The Patient's Access to Records' Act has been trumpeted by the DOH as giving patients "full access to their health records." It imposes a "duty on all holders of health records to disclose information," says the DOH (our italics). All very admirable and about time too, you might think. The reality, however, is a little less impressive. The Act has serious flaws which water down its provisions and could make them almost impossible to enforce in the face of an obstructive doctor.

The first problem is what the Act doesn't cover. It is not retrospective no health records written before 1 November 1991 are covered. The rationale for this is that doctors may want to temper their comments if they know they may be read by the person they are about. With cases of records including comments like: "Mr X thinks more of his cat than his wife"; and "NFN", which on further investigation turned out to mean "Normal for Norfolk", it is not hard to see why. It is also telling that the British Medical Association felt obliged to advise members that, with the advent of the Act: "Health records should be legible and factual." Presumably, this kind of thing wasn't so important if they were being read only by other doctors.The other omission is records held by practitioners of alternative medicine.

The Act provides for all or part of a record to be withheld if the recordholder thinks it would do you serious mental or physical harm if it were revealed. A doctor can secretly withhold the whole of a record or show you an incomplete record

The Act has been strongly condemned by consumer and medical groups alike for failing to set up a complaints or appeals procedure. Very often, particularly with GPs' notes, it will be the doctor who compiled the record who has sole discretion as to whether or not you can see it. If you suspect information is being wrongly withheld, your only recourse is to go to court. However, because the doctor is not obliged to give you any kind of explanation, you have no way of knowing whether you may be wasting your time and money because he is withholding information correctly under the Act or whether he's simply being bloody minded. Put simply, going to court is the only way you can find out if you've got a case.

Your only other option is to change your GP and reapply for access: it is the current recordholder who decides, without having to refer to any previous holder.