By Luke Gribble, DTI

Dental hygienist fired for breach of patient confidentiality.

GOTLAND, Sweden: The Swedish island of Gotland has been front and centre of the refugee debate after a dental hygienist was fired for releasing the information of an undisclosed number of migrants. With opinions on workers’ rights, human rights, privacy and ethics all being discussed, the case was eventually brought before the Gotland District Court.

Bernt Herlitz is the dental hygienist who released information of an undisclosed number of unaccompanied child migrant patients who were receiving treatment at his then place of employment, Folktandvården. Herlitz was concerned with the age of about 80 per cent of the patients he was treating, believing they were older than 18—the cut-off age to be classified as a child migrant in Sweden.

After attending a seminar on how an individual’s age can be assessed by his or her teeth, Herlitz spoke with Åsa Carlander Hemingway, a unit manager from the Swedish Migration Agency, who told him that all suspicions about the age of unaccompanied refugees should be reported to the government body. Upon returning to work, Herlitz sent several e-mails alerting the migration board of his concerns. Two weeks later, he was suspended pending an investigation and was eventually fired.

Herlitz lodged an unfair dismissal case against the municipality of Gotland and the case was taken to court on 21 June. According to the court transcription, Herlitz and his lawyers argued a number of points, including there being a lack of proper training and protocol on how to deal correctly with such matters, and if a breach of confidentially did take place, there was still a lack of reasoning for the termination of his contract. The municipality argued, among other things, that Herlitz had broken patient confidentially and thus violated the National Board of Health and Welfare’s regulations. It stated that, in addition to written information and instructions, the municipality of Gotland also worked to broaden employees’ knowledge about many issues, including the treatment of patients. The case ended with the court ruling in favour of the municipality on the basis of the dismissal being fair owing to the breach of patient confidentiality. However, it also stated that the termination of Herlitz’s contract had not been absolutely necessary.

Despite winning the case, the municipality of Gotland has decided to appeal the ruling, in the hope of removing any doubt about the termination of Herlitz’s contract. Speaking to Dental Tribune Online, director of health care at the municipality Maria Dalemar said, “We appealed against the verdict to the Labour Court because it is very important to us that our patients feel safe when they receive treatment they have applied for, that integrity is fully respected and that no patient information is disclosed without the patient’s knowledge and absolutely no information that could seriously risk patient safety”.

In a phone conversation with Dental Tribune Online, Herlitz stated that he felt he had partly won and partly lost the case, since he received around €3,500 in compensation, but did not get his job back. “Now, the City of Gotland wants to take the case to a higher court, which could cost me between €100,000 and €150,000 and that is the kind of money that I do not have,” he said. Herlitz continued: “It is a strange situation; I was told what to do by the Swedish Migration Agency and when I did, I was the one in trouble.” According to Herlitz, if the case goes ahead, he may be forced to sell his house to cover legal fees.

Dalemar went on to say that there are proper protocols staff can follow if they have concerns and that patient confidentiality is the law and not a general recommendation, stating it as one of the basic principles in the health care profession. “That’s why the municipality of Gotland has chosen to appeal the verdict to establish that such action is unacceptable for a registered professional in the general health care system,” said Dalemar.

The Swedish Labour Court is due to decide in autumn whether the appeal will be heard.