> "Why shouldn't the licensing authorities be aware..." - Of course they
> should be aware of what clubs are associated with the most violence, which
> drivers drive under the influence of alcohol, which politicians present with
> evidence of drug use, which homes abused women and men come from... But not
> from us!
I think your mistaking anonomysed data for confidentiality breaches. No-one
is talking about giving the police patient sensitive information. However,
we have no duty of confidentiality to the pub landlord any more than we have
a duty of confidentiality to the measles virus. Our duty of confidentiality
is to the patient (who was the victim of violence, whether s/he was partly
to blame or not)
I'm assuming you use anonomysed data to audit your own performance and some
of this is passed to the DoH to allow strategic planning to occur in the
fight against disease (or tactical information such as public health
issues). Violence is also a disease, but the instruments of prevention are
not clean water and immunisation, but the police and the courts.
> It is true that some people might not present if they thought their visit
> would not be 100% confidential, but this is not the reason. We don't tell
> because we don't. Neither do a few other groups of professionals.
In fact we do tell, as you mention above, if there is an over-riding public
interest. But that's a different issue.
> But they can't get
> us to do this work for them - it's not in our job description.
Hmmm. What exactly is our job description? I think preventative medicine
must be in there somewhere. No doubt there were many doctors who felt the
same about public health in the peri-Typhoid-Mary's era.
I agree that like any such data the veracity of it would be suspect, but
that is unavoidable. Whether I agreed with such a policy would depend
heavily on the small print - ie: how the data is collected and anonomysed
and how the policy is publicised.
In don't think workload should be an issue if it can be shown to reduce
attendences.
Rowley thinks that they will just go elsewhere and be violent, but I think
he is missing the point. My experience from prisons is that most violent
offences are random, sudden, unpremeditated acts by people who have limited
self control (either because of personality factors or the influence of
drugs such as alcohol). These acts could have been avoided by changes in
the environment (licensing laws, use of plastic glasses, street lighting,
policing issues, overcrowding etc).
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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