphere, I am keen for the CQC to realise that their actions are still under very close scrutiny by the public, even if the board have stopped looking at the detail. Anything anyone had a moment to do on this could only help.
 
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Esther12

Senior Member
Messages
13,774
Thanks for the info nolegion.

Do you have a link to any brief summary that might allow people to submit brief comments, without needing to be too well informed?

I expect that a lot of people will agree with your concerns, but also not necessarily want to spend too much time looking into the details (I say this having spent time reading long and evasive reports from other organisations... it's no-one's idea of a good time!).
 

Esther12

Senior Member
Messages
13,774
Actually, the post above is probably a good enough summary for a brief comment to the CQC.

I had heard that they were meant to be improving... must never trust these sorts of claims unless people have been fired!
 
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Thank you, Esther. Here goes:-

Extract from DRAFT CQC Board papers 19 11 2014:-

" Contractual and legal issues

4.6.When deciding whether to use a camera or any sort of recording device in a care setting you should consider the policies that the provider may have in place. These may limit the use of recording devices to protect the privacy of staff, other people using the service or visitors. For example, some hospitals request you don’t take photographs on wards.

4.7. If you decide to use a camera or audio recording device yourself, you should consider whether this could put you in breach of a policy and have implications for your care or the care of your loved one. For example, will staff refuse to treat someone if there is an insistence that they are filmed or recorded doing so?

4.8. The provider could remove a hidden device that they find. However, they would be committing an offence if they deliberately destroyed or damaged the camera or refused to return it to you. A provider may feel obliged to remove a camera ,especially one in a shared area if they consider that it is an intrusion upon the privacy of service users, staff or visitors."

This is completely wrong in law (and practice), and it is frankly disgraceful that such wording should still be in draft documentation awaiting final approval last Wednesday. All too obviously, in my assessment, the staff at CQC are still trying to placate 'service providers' at the expense of clear statements of law for the benefit of 'service users'.

Right at the end of the discussion, one particular non-executive director (Michael Mire) landed some commentary which I truly hope has strong and lasting effect. In my view, he happens to be entirely right, both legally and practically.

Stripping out the caveats, he said:-

" ' Will staff refuse to treat somebody…? ' I think we should say in the provider paper…that if a resident or relatives have installed some sort of covert surveillance it is because they are worried about the care they are getting…and this is a totally legitimate thing to do…

We don't actually give to the provider any guidance on what to do if one of the residents or relatives install covert surveillance, but I think in that way we can take a more positive stance…

This is because a relative or resident is worried about their care and it would be completely illegal if you withdrew or restricted care if you found that someone was using covert surveillance…

I think that is a very important part of the advice we should be giving to providers, and it can position us…on the patients' side, which is the point that colleagues are making – I mean residents' side or users' side – because that's the place we want to be. "

It's Mr Mire's view that needs reinforcement. I simply do not trust the CQC staff to react to this in a clear, unarguable way. They need to know 'we are watching very, very carefully…

While the last board meeting lasted nearly3 &1/2 hrs, the surveillance discussion only runs from roughly 2:44 to 3:13:-

http://www.youtube.com/watch?v=x0-oFWxiNAE
 
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11
I think I was compiling my response as you were posting your further comment, Esther.

In any event thanks for the interest. Any comment to CQC from the patients' side would help.
 

Esther12

Senior Member
Messages
13,774
Thanks nolegion, those extracts were exactly what I was after, but too lazy to look for (sorry for putting you out). I've spoken to a few people about these things previously, and will pass this on to them too.
 
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Remember Dr Arun Kumar Singhal? The one who was caught, in a recording, telling a patient she could jolly well go and kill herself? (see Golden's post in this thread of 17 Sept 014)

...but who didn't bother to turn up to the fitness to practise hearing, and was still suspended for a mere 3 months?

His case came up for review last month, and he didn't bother to turn up again. This time he has been suspended for (a further) 12 months.

Should have been struck off, in my opinion, but it's progress all the same.

And all on the strength of a 2 mins 30 seconds recording on a mobile phone. These days I wouldn't dream of attending a medical appointment without audio recording from start to finish.

Press story here:-
http://www.liverpoolecho.co.uk/news/liverpool-news/doctor-who-told-patient-kill-8404877

Full case report made available yesterday, here;-
http://www.mpts-uk.org/static/documents/content/SINGHAL_6_January_2015.pdf