1 Feb 2003, 09:00

The patient attended a pain clinic, run by a hospital, to see a specialist. On arrival he was interviewed by a doctor, and questioned about his personal history. The doctor passed this information to the specialist. The patient asked what else was going to happen to the information. The doctor said he was going to forward it to a community mental health centre with which the patient had had previous dealings. The patient objected, saying he wanted nothing further to do with the centre, but the doctor forwarded the information anyway. The patient complained to me that this was a breach of his privacy.

I considered the complaint under rules 3 and 11 of the Health Information Privacy Code 1994 and concluded there was no breach.

Rule 3(1) provides that when a health agency collects information, it must take reasonable steps in the circumstances to ensure that the individual concerned is aware information is being collected, the purpose of collection, and the intended recipients of the information. The hospital said that it was not practicable to inform the patient of these matters before the information was collected (rule 3(2)).

The hospital told me that a psychiatric assessment was a routine procedure at the pain clinic and the patient had agreed to attend. It was only during this assessment that the patient advised the doctor that he had previously attended a community mental health centre.

The doctor said that as a result of the information given to him by the patient he considered the patient was depressed and that he needed to be in contact with the mental health centre. The patient disagreed. The doctor advised the patient that he believed the patient's judgment about further contact with the Centre was impaired because of the depression, and that he was obliged to inform the Centre so that appropriate treatment could be provided.

I accepted that the doctor was not able to inform the patient at the beginning of the interview about the intended recipient of the information, as he was not aware of the patient's previous contact with the Centre. I noted that the doctor advised the patient of his purpose for collecting the information and intended recipients as soon as practicable as required by rule 3(2).

Health information must not be disclosed unless an exception applies (rule 11(1)). One of the exceptions covers situations where it is not practicable to obtain authorisation from the individual, and the disclosure is directly related to the purpose for which it was collected (rule 11(2)(a)).

I was satisfied that it was not practicable for the doctor to obtain the patient's authorisation as the patient had already said he wanted nothing further to do with the Centre. I was also satisfied that the information disclosed by the doctor was an appraisal of the patient's current state of mental health, and that disclosure was directly related to the purpose for which the information was collected. I formed the opinion that the hospital could rely on rule 11(2)(a).

I advised the patient of my opinion that there was no breach of rules 3 and 11, and of his right to take his complaint to the Human Rights Review Tribunal. I closed my file.

March 2003

Indexing terms: Collecting personal information - Hospital - Doctor became aware of information during psychiatric assessment - Patient advised as soon as practicable of purpose of collection and intended recipients - Health Information Privacy Code 1994, rule 3(2)

Disclosure of personal information - Hospital - Doctor disclosed information to another health agency - Authorisation from individual not practicable - Directly related purpose - Health Information Privacy Code 1994, rule 11(2)