Every patient visiting their family doctor or attending a hospital appointment in England will be asked to declare if they are gay, straight or bisexual under controversial new rules imposed by the NHS.
The astonishing diktat – condemned last night as ‘intrusive’ and ‘insulting’ – orders doctors to include details of a patient’s sexuality on their permanent medical record for the first time.
An official NHS directive, seen by The Mail on Sunday, reveals that from April 2019 all patients aged 16 or over will face questioning about their sexual identity.
NHS England last night refused to give details about how the highly personal information will be collected – leading to fears patients could be quizzed by GPs, nurses and even receptionists.
Every patient visiting their family doctor or attending a hospital appointment in England will be asked to declare if they are gay, straight or bisexual under controversial new rules (file photo)
Its instructions, published last week, say that ‘sexual orientation monitoring’ should take place ‘at every face-to-face contact with the patient, where no record of this data exists’.
The directions suggest patients could be asked the highly personal question regularly if the records are not properly shared between different parts of the NHS as patients attend GP appointments, A&E, outpatients or even antenatal classes.
There are also fears about the security of the data, as any leak could potentially ‘out’ thousands of patients.
Health chiefs say NHS organisations and councils must ask so that they can obtain better data on the health of gay and bisexual people throughout England.
Failing to do so risks breaking the Equality Act 2010, gay rights groups have warned.
But last night politicians and doctors said the NHS had ‘no place’ asking all patients the question.
Former Labour Minister Graham Stringer, MP for Blackley and Broughton, said: ‘Unless it’s related to your health, your sexuality is not the NHS’s business.’
And Conservative MP Jacob Rees-Mogg said: ‘It sounds intrusive and Orwellian.’
Never before has the State insisted citizens face a question about their sexual identity. The Office for National Statistics considered including it in the 2011 census but decided against due to ‘concerns about the quality and accuracy of data… and issues of acceptability to respondents’.
The astonishing diktat – condemned as ‘intrusive’ and ‘insulting’ – orders doctors to include details of a patient’s sexuality on their permanent medical record for the first time (file photo)
People over 16 will be asked: ‘Which of the following best describes how you think of yourself?’ They can say they are ‘straight’, ‘gay or lesbian’, ‘bisexual’ or ‘other’.
They will also be able to state that they are ‘not sure’ of their sexuality, or ‘decline to provide a response’. But whatever answer they give – including if they refuse to divulge their sexuality – will be noted on their medical record for ever.
Dr Peter Swinyard, chairman of the Family Doctor Association, said: ‘I think it’s a confounded cheek to ask GPs to do this. It really is not the place of family doctors, to start monitoring people’s sexuality.
‘We are at risk of becoming state apparatchiks, asking questions about patients’ sexuality, housing, whether they can cook, or do crochet! When someone comes in for their precious eight minutes with me, I’m interested in what they want from the consultation.
‘It isn’t relevant to ask an 87-year-old grandmother if she has ever had a relationship with another woman. She would find that incredibly insulting and storm out. It would ruin the consultation.’
The project is being launched – without full public consultation –after at least seven years’ lobbying by the LGBT Foundation.
NHS England said the Manchester-based gay rights charity had ‘led the work to develop’ the so-called ‘sexual orientation monitoring information standard’ – the framework under which ‘all patients/service users aged 16 and over across all health services and local authorities’ will be quizzed about their sexuality.
The document, bearing the logos of both organisations, says there is ‘strong evidence’ that lesbian, gay and bisexual [LGB] people are ‘disproportionately affected’ by sexually transmitted infections, substance abuse, poor mental health and loneliness in old age.
More data would enable NHS and social care bosses to ‘better understand, respond to and improve LGB patients’ service access, outcomes and experience’ and allow ‘targeted prevention and early intervention’ work to improve their health.
The Equality Act 2010 contains a legal obligation for all public sector bodies to pay ‘due regard’ to the needs of lesbian, gay and bisexual people’ to ensure they are not discriminated against.
Collecting and analysing data on sexual orientation would be ‘evidence of compliance’ for health and social care providers, the document adds.
Dr Ian Banks, former president of the Men’s Health Forum, said in an ‘ideal world’ it would be good to have ‘big data’ about patients’ sexuality to improve health services. But he warned: ‘Some people don’t want others to know their sexuality. It’s up to them – it’s not up to NHS England to know, or the GP to ask.’
Many justifiably feared that a data breach, or request from an insurance company, could mean details of their sexuality being made public.
In March, the Information Commissioner announced it was investigating fears that medical records held by 2,700 GP practices – a third of those in England – were not secure and could be read by workers including clerical staff. Changes have since been made.
‘People don’t believe that their notes are going to stay confidential,’ Dr Banks said. ‘Once it’s down on our medical notes, that’s it – you can’t get rid of it. And then it goes out to numerous databases.’
Those who refused to state their sexuality could face uncomfortable questions about why, he added.
In a statement, NHS England said: ‘All health bodies and local authorities with responsibility for adult social care are required under the Equality Act to ensure that no patient is discriminated against.
‘This information standard is designed to help NHS bodies be compliant with the law by consistently collecting, only where relevant, personal details of patients such as race, sex and sexual orientation. They do not have to do it in every area, people do not have to answer the questions and it will have no impact on the care they receive.’