Summary

  • Clause 52 of the Health Bill would authorize the Secretary of State to establish a system that makes patient information available to patients and people involved in health or social care.
  • Regulations could decide who must supply data, which roles may see it, how representatives access it and which bodies can impose financial penalties.
  • The House of Lords Delegated Powers and Regulatory Reform Committee says the basic access and confidentiality rules belong in the Act: Parliament can debate affirmative regulations, but cannot amend their individual provisions.

“Single” does not mean one national hard drive

The name invites a picture of every medical record poured into one central database. The Department of Health and Social Care’s impact assessment describes a different design: connect existing clinical records and make them available across settings, rather than replace current systems with one new IT platform. Clinicians are expected to work through their existing systems; patients would use the NHS App.

The Government’s diagnosis is straightforward. Records can be incomplete or inconsistent when a patient moves between providers, and information is sometimes transferred by hand. A shared route can reduce that friction. It cannot decide who holds the key.

Clause 52 hands the minister the rulebook

The Bill would insert a new section 250E into the NHS Act 2006. The Secretary of State could establish the system through regulations, assign operating functions to public authorities, and require or authorize the processing or disclosure of patient information. Those regulations could define access for patients, their representatives and people involved in health or social care. They could also give the Secretary of State, the Care Quality Commission or a Special Health Authority power to impose financial penalties in specified cases.

Those are not choices about file formats. The rules for appointing a representative, limiting a clinician’s view to the information needed for a role, deciding which records travel between care settings and investigating improper access define the system’s reach.

The Government says the Bill creates no new legal route for research, service planning or commissioning. Such secondary uses would still need a separate existing legal basis, and current UK data-protection law would remain in force. That boundary matters: a shared record is not a general licence to reuse its contents.

But the Bill asks the minister only to have regard to the need for adequate safeguards against improper use. It does not say in direct terms that the minister must ensure those safeguards are in place. Before making regulations, the minister must consult people the minister considers appropriate. The statute itself does not yet say who can see which material, on what conditions or with what transparency for the patient.

A parliamentary vote is not a redline pen

The House of Lords Delegated Powers and Regulatory Reform Committee has drawn the line. Who may access what information and when, under which conditions, and with what confidentiality and privacy protections are core policy questions. They belong in primary legislation. An affirmative procedure does not fill the gap: Parliament can debate the regulations and accept or reject them as a whole, but cannot amend a particular provision while considering them.

A long instrument can combine a sensible objective with an access clause that reaches too far. If Parliament wants to fix that one clause, it may have to defeat the entire instrument. The Government’s case for delegation rests on detail, technological change and the need to update rules. That is a reason to keep interfaces and technical standards adaptable. It does not explain why basic patient rights should arrive later.

The committee went further: it found new section 250E not currently fit for purpose and said it should be removed unless significantly amended.

The launch calendar is ahead of the rights

The Government aims to give some specialties clinical access by mid-2027 and wants all patients in England to see a core set of their data through the NHS App from 2028. Those are forward plans, not live features. Government material also says patients will be able to spot errors and request corrections. The response deadline, reasons for refusal and route for resolving a conflict between the shared record and a source clinical system still need rules and operating procedures.

Put the floor of rights in the Act

The statute should set a minimum: role- and purpose-based access; a patient right to inspect the record and request a reasoned correction within a stated period; an access history patients can understand; named responsibility for investigation, penalties and appeal; and a visible line between direct care and other uses. Regulations can update interfaces, data formats and synchronization intervals. They should not renegotiate the basic floor of patient rights with every update.

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