What does the LMC do?

The LMC is the only elected, representative body of local GP opinion. It has certain statutory duties and must be consulted on certain issues. It exists to represent, advise and support GPs and General Practice.

Click here for the history

Click here for who the Chief Executive and Medical Directors

Parental responsibility - One of my patients is divorcing his wife and has now requested access to his children's medical records. He claims that, although he was unmarried at the time of his children's birth, he acquired parental responsibility for them by subsequently marrying the mother. Is this correct?     

28/04/05
Answer - The natural mother has automatic parental responsibility, unless it is removed by the courts, which is very rare. The father does not automatically have parental responsibility for any of his natural children that were born to his wife before they married.  (The law changed in this respect on 1 December 2003 and since that time a child born to an unmarried father, who agrees to be named as the father on the birth certificate, automatically acquires parental responsibility.)

The father may, however, obtain parental responsibility in a number of ways* including subsequently marrying the child's mother. A father who had acquired parental responsibility in this way would only lose some or all of that responsibility if the court ordered it, or when the child reached the age of 18.

BMA guidance on the subject states quite clearly that 'Both of a child's legal parents have parental responsibility if they were married at the time of the child's conception or at some time thereafter.'

It is important to remember that even quite young children may be 'Gillick Competent' and therefore may have legal capacity to consent or dissent to disclosure of their confidential medical records.  In addition, you must always take into account your legal and professional obligation to act at all times in the child's best interests. 

In a contentious divorce situation it would be worth checking with your medical defence organisation if there is any doubt about the wisdom of providing access to the medical records. 

Acquired parental responsibility

* An unmarried father can acquire parental responsibility by; 

applying for and getting a Residence order
applying to the court for a Parental Responsibility order
making a parental responsibility agreement (in a set procedure) with the mother
being appointed the child's guardian (once the appointment takes effect)
subsequently marrying the mother of the child.
Step-parents do not acquire parental responsibility on marriage, but they do have a responsibility to safeguard the welfare of any step-children in their care, and are responsible for the maintenance of a step-child where a marriage means the step-child is a "child of the family." (ie a child who has been treated as a member of the family. 

A step-parent may acquire parental responsibility by:

obtaining a Residence order
adopting the child.
CED   
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Can I charge interest on late payments from debtors?

The short answer is yes, under certain circumstances.  It would be wise to take individual legal advice in most cases.

http://www.opsi.gov.uk/acts/acts1998/ukpga_19980020_en_1

Copies of records after death - The wife of one of our patients who recently died has asked for copies of her husband's medical records. However, a few months before he died he wrote to us saying that his wife was not to have access to his medical records. May we release them to her now that he is dead? 
                                                                                 (05/05/05) 

Answer - Your legal and professional duty of confidentiality to a patient extends beyond death.  In view of the husband's explicit dissent to disclosure of his medical records to his wife you must maintain his confidentiality. If she needs a copy of the notes to settle a claim arising out of her husband's death the notes may need to be made available. The wife should seek legal assistance and if necessary a court order may be obtained to require disclosure.  In the absence of a court order you should not release the notes without first seeking specific legal advice from you medical defence organisation. 

CED   

Storing police information - What should we do with this and the CYP forms?

The answer is complex* and you can get different answers from different organisations. We recommend the following

• Do not scan the information in but clearly notate the record that a report has been received
• Formulate a practice policy for how to handle these when they arrive, how to store them and how to  ensure when the notes leave the practice that important information is passed on
• the CYP forms are "owned" by the police and copied to Social Services so the original documents maybe retrieved at source at a later date

Examples of practice include:

• keeping the forms in a spearate file and flagging the notes that this exist and ensuring that notes leaving the practice which are flagged carry separately this information
• discussing the forms in the practice partner's meetings and notating the records of the forms receipt and the source of the  report so that future practitioners can obtain a copy should it be necessary

(* for a more detailed discussion of the legalities click here )

Confidentiality and public health information - We have recently received several calls form the public health department asking for confidential patient information. We have refused because they could not provide patient consent. Are we correct to do so?  
                                                                                   (24/03/05) 

Answer - If this is a routine matter where it would be practicable to obtain consent, then you would be right. However, very often the Public Health Department is carrying out their statutory duty to protect the public form a serious health risk.  In this situation consent may well not be practicable within a tight enough time frame.   In those circumstances if disclosure without consent is essential to prevent death or harm to the patient or any other person, or if it  is judged to be overwhelmingly in the public interest, it is almost certainly permissible to disclose sufficient data to serve this statutory function, without consent if necessary.  

One of local Public Health Departments wrote this:

In the course of our work we frequently call GPs' surgeries to check the data we hold or to request additional information. This may be specifically medical, such as patients' vaccination status, or more administrative - checking the right address or asking for a telephone number. Particularly we often need 'phone numbers so that we, or our Environmental Health Officer colleagues, can liaise directly with patients to try to determine the source of infection and - equally important - the possible risks of further transmission (especially from those involved in food handling, patient care etc.).

Wessex LMCS would ask practices to cooperate with public health doctors in such circumstances and to seek advice from their own defence organisation or the LMC if they are unsure.

I have been asked by my local Orthopaedic Consultants to swab Mrs Bloggs for MRSA prior to her hip operation? Am I obliged to do this?

(25/06/08)

Answer - You may if you wish assist a colleague in this matter. However we do not consider this to be part of core services. Further information here