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Making use of the Freedom of Information Act

GPs can use the Freedom of Information Act to their advantage – for example by seeking better treatment for their patients. Dr Peter Saul reports

GPs can use the Freedom of Information Act to their advantage – for example by seeking better treatment for their patients. Dr Peter Saul reports

Two years ago practices were faced with the need to develop policies to comply with the then new Freedom of Information Act (FOI). Most were apprehensive about facing a deluge of requests.

In the event things have been relatively quiet: GPs are traditionally pretty open in providing information to patients and prospective patients. And recently it has become clear that we can use the legislation to our advantage – we can be poachers rather than gamekeepers, evening up the odds with Health Service management.

The FOI places a duty on public bodies such as the NHS or local and national government to provide on request information about their activities. Almost any question can be asked – about finance, for example, or policy, or operational matters. You can ask for data, for copies of reports, for details of emails concerning various topic, for written correspondence…the list is endless.

Obviously some information is exempt. Anything to do with security and defence is classified, and matters concerning private individuals are also confidential. Other types of information have ‘qualified exemption' where the test concerning release is whether the material is in the public interest. Examples here would be the home phone number of the PCT chief executive! Specific exemptions also cover commercial confidentiality.

Still, access to information is pretty wide. So how can the regulations be used by GPs in the interests of patient care?

Simple. Ask a Trust or Primary Care Organisation a question. This will very often result in that body looking again at a decision or policy. And forewarned is forearmed. The ability to obtain information can help level the playing field when arguing a point with such organisations. Often the key can be incorporating the information obtained into your own comments and presenting these to the local media.

I have just used FOI in a case where a patient was turned down for bariatric surgery. In Wales such services are commissioned centrally by Health Commission Wales (HCW). I didn't think my patient was getting a fair deal. He met all the NICE criteria but still HCW refused to fund the operation.

I put in an FOI request which confirmed two things: HCW funding was indeed rare and the commission did not adhere to the NICE recommendations. Armed with that information I can now start causing ‘waves' to change things.

Two other requests to the local Trust are in the pipeline. One is designed to highlight the myriad of different referral forms GPs are faced with when accessing hospital services. The other relates to the profit made on hospital car parking charges.

A more speculative request came to mind recently when I was on duty at the OOH service. The driver complained that he had been caught early one morning by a police speed camera while going to an urgent call. Explanations and a polite request for leniency went unheeded and he had to pay the fine. I wondered if a request asking the force to detail the number of tickets issued to police vehicles and the number subsequently remitted might prove interesting.

I'm not sure that such requests and ‘agitation' will endear you to the authorities. But GPs have to remember their important role as advocates both for patients and delivery of an efficient and effective health service. FOI has a part to play in helping this.

Requesting information

Requests for information under the FOI have to be made in writing (email is fine) and include the name and address of the requester. Under the environmental rules verbal requests can be accepted. It is a good idea to frame your request as specifically as possible. Under the act the public body has a duty to assist people in making such requests, so it can be worthwhile talking to a member of staff with a view to ‘honing' questions. Public authorities have to release the information "promptly" and at the latest within 20 working days unless they need longer to carry out an assessment of the ‘public interest'. In those cases there is no explicit time limit but it has to be ‘reasonable'. They can charge a fee for any photocopying and postage and if the request involves more than £450 worth of administrative time they can charge for this too.

If the body refuses the information it must tell the applicant exactly why. If refused you should first ask for an internal review and if this is turned down go to the Information Commissioner who can look at the case and make a binding decision concerning release.

One of the anomalies with this system is establishing what exactly is classed as a ‘public body'. GP surgeries and dentists are classed as public bodies. So are NHS Trusts and GP OOH Co-ops. But private hospitals and treatment centres and private OOH services are not classed as such. And these are arguably some of the organisations that need most scrutiny.

More information at :

Friends of the Earth

BBC online

Dr Peter Saul is a GP in Rhos, nr Wrexham

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