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Are you disciplined about grievances?

Access to the notes of children in care

Q. Two young children registered with our practice are in foster care because there have been problems with the parents. There was recently a case conference where things were said that upset the parents who have since demanded to see their children's records. Are they entitled to access data we hold on their children?

A. The natural mother automatically has parental responsibility and the natural father also has parental responsibility if he was married to the mother at the time of the birth or subsequently acquired legal parental responsibility.

They will retain this responsibility provided the courts have not removed or restricted their responsibility in any way. They may therefore quite legally seek access to their children's medical records under the Data Protection Act and you would be obliged to provide that data within the legal framework of that Act. The social services should know if parental responsibility has been modified or withdrawn by the courts.

Access could probably not be denied under the Data Protection Act unless the GP felt it would cause harm to the children, in which case withholding the data could be permissible in the best interests of the children. Any data relating to a third party must be excluded, unless the third party has given prior consent to disclosure.

Data may also be withheld if it is subject to legal privilege, or if disclosure would impede due process of the law in a criminal prosecution. Social services should know if either of these conditions would apply.

Case conferences are, however, organised by social services as the lead organisation in child protection procedures. It is therefore preferable for social services to be asked to supply a copy of the records of the conference to the parents following their own organisation's data protection protocols and procedures.

It should not be necessary, and is probably not desirable, for the practice to retain and file the whole record of the case conference.

Practices should generally extract information relevant to the ongoing medical care and protection of a child from a case conference report and add this to the medical record, clearly flagging up any problems or potential problems, and recording the fact that the full record of a case conference that took place on a particular date is held by social services.

Parents requesting access to case conference reports should generally be referred to social services. They should have experience of all the relevant legal and procedural issues and should have clearly defined protocols to deal with such requests.

Data from a case conference that has been included in the medical records, with the provisos detailed above, must be disclosed if a parent with legal responsibility requests access. Similarly any data filed at the practice separate from the medical records must also be disclosed under the terms of the Data Protection Act.

It is entirely appropriate that the GP takes full responsibility for those things for which he or she is responsible and refers all other matters through social services as the lead organisation. By indicating clearly to parents that detailed data relating to a case conference may be accessed through social services the doctor will hopefully be seen to be co-operative rather than obstructive.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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