Access – medical records – disclosure – human rights
A, who had a background of psychological problems, had repeatedly requested access to his medical records, all of which had been made before 1991 and were not subject to the Access to Health Records Act 1990 or the Data Protection Act 1984. Voluntary disclosure of the records was refused by the health authorities. In proceedings for judicial review, Popwell J held that A had no right of access to his medical records at common law and that a refusal to disclose them did not constitute a breach of the provisions of article 8 of the European Convention on Human Rights.
Dismissing A’s appeal against that decision, the Court of Appeal held that a health authority, as the owner of the patient’s medical records, may deny the patient access to them if it is in his best interests to do so.
However, a health authority, and likewise a private doctor, had no absolute right to deal with medical records in any way that it chooses. The doctor’s general duty, likewise the health authority’s, was to act at all times in the best interests of the patient. Those interests would usually require that a patient’s medical records should not be disclosed to third parties; conversely, that they should usually, for example, be handed on by one doctor to the next or made available to the patient’s legal advisers if they are reasonably required for the purposes of legal proceedings in which he is involved. Where disclosure was likely to cause serious harm to the physical or mental health of the patient or any individual, disclosure could legitimately be refused.
The HA’s solicitor had written to the applicant’s legal advisers offering to disclose the records to a medical adviser nominated by the applicant, who would then be in a better position to decide whether and to what extent disclosure could be made to the applicant without causing him harm, which offer A had refused. On the facts, the offer made to A by the HA’s solicitor was a complete answer to his application for disclosure and since the court was satisfied that the HA had done all that was necessary to comply with its duties to A, the judge in the exercise of his discretion had been entitled to refuse the relief sought.