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Please note that text in red denotes my comments

An article by Adam Raphael in The Observer dated 29/10/89.
Patients must have right to their records.

Lieutenant Robert Lawrence MC, the Scots Guards hero who overcame injuries when half his brain was destroyed by a sniper's bullet in the Falklands, sought his medical records when he emigrated to Australia this summer. The request was refused by the Army, which said whey were 'classified'.

Secrecy over medical records is not confined to the military. Before emigrating to the Netherlands, Mrs Janey Tucker wrote to the Greater Glasgow Health Board asking for her family's health records to be sent to their new doctor in Amsterdam. She was told the records were confidential and the propety of the NHS.

The principle that patients should have the right to know what their doctors record about them is so obvious that it is extraordinary that it has not yet been fully accepted or entrenched in law.

However, a new survey of more than 1,000 doctors, conducted by the Campaign for Freedom of Information, suggests that attitudes are beginning to change. According to the survey, published tomorrow, four out of five GPs questioned would now be willing, if patients asked, to allow them to see their medical records.

A minority (26 per cent) said they would welcome legislation giving patients a non-retrospective right of access. A majority (54 per cent) said they would not object to such a legal right.

But some doctors have criticised traditional practices, saying that witholding information is more to do with doctors' insecurity than with promoting health.

A compelling argument in favour of a legal right to access is that it would enable patients to correct false and inaccurate records which are held about them. One doctor reported that one of his current patients had been described as a 'vicious psychopath' by her previous GP, yet he could see no medical evidence to justify the observation.

Those who are explicitly opposed to a legal right of access - 17 per cent of the doctors surveyed by the Campaign for Freedom of Information - say that it would prevent frank assessment, would inhibit speculative diagnoses, and would be time -wasting.

Many of them also claimed that there is little demand for such information from patients.

One doctor said: 'Many frank comments - "grossly obese, lead-swinger, habitual drunkard, neurotic, probably homosexual, belligerent, wife beater, child abuser" - are relevant and accurate but offensive to patients.' Another doctor said simply: 'I am prepared to tell them what I think they should know.'

Answers such as this surely makes the case for new legislation. The Access to Medical Reports Act, which came into force at the beginning of the year, only gives patients the right to see medical reports provided by their doctor at the request of their employer or an insurance company. The Data Protection Act only provides access to medical records kept on computer files.

The Department of Health has now proposed a further voluntary code under which patients would be able to request information about written medical records. But this falls far short of a legislative right to see everything that is in your medical records.

Certain types of information - touching, say, on third parties - might still have to be restricted. But the general principle of open access should be fought for. If it leads to some restriction on gratuitous wounding comments which pass as medical witticisms, so much the better.



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