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Our survey shows shocking naivety on patient consent

I was interested to read Dr Ian MacGregor's letter (December 1) concerning consent and the view that it is not the GP's responsibilty to ensure patients fully understand what they have signed. With regard to consent, the GMC requires doctors to: 'Be satisfied that the patient has been told at the earliest opportunity about the purpose of the disclosure, the extent of the information to be disclosed and the fact that the relevant information cannot be concealed or withheld.'

We went through the process of checkingsolicitors' consent with the patient as part of a small survey and found a whopping one in three patients had not realised their complete records would be sent, and a number of these refused to give consent for this once they did understand.

Some dropped the cases they were considering, while others felt that given the options of not pursuing the claim they had no recourse but to give consent if they wanted the case to continue.

This would appear to show some patients do feel strongly about this issue even if it means giving up what might be a potentially lucrative case.

Consent is meant to be 'informed' and our survey must cast doubt on whether this is happening when a patient is asked to sign. The variety of wording on consent forms in use is considerable.

The BMA and the Association of British Insurers have produced an excellent consent form which will leave the patient in no doubt about disclosure and which the patient cannot fail to understand.

Vivien Bywater

Practice Manager

Worthing

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Dr Ian MacGregor (Letters, December 1) indicates he sees many more sets of notes that would have cost less than the £50 access fee to photocopy.

Since he is experienced in preparing private medicolegal reports it is particularly unfortunate that he fails to take account of the statutory obligation on GPs to read the whole record to ensure no third-party information is released without appropriate consent and that no information that could prove harmful to the patient is released.

When these factors are taken into account I suspect there are few records that do not merit the £50 fee. Time and again we see no account taken of GP time in costings, and we must avoid shooting ourselves into the foot in this respect.

Dr Steve Haigh

Livingston

Scotland

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