Prevention not Punishment graphic

For health workers, the Police, Crime, Sentencing and Courts (PCSC) Bill’s ‘Serious Violence Duty’ is a major cause for concern, as it proposes new obligations to share confidential patient information with the police. As the government seeks to extend policing into spaces of healthcare, co-opt the language of public health, and introduce new practices which will worsen social inequalities rather than resolve them—resistance from the health community is vital.

This week, the PCSC Bill will progress to committee stage in the House of Lords. Despite mass public protest and widespread opposition from human rights, public health and civil society organisations, the government continues to push ahead with plans to expand police presence and powers across public life. 

The PCSC bill threatens a range of civil liberties. As outlined by Liberty’s most recent briefing, the bill will impose serious restrictions on the right to protest, increase targeted criminalisation of Gypsy, Roma and Traveller communities’ way of life, and strengthen police stop-and-search powers. This legislation will undoubtedly have devastating impacts, particularly for minoritised communities who experience disproportionate policing and criminalisation. 

Policing powers undermining patient confidentiality

Crucially for health workers, the bill will introduce dangerous new obligations to share patient data with the police as part of the proposed Serious Violence Duty (SVD), detailed in Part 2 of the bill. These duties will require health workers, education providers, youth workers and local authorities to share information with the police, and allow the police to override data protection and confidentiality obligations upheld by our health and public services.

The Serious Violence Duty has been spuriously presented as a public health approach to safety. However, as outlined in Medact’s recent briefing for Lords, we know from similar programmes such as Prevent that the duty will, in practice, enable the police to override data protections, undermine confidentiality and erode public trust in health services by requiring health workers to share confidential patient information. This will undermine public health rather than strengthen it.

The government’s National Data Guardian, Dr Nicola Byrne, recently expressed “significant concerns” about the PCSC bill’s implications for patient confidentiality. Appointed by the health secretary to maintain independent oversight of patient data usage in the NHS, Dr Byrne stated:

Whilst tackling serious violence is important, it is essential that the risks & harms that [the serious violence] duty pose to patient confidentiality, and thereby public trust, are engaged with and addressed.

If unaddressed, Byrne expressed concern that the bill will “erode trust and confidence, and deter people from sharing information and even from presenting for clinical care.” 

Antithetical to public health

Alongside Liberty and the British Association of Social Workers, Medact organised a letter to Home Secretary Priti Patel, signed by over 660 GPs, nurses and social workers, warning against the bill’s serious violence proposals. The letter draws directly on the knowledge of frontline workers, who stress the importance of trustworthy relationships between public services providers and the people they support. Health and social workers also highlight that the bill’s supposed ‘public health approach’ to serious violence is in actuality police-led – directing people away from public services and into encounters with the police.

On top of the proposed SVD, part 10 of the bill proposes Serious Violence Reduction Orders (SVROs) which would in effect make previous conviction alone enough justification for police to target individuals for stop and search. By the government’s own admission on p.15 of its public consultation, “a disproportionate number of Black people… Black males in particular” are likely to be subject to SVROs. The government itself even recognised that “ethnic minorities who are subject to an SVRO are more likely to be searched in practice.” SVROs will likely deepen racist predictive policing practices – disproportionately targeting Black men, and subjecting the same minoritised communities to heightened police presence.

Both the SVD and SVROs will serve to embed discrimination and worsen existing societal inequality – tackling symptoms not causes, and leading to punishment not prevention. Public health approaches seek to reduce risk factors for violence by deploying evidence-based solutions addressing root causes. By contrast, the PCSC Bill’s approach to serious violence relies on criminal law enforcement measures with no evidence of benefits to public health.

A truly meaningful approach to addressing serious violence will not be rooted in the punitive responses of policing. A public health approach to serious violence would not respond with further social harm, but instead seek to divert people away from the criminal legal system entirely—aiming to address the social and economic issues at the root of social harm, and redress the unmet needs of chronically under-resourced communities.

The Serious Violence Duty should be understood as part of the government’s growing efforts towards the securitisation of healthcare. As witnessed in the harms of the Prevent Duty and hostile environment policies within the NHS, the Serious Violence Duty is another overt attempt by the Home Office to use the NHS in order to expand its powers and remit.

Everyone committed to public health must resist the PCSC bill and all future attempts by the government to increase police powers under the guise of ‘public safety’. As health workers, we must interrogate and challenge the government’s increasing co-optation of public health language. We’ve seen how the Prevent duty has caused harm to both health workers and patients alike – resisting further securitisation efforts is an essential part of our work.

On Monday 15th November at 7pm, we will be launching a new briefing ‘The Public Health Case Against the Policing Bill’. Developed by the Medact Research Network (MRN), the briefing will explain why the measures proposed in the PCSC bill will harm public health and entrench discrimination.

RSVP to the briefing launch event here!

For the launch, we’re delighted to be joined by health workers from the MRN and a line-up of brilliant speakers. Together, we’ll outline the public health case against the bill and explore alternative responses to serious violence which truly centre health for all.

Sarah Lasoye