Protecting young people’s right to confidential services: responding to the consultation on information sharing databases
Background
The Children Act received royal assent in November 2004 and comprises a package of measures intended to safeguard and promote the wellbeing of children and young people. These include giving the Secretary of State for Education and Skills powers to make regulations to require the establishment of information sharing databases in children’s services.
The proposed databases will include details of all children and young people up to age eighteen and are intended to help protect children and young people by facilitating sharing of information between practitioners who work with them. It is intended that the databases include the following basic information:
- Basic data in order to identify a child and whether they are using universal education and primary health care services.
- Names and contact details of other practitioners involved with the child or young person
- An indicator of whether a practitioner currently has a concern about the child or young person
During the passage of the Children Bill through Parliament a number of organisations raised concerns about the ethical implications of these proposals and their potential impact on young people’s uptake of sensitive services such as sexual health and mental health provision. Brook particularly expressed concern that young people’s use of sexual health services would be flagged up via the databases to other professionals such as police or youth workers. The organisation was anxious that this could prove a significant deterrent to service access particularly among younger age groups, as well as potentially violating young people’s right to privacy and confidential service use.
As a result of this lobbying the Government announced a consultation looking at its information sharing proposals in relation to sensitive services.
The consultation
The Information sharing databases in children’s services: consultation recording practitioner details for potentially sensitive services and recording concern about a child or young person was launched on 27 October 2004. The closing date for responses is 19 January 2005. The results of the consultation will inform the regulations to accompany the Children Act. Any regulations made about the information sharing databases will be subject to debate in both Houses of Parliament under affirmative resolution procedures.
The Government is specifically consulting on whether practitioners from sensitive services such as sexual health should record their involvement with young people:
1) As a matter of course
2) Only with consent
3) Not at all
They are also consulting on whether, where such details are recorded, access to those details should be:
A) Visible to all users that are able to access that child or young person’s record
B) Visible only to essential practitioners determined by regulations (e.g. lead professional, child protection social worker, database manager)
C) Visible to essential practitioners as at option B plus individual categories of practitioner as specified by the young person or the child’s parent/caregiver
Brook’s position
Brook strongly argues that it is unnecessary to routinely flag young people’s use of sexual health services, even with their consent. Mutually consensual sexual activity between young people is a normal part of adolescent development and should be clearly distinguished from sexual abuse. We feel that information should only be shared when there are clear child protection issues in accordance with current government guidance.
Moreover young people agree with this approach. When the Government consulted young people about the information sharing proposals in Every Child Matters the majority who responded said information should only be shared when a child is in danger, and a significant number felt that information should never be shared.
Any measures to record young people’s use of sexual health provision would undermine their belief in the confidentiality of services. This could act as major deterrent to their seeking help at a time when England and Wales continue to have the highest rate of teenage pregnancy in Western Europe and rates of sexually transmitted infection amongst young people are increasing.
Research has consistently demonstrated that confidentiality is of paramount importance for young people using contraceptive and sexual health services as has been consistently acknowledged by government guidance. A Brook survey found that 25% of women under 16 at the time of first intercourse did not attend services because of worries about confidentiality compared with 12% who were over 16.
As an organisation that campaigns on young people’s rights to confidential, accessible services Brook is extremely concerned that any proposal for routine recording of sexual health service uptake would potentially breach young people’s right to privacy under Article 8 of the European Convention on Human Rights.
With regard to the proposal that information be included on the database with young people’s consent Brook has major reservations as to how far consent would be explicitly sought in all cases. There is already a tendency within statutory services for consent to be taken as implied unless the client says otherwise. Young people may not always be assertive enough to specifically say that they do not want information shared outside the service or indeed realise that they have the right to refuse consent.
Brook also believes that making information available with consent to essential practitioners fails to properly protect young people’s right to privacy, with risks that essential practitioners might subsequently take decisions to share information without the necessary steps to seek additional, explicit consent from the young person.
Brook called on all individuals and organisations with an interest in young people’s rights and sexual health to respond to the consultation in order to protect young people’s right to privacy and to safeguard their sexual health.
