Practice dilemma - Father asks for his daughter's medical record?

The Dilemma: A 12-year-old girl lives with her mother. Her parents separated after an acrimonious divorce.

The father rings the practice and asks if his daughter has recently been to the surgery. He feels that his ex-wife is not looking after her properly. He wants to see his daughter's notes to check that the mother has brought her to the surgery.

Does he have a right to know if his daughter attended surgery, to know why she attended surgery and to see her medical records?

A GP's view - Dr Louise Warburton is a GP in Telford, Shropshire
This is a potentially difficult situation. The father does not have the right to view his daughter's notes, or discuss her medical records without her being present.

The reception staff should not disclose information about another person without explicit consent from the party concerned. Therefore, they should not tell the father if his daughter has been into the surgery or not.

Of course, this may inflame the situation. If the father actually comes to the practice, it may be wise to invite him into a consulting room to explain the situation.

We are not told if the father has visiting rights or access to his daughter. If he does, then he may bring his daughter into the surgery and discuss the situation with a doctor or nurse.

His allegations that she is not being properly cared for can then be addressed.

It may be that he does not have access rights, which could be why he is requesting this information from the practice. In this case, he will have to discuss his allegations with his ex-wife and cannot have access to his daughter's records at this point in time. His allegations may need to be addressed through a solicitor.

If the situation is dealt with in a sensitive manner, then it can be diffused. The father is obviously upset and some sympathetic discussion may be all that is required. There may be a real problem of neglect from his ex-wife and his allegations should be taken seriously. His concerns could be recorded in his daughter's notes for use in the future.

A medico-legal opinion - Dr Roger Palmer is a medico-legal adviser at the MPS
It is never easy to deal with warring parents and they often forget that there is a child involved who is aware of, and influenced by, events happening around them. Your priority is the health and well-being of your 12-year-old patient.

At this point you cannot confirm, nor deny, whether his daughter has attended the surgery without more information. Parental responsibility includes the right to access your children's medical notes, and divorce alone does not change this.

However, from around 12 years of age it is generally assumed that young people may have the capacity to give, or refuse, consent for their parents to access their medical records.

Therefore, before granting the father access to his daughter's records you need to assess her capacity to consent to this disclosure. If she has capacity and agrees, you should disclose the records.

Conversely, if she refuses, you should not disclose the records. If she lacks capacity, you should disclose the records so long as it is in the daughter's best interests or assists the father in discharging his parental duties.

Whatever the outcome, you should discuss the father's request with his daughter and inform her of your decision. It would also be sensible to involve the mother in these discussions.

However, if in light of the father's concerns you believe the child to be at risk of abuse or neglect, you should disclose this information promptly to an appropriate person or authority.

You must document and justify any such decisions and discussions, whether you decide to disclose or not.

A patient's view - Ailsa Donnelly is a member of the RCGP Patient Partnership Group
I don't know the legal situation but the child's welfare and interest must be paramount, particularly if she is being used as ammunition in a parental war. On the information available it is difficult to say where the child's best interests lie.

A lot will depend on how much is known about the family situation. There may be some knowledge in the practice of the divorce. Does the GP know whether the father has any custodial or contact rights, which may affect his right of access to confidential information?

It is significant that the father does not appear to have taken the simple route of asking his daughter. This might indicate that he has no contact with her.

Is there a medical reason why the child should be regularly monitored and reviewed by the GP, which might explain the father's anxiety?

If the father's suspicions are correct, they may act as a useful warning signal. It is also crucial that the GP considers the possibility of child safeguarding issues involving either parent.

If the father is a patient in the same practice, then his health needs (possibly any mental health issues) must also be taken into account.

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