General Dental Council v Rimmer

Disclosure of confidential clinical records may be authorised where a compelling public interest justifies the interference with confidentiality and satisfies the requirements of necessity and proportionality. The court must balance the public interest in confidentiality against the public interest in effective professional disciplinary proceedings. Disclosure must pursue a lawful and legitimate purpose and be confined to what is necessary. Effective safeguards, including limits on use, anonymisation and protection against onward disclosure, are important to the proportionality assessment. The availability of a less intrusive means is also material.

The General Dental Council sought, under Part 8 of the Civil Procedure Rules 1998, access to and forensic copying of the defendant dentist’s computer hard drives. The purpose was to investigate whether records concerning 16 child patients had been retrospectively altered in connection with fitness-to-practise proceedings.

The drives contained approximately 30,000 patient records, legal professional privileged material and other confidential information. The central issue was whether the proposed examination could lawfully and proportionately interfere with patient confidentiality and privacy.

1. Jurisdiction and procedure. Part 8 of the Civil Procedure Rules 1998 was an appropriate procedure because there was no substantial factual dispute. The Administrative Court had jurisdiction because the application concerned competing public interests and the application of Article 8 rights.
2. Confidentiality and public interest. Dental and clinical records were protected by obligations of confidentiality. The court could authorise disclosure where sufficient justification existed, balancing the interests of patients and the public in confidentiality against the public interest in the proper and effective conduct of professional disciplinary proceedings.
3. Article 8 assessment. The disclosure had to be lawful, pursue a legitimate purpose within Article 8(2), be necessary in a democratic society and be proportionate. The approach in A Health Authority v X and others [2010] EWCA Civ 2014, although expressed in the context of Children Act proceedings, was apposite. Effective disciplinary proceedings involving a registered practitioner constituted a proper public interest, including the protection of health and the rights and freedoms of others.
4. Necessity and safeguards. Complete copying of the hard drives was necessary because the relevant records could not be isolated. The parties’ enquiries established that no less intrusive means would achieve the objective. The interference was proportionate because use was limited to investigating the 16 records, patient details would be anonymised at any later hearing, and confidentiality agreements and undertakings restricted misuse and onward disclosure.
5. The same reasoning applied to the databases associated with the defendant’s former practices. The disclosure sought was therefore justified and required in the public interest, and the declarations were granted, subject to the agreed safeguards and undertaking.