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Counter-extremism strategy undermines relationship between doctor and patient

The Government’s counter-extremism strategy threatens clinicians’ relationships with their patients and compromises their duty of confidentiality, Faculty of Public Health (FPH) President Professor John Middleton has warned.

The media widely covered Professor Middleton's warning that the Prevent strategy is jeopardising the trust and confidentiality that are at the heart of the doctor-patient relationship.

Writing in the Lancet, Professor Middleton says that a report by the Open Society Justice Initiative published on Wednesday (19/10/16) "is the latest in a series of critiques of what is a flawed approach to the challenge of so-called home-grown terrorism".

The Prevent strategy requires health professionals to identify and refer to the authorities anyone they deem as at risk of being drawn into terrorism – including non-violent extremism.

The report confirms, Professor Middleton says, that the level of concern or evidence that requires a health professional to act is much lower than that normally needed to over-ride the common-law duty of confidentiality.

He writes: "Prevent risks undermining the trust that patients have in health professionals. Distrust will be generated not only with respect to the patient whose confidentiality is breached, but also with respect to the larger community which the professional services."

This could damage the health of communities who already face significant health challenges, he says.

"Such an approach is likely to discourage patients from providing relevant information to doctors and to deter them from accessing healthcare. Prevent risks creating a serious public health problem, particularly with respect to Muslim communities which are already disadvantaged by higher rates of reported ill-health and poverty as compared to other religious groups in the UK."

He concludes: "Rather than a top-down approach that opportunistically targets particular communities for combating terrorism, we need to address the problems that communities themselves say they are experiencing at a local level."

These include educational and job opportunities and ending the stereotyping of Muslim communities as hotbeds of radicalisation.


Written: 21/10/2016 , last modified: 27/10/2016