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At the heart of general practice since 1960

Vit E of little help in Ca and CVD prevention

Dr John Clayden may be one of the doctors the BMA is trying to warn if he continues to send a computer printout copy of patients' full medical history to insurance companies when they have applied for life insurance (Letters, July 2).

Supported by research evidence, many of us have recognised for a long time that patients withhold sensitive information from doctors for fear of it being passed on to insurers.

The patients of good doctors who identify risks are disadvantaged by these reports. A mortgage is so essential in the UK that patients cannot be regarded as giving their consent freely. Patients are commonly not aware that information may be used in this way at the time it is divulged to the GP.

It was a step in the right direction in December 2002 when the BMA and the Association of British Insurers jointly published detailed guidance on the provision of such reports confirming that some information must not be included (http://www.bma.org.uk/ap.nsf/Content/Medica · InfoInsurance).

The Data Protection Commissioner's office had previously advised the RCGP that even with valid patient consent,

the Data Protection Act requires

that information released by GPs

must be 'adequate, relevant and not excessive'.

Since that guidance, Dr Clayden and others should not have been releasing information about drinking, smoking and drug use, sexually transmitted infections and their testing, and genetic information ­ all explicitly listed in the guidance.

And there are other sensitive and actuarially irrelevant matters included in the GP records such as abortion, infertility treatment and psychosexual and relationship difficulties that should also be withheld.

There is nothing to prevent the use of specific computer software to generate completed templates for these reports, but the software is not sufficiently sophisticated and the final document must be checked and edited in a word processor by the GP before it is sent.

Dr Philippa Matthews

Birmingham

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