Appropriate use of patient data is becoming increasingly difficult to ensure, writes Éibhir Mulqueen
Increasing demands are being made on GPs to release patient data to insurers, health boards, patients' employers and solicitors. As a result, a code of best practice is being drawn up by the Irish College of General Practitioners (ICGP) to clarify the issue of patient records and data protection.
Dr Brian Meade, chairman of the ICGP's Health Informatics Group, says correct use of patient records has become an increasingly complex area. He envisages that it will be at least a year before the code is drafted, following the example of Britain, Australia and Canada. In the meantime, the ICGP has produced a guide on data protection called 'Managing and protecting the privacy of personal health information in Irish general practice'.
"There is an increasing demand for access to GP records. We are now facing dilemmas on an increasing basis as to when and to whom we should provide files."
"There is a general feeling that we need to take stock of it all and decide for ourselves what is appropriate and what is not in the light of recent legislation."
Records are protected by the Data Protection Act, and the Freedom of Information Act governs patients' rights to access these records.
John Sidebottom, a senior executive officer in the Medical Council's Professional Standards Department, says there were six complaints last year relating to patients seeking medical records. None of the complaints was upheld.
According to the ICGP guidelines, when a patient is transferring to another GP, the existing doctor should "facilitate that decision by making available to the patient's new doctor a copy of the patient's health information".
The existing doctor should also retain a copy of the file for a period "consistent with medico-legal and other professional responsibilities".
A more common complaint to the Medical Council relates to practitioners, usually consultant practitioners, failing to provide medical reports for legal cases. There were 17 such complaints last year.
"GPs feel they are being called upon unnecessarily by health boards to validate patients' requests for various health services, for example, for a disabled parking disc or a chair lift.
"I think the health boards could do this for themselves," Dr Meade says.
Another issue of concern is when information on pregnancy is transferred to a local health board office as part of an application under the Maternal and Infant Care Scheme. "If this involves a single mother in a small local area, the fact that she is pregnant or had a baby will be known to local health board officials who may know the girl in question. This is even where the doctor has assured the girl of confidential treatment," Dr Meade says.
Dr Meade believes solicitors are getting unnecessary access to records when, for example, a person is taking a personal injuries case. "Instead of seeking a legal report from the GP, which is expensive, some solicitors making a personal injuries claim seek copies of the records under data privacy legislation. Under this Act, they seek the entire record.
"This will not only get into the hands of the solicitor acting for the patient but under new regulations... can also be passed on to the opposing solicitor."
Another area of concern is the workplace. "I regularly get sick certs sent back to me because they want to know the reason why their employee is off. There is no good reason why an employer needs to know the reason for taking sick leave unless it is occupational or special requirements are required by the company when the person returns to work." He says some GPs are writing down unintelligible diagnoses in these cases. "It is a game and it is wrong."