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Practice dilemma: Access to a child's record when parents are separated

A mother and father of two young children that are 5 and 7 have both called the practice asking for information from their children's records. Both of them have said they have sole custody of the children and not to disclose information to the other parent. What should we do?

Dr Daniel Kremer, medicolegal adviser at Medical Protection advises:

In the circumstances that are described, the children are of an age when it can reasonably be assumed that they will not have the capacity to consent to the disclosure of their medical information to either (or both) of their parents.

According to the Children Act 1989, any decision you make must be in the children’s best interests, and in most circumstances, being parented by people who are suitably informed about their medical history will be in the children’s best interests.

Anyone with parental responsibility will therefore, on the face of it, be entitled to a child’s medical information in order to fulfil that responsibility. It is important to understand that a parent may retain parental responsibility even if they are not granted any custody rights.

In order to determine parental responsibility, a good starting point is for the GP to ask to see a copy of the children’s birth certificate. The biological mother of a child will be given parental responsibility, as will the father of a child whose birth was registered from 15 April 2002 in Northern Ireland, from 1 December 2003 in England and Wales and from 4 May 2006 in Scotland if named on the birth certificate. Therefore in this case, if both parents are named on the birth certificate, they would both retain parental responsibility unless it has been removed by the courts or the children have been adopted.  

It seems that at least one parent is not trustworthy, so you may want to investigate further by asking each parent individually where parental responsibility lies. If the stories are consistent with each other, it could be reasonable to rely on them.

You could also ask whether there is any reason why disclosure to the other parent might not be in the interests of the child, but you would need to explain that their views are not determinative of the issue.

If the parents give differing accounts as to parental responsibility, perhaps denying that the other has it, then you can ask them to get their lawyers to write to you with details of who has parental responsibility, which you could rely on as being accurate.

You should not disclose information to one parent that would be confidential to the other (or any other third party identified in the child’s records, other than healthcare professionals involved in the child’s care), or information that might lead to serious harm being caused to someone. For example, if the mother was subject to domestic violence from the father, it would be wrong to disclose the child’s current address, as doing so could reveal the whereabouts of the mother and put her at risk.

Ultimately, it is the GP's decision as to what records are disclosed, and to whom. If the GP concludes it is in the children’s interests, you can disclose information about the children that you deem to be appropriate to a person that you are satisfied has parental responsibility.

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