Are you being heard? The perils of working on the train

Sometimes, I’m a bit nosey. Especially when I am on the train with an hour or two to kill. If I’m on my way to a meeting, I can read my notes, and do some work along the way, but always, in my line of work, ensuring that I keep those notes and work to myself.

Not everyone is the same though: I am always amazed by the number of professionals who are quite happy to discuss their clients’ cases or other confidential information on the phone in a crowded train carriage. I am also amazed at how careless some people are with the papers they spread around the train table as they work during the journey. 

As I said, I’m a bit nosey and if there are papers on the table in front of me, I’m going to read them. I’m also good at reading upside down, so that won’t stop me either. (It’s a handy skill which I’ve used many times in the past). I’ve read business plans, marketing briefs for well known brands, listened in on the details of a very interesting contract dispute (and privately disagreed with the advice being given) and sat through a thorough bollocking being administered on the phone to some hapless junior back in a distant office. 

So, I wasn’t that surprised to find that sometimes people get caught out. The British Medical Journal reports that a consultant forensic psychiatrist who discussed a patient’s medical report with a colleague on a crowded train could be disciplined. The Court of Appeal quashed a High Court injunction which had prevented the Mental Health NHS Trust from convening a disciplinary panel to hear allegations of breach of confidence against the psychiatrist.

The main allegation was that the psychiatrist had the patient’s report on her lap and discussed it with a colleague when the two doctors were passengers on a train in November 2010. Opposite them happened to be sitting the head of secure services policy at the Department of Health. She did not speak to the psychiatrist at the time but later wrote a letter to the patient's hospital, outlining details of the incident, indicating that the patient’s name was clearly visible.

The psychiatrist admitted reading the patient’s notes on the train but said that she had not realised that his name could be seen. She also admitted dictating two reports on the train but she said that she had ensured no other passengers were close by.

Lord Justice Pill, delivering the leading judgment in the Court of Appeal said that a patient’s right to confidentiality “is fundamental in the health service and must be respected by doctors and other staff.”

And that goes for lawyers and other professionals too. When on the train, do not forget where you are: keep your files out of sight and confidential conversations for another time. 

Don’t spill it, zip it.