When the truth hurts

Mr D contacted his GP requesting a medical report for employment purposes. The patient had a history of alcohol abuse manifest by abnormal liver function tests which were a matter of record in his medical files. Upon making his request he also asked the GP to withhold details of the alcohol abuse, stating: "doctors are entitled to withhold any information which might be harmful to the patient". Mr D worried that if his problems with alcohol were disclosed he could be denied further job promotion.

Analysis and outcome

The GP contacted the MDDUS for an opinion on the matter and one of our medical advisers responded as follows:

In reply to the question about the doctor being entitled to withhold information that might be harmful to the patient the fact of the matter is The Access to Medical Reports Act 1988 says that you may withhold access if disclosure would "be likely to cause serious harm to the physical or mental health of the individual or others" ... It is thus the case that simply because a person might have an adverse outcome of an employer's decision that would not qualify as causing serious physical or mental harm.

Furthermore, the giver of the report must abide by the GMC guidelines which state quite clearly in paragraph 65: "You must do your best to make sure than any documents you write or sign are not false or misleading. This means that you must take reasonable steps to verify the information in the documents, and that you must not deliberately leave out relevant information".

Thus any general practitioner responsible for the patient's care who does a report for employment purpose is given the authority to decide what the report should contain and what it should not contain.

The patient does have some rights in that he may ask to see the report and is entitled to a copy of the report for which a reasonable charge may be made. In addition, if the patient believes the report to be incorrect or misleading he may write to ask the report writer to amend it before it is sent to the applicant.

The writer of the report may refuse to do so but if the patient asks that his comments are attached to the report writer's comments that should be agreeable. The patient also reserves the right to withdraw consent and under those circumstances the report should not be forwarded to the employing agency.

The patient was shown this response and as a result developed a better appreciation of the GP's position on the matter.

Key points

• Information can be withheld but only where 'serious' mental/physical harm will result - not when it would only be uncomfortable or of nuisance value to the employee!
• GMC guidance states you must be 'honest and trustworthy' when writing reports and must not deliberately leave out relevant information - even if this means promotion is denied to the employee.