Patient data and AI: what GDPR allows in an Irish practice

A referral letter is the most tempting thing in a practice to hand to an AI tool. It is long, repetitive and full of the identifiers the GDPR guards most closely. If you hold HR files rather than charts, read special category data in Irish firms instead.

This one is for GP practices, consultants in private rooms, physios, dentists and practice managers. It works from Irish texts: section 52 of the Data Protection Act 2018, the Health Research Regulations, two statutes on patient numbers, the Medical Council’s Guide, and what the College of GPs, HIQA and the HSE have written.

Section 52 and the lawful basis for patient data in AI tools

Section 52 is the Irish exception for care. Health data may be processed where necessary for preventative or occupational medicine, working capacity, diagnosis, care or treatment, managing health services, or a contract with a health practitioner. Suitable and specific measures are a condition of the exception, written down before the processing starts.

Subsection 2 is where a chatbot struggles. The processing must be done by or under the responsibility of a health practitioner, or someone with an equivalent duty of confidentiality. A provider fits only as your processor under an Article 28 contract; the provider side is in which AI tools meet the GDPR in Ireland.

The word that decides most cases is “necessary”. A model drafting a cardiology referral needs the history and the question. It has no use for the PPS number. Any identifier the model can’t use is, to my mind, a breach of necessity waiting to be found.

In a Word draft the name hides in more places than the body text. Headers, comments and old tracked changes all travel with the file, as redacting a Word document properly shows step by step.

What counts as health data in a referral letter

Article 4(15) defines data concerning health as data about physical or mental health, including the provision of care, that reveals health status. Article 9(1) then prohibits processing it unless an exception applies. Most people stop at the diagnosis. The Regulation doesn’t.

Recital 35 adds details collected when someone registers for care, and any number assigned to identify a person for health purposes. So the IHI and the chart number are health data before any clinical word sits beside them. Swapping the name for a label leaves both, which is why de-identified and anonymised data differ.

The addressee is the line I would worry about. A letter to a named HIV clinic, a fertility unit or a community mental health team tells the reader the diagnosis without writing it down.

The last row is the one practices forget. The Irish identifiers with fixed formats, from PPSN to Eircode, are listed in what personal data to redact before AI.

PPS number and IHI: the patient numbers with laws of their own

Two numbers on an Irish letter carry their own legislation. Section 11 of the Health Identifiers Act 2014, in operation since 31 March 2022, tells a health services provider to ask for the Individual Health Identifier, attach it to the record and indicate it in any relevant communication. The law puts it on the letter.

Section 22 makes it an offence to knowingly process someone’s IHI outside a relevant purpose: up to €100,000 on indictment. Providing care is a relevant purpose. Whether a paste to an outside model still counts, no Irish court has said, and I wouldn’t volunteer to be the test case.

The rules on the PPS number changed in August. Since 17 August 2026, section 12 of the Health Information Act 2026 obliges health services providers to record each patient’s PPSN and link it to every record they make. The background on that number is in whether a PPSN is personal data.

Section 12(6) says a person using the PPSN “in accordance with this Act” commits no offence under section 262 of the Social Welfare Consolidation Act 2005. That shelter covers the Act’s own uses. A prompt is not one of them, so more letters will now carry a number the model never needed.

Medical Council confidentiality rules applied to a chatbot

The Medical Council’s Guide, 9th edition, has applied since 1 January 2024. Paragraph 25.3 says patient consent is required before information is disclosed to others inside or outside the team, except where law or the public interest requires it. Paragraph 27.1 adds that only what is necessary is shared, even within the team.

Paragraph 28.1 is the one a paste has to pass. Before identifiable information leaves the team you need a clear purpose and consent or another legal basis, and four more things. Tick what is true of the tool and the text in front of you.

The Council’s position statement on AI is blunter still. It warns that with public generative AI software, personal information “becomes public domain”, and that patients recorded by an AI tool need to be told how it works. A partner meeting that writes this into the practice’s AI policy saves everyone deciding it letter by letter.

What the HSE, HIQA and the College of GPs say about AI tools

The State is pushing AI into care. AI for Care, the 2026 to 2030 strategy launched on 11 March 2026, lists AI literacy training for HSE staff and large-scale enablement of Copilot Chat. Which Copilot a given account is, and what it keeps, depends on the licence; our Copilot data guide sorts the versions out.

On 29 July 2026 HIQA published national guidance on safe AI use in health and social care, meant for every service, general practice included. It ties AI use to the GDPR, the 2018 Act and the AI Act, whose literacy duty is in our AI Act guide for Irish businesses.

The College of GPs updated its AI paper in September 2026. It still bars patient identifiable information from any general purpose model’s prompt, and adds a word practices will hear more: “shadow AI”, staff using tools nobody approved. A list of approved tools is the cheapest control any practice has.

The survey numbers say why this matters. In the EY and RCPI study of 516 physicians in Ireland, published in April 2026, 58% had used AI in clinical practice in the past year, and 65% believe AI raises the risk of data breaches.

Read together, these papers ask for something a GP surgery can do this month: approved tools, trained staff, and no identifiers in anything general purpose. That is the setting AI tools for Irish GP practices are built for.

Is there a medical version of ChatGPT for Irish practices?

OpenAI now offers health versions of ChatGPT, and they come up whenever someone here asks whether patient data can go into it. Its help centre describes three. On 8 November 2026 each page either limited the product to the United States or named no countries at all.

HIPAA, the US health privacy law the enterprise version is built around, has no force in Ireland. A practice here still needs the Article 28 contract and the section 52 conditions, whatever the US paperwork says.

The other half of these searches comes from patients loading their own records into a chatbot. The GDPR doesn’t reach a purely personal activity, so that is their call. I’d still warn anyone photographing a hospital letter that every number on it goes too, and an uploaded photo can outlive the chat.

An Irish referral letter before and after redaction

Here is an invented GP referral to a cardiologist, the sort a practice might ask a chatbot to tidy. Every name, address and number is made up. We ran the whole letter through Nonimo, and the table shows what the model received for each identifying line: real output, invented letter.

The last row is correct behaviour for a tool that swaps identifiers, yet it still describes one woman in north Mayo. “A woman in her sixties, formerly a teacher, in the west” costs the consultant nothing. That rewrite is the doctor’s call, as is making sure old tracked changes are gone for good.

Hospital letters often arrive as PDFs, where a black box over the name leaves the name inside the file. Before uploading anything, paste the header below and see which fixed-format numbers are still in it.

What a provider receives is read, sometimes by people: Google’s terms allow human reviewers on selected chats, as our Gemini guide quotes.

A report for a solicitor that becomes High Court evidence carries one more duty: the AI declaration under HC 142.

AI scribes, patient consent and health research rules

Three jobs get called “using AI with patient data”, and Irish rules treat each differently. Personal plans run on consumer terms; business plans add the processing contract. Where practice software calls a model itself, Cloudflare’s AI Gateway can flag or block personal data, though it doesn’t swap it out.

Scribes are what patients ask about. Consent isn’t necessarily the legal basis, since section 52 can carry care, but the Medical Council says patients should be told when AI is used in their care. The College of GPs goes further: the GP should give them the chance to decline the scribe.

Health research is where practices get caught out. The Health Research Regulations 2018, S.I. No. 314 of 2018, require ethics approval and, as a rule, explicit consent obtained before the research starts. Comparing an AI tool across many patients’ charts to see whether it improves care can fall inside their definition of health research.

For a practice building its own tools, a prompt screener such as Lakera Guard blocks a call that contains personal data, but puts nothing back into the answer.

Teaching is its own trap. Paragraph 28.3 wants audit and training material anonymised or coded, and the speaker notes of a case presentation are where the name usually survives.

Patient data pasted into a chatbot: breach steps and deadlines

If identifiable patient content has gone into a chatbot on a personal account, treat it as a possible personal data breach. Record what went and when, then delete what the provider lets you delete. A chat can leave a memory or an uploaded file behind, so work through every ChatGPT delete option in order.

Article 33 gives the practice 72 hours from becoming aware, where feasible, to tell the DPC, unless the breach is unlikely to put the patient at risk. With health content, that exception rarely fits. Article 34 adds telling the patient where the risk is high.

The DPC has dealt with a GP on exactly that second step. In one case study a box of over 2,000 files went missing in a move, and the GP first judged the risk low. After the DPC pointed to Article 34, he wrote to every affected patient.

Paper or prompt, the regulator fined the missed 72 hours and the patients who were never told separately. The question of whether a paste is notifiable is worked through in our walkthrough of client data in ChatGPT.

Before the next referral leaves the surgery

The professional rules end in the same place the statutes do: the model gets the clinical question and nothing that points to the person. My suggestion is one paragraph the whole practice signs, and then make it easy to follow on a busy afternoon.

Software can carry the first sentence. Highlight the paragraph on the practice computer, press Nonimo’s key, and names, dates of birth, PPS numbers, the IHI, chart numbers, addresses, Eircodes and contact details become labels before the text reaches the model. Nonimo for Irish practices puts the originals back into your copy of the answer.

The letter never reaches us (our security page has the detail), and the mapping stays on your machine, so the text remains personal data for the practice. Whether section 22 or the Health Research Regulations cover a given project turns on its facts, and that call belongs to your data protection officer or solicitor.

Sources

• GDPR, Regulation (EU) 2016/679. Articles 4(15), 9, 28, 33 and 34; Recital 35.
• European Health Data Space, Regulation (EU) 2025/327. Article 14 priority categories; Article 105 dates of application.
• Data Protection Act 2018, section 52. Health purposes, under a health practitioner or equivalent duty. Health Identifiers Act 2014 (ss. 11, 22) and Health Information Act 2026 commencement read on the same site.
• Health Research Regulations 2018, S.I. No. 314 of 2018. Ethics approval, explicit consent before the research starts; amended by S.I. No. 18 of 2021.
• Health Information Bill 2024, Houses of the Oireachtas. Signed into law on 30 April 2026 as the Health Information Act 2026.
• Medical Council, Guide to Professional Conduct and Ethics, 9th edition. Paragraphs 25.3, 27.1, 28.1 and 28.3.
• Medical Council, position statement on AI. Public generative AI and personal information; informing patients about AI scribes.
• Irish College of GPs, The Use of Artificial Intelligence in Irish General Practice, September 2026. Identifiable information never in a general purpose LLM; shadow AI; vendor checklist.
• HIQA, National Guidance for the Responsible and Safe Use of AI in Health and Social Care Services, 29 July 2026.
• HSE, AI for Care 2026 to 2030. Launched 11 March 2026; staff training and Copilot Chat.
• OpenAI Help Center, Health in ChatGPT. U.S. users only; not for clinical use. The ChatGPT for Clinicians article gives U.S. only, with NPI.
• OpenAI Help Center, ChatGPT for Healthcare. Enterprise product, HIPAA support, sold to hospitals and health systems.
• EY and RCPI, Physician Survey on AI in Healthcare, April 2026. 516 physicians; 58%, 86%, 65% and 93%.
• Data Protection Commission, final decision on the HSE, 2 September 2026. €645,000 and its breakdown.
• Data Protection Commission, case study: a GP moving premises. Article 34 notice to patients; referral to the College’s data protection guideline.

Checked on 8 November 2026.