DISCLOSURE OF INFORMATION AFTER THE MAKING OF AN ADOPTION ORDER
In drafting the regulations we considered occasions where access to medical history may be required by an adopted person, such as where information on susceptibility to late onset conditions would be useful, or where such medical information may be required by the adopted person. In considering how the disclosure of this information may be regulated we drafted the following regulation, which is not currently included in this set.
Disclosure of medical information about natural parents after the making of an adoption order
(1) After the making of an adoption order under the Act a registered medical practitioner of the natural parents may disclose to the registered medical practitioner of the relevant child information relating to whether there is any history of genetically transmissible or other significant disease in the family history of either the natural father's or natural mother's family ("the relevant information").
(2) The relevant child's registered medical practitioner may disclose the relevant information to the relevant child where the relevant child has attained the age of 16 years, if in Scotland, or 18 years, if in England or Wales.
(3) In considering whether to disclose the relevant information to the relevant child under paragraph (2) the registered medical practitioner must have regard to the welfare of the relevant child.
(4) Where the relevant child has not yet attained the age of 16 years, if in Scotland, or 18 years, if in England or Wales, the relevant child's registered medical practitioner may disclose the relevant information to the relevant child only if the practitioner thinks it appropriate to do so.
(5) In considering whether it is appropriate to disclose the relevant information to the relevant child under paragraph (4) the registered medical practitioner must have regard to-
(a) the age and maturity of the relevant child; and
(b) the welfare of the relevant child.
(6) Where, under paragraphs (4) and (5), the registered medical practitioner thinks that it is not appropriate to disclose the relevant information to the relevant child, the practitioner may disclose the relevant information to the relevant child's adoptive parents.
(7) In considering whether to disclose the relevant information to the relevant child's adoptive parents under paragraph (6) the registered medical practitioner must have regard to the welfare of the relevant child.
(8) Any relevant information disclosed to the relevant child's registered medical practitioner under this regulation must be treated by that practitioner as confidential.
(9) The consent of the natural parents of the relevant child is not required for any disclosure of relevant information under this regulation.
The provisions of this regulation would allow the GP of the natural parent to disclose information on their patient to the GP of the adopted person without first seeking the consent of their patient. It is envisioned that this disclosure of information would be instigated by the GP of the adopted person in the first instance. This regulation would also provide for that information being disclosed to the adopted person and/or their adoptive parents if it was considered to be in the interests of the child, with consideration to their age and maturity.
However, in discussion with the medical organisations it is clear that there is currently well established guidance and practice for the disclosure of this information. Where disclosing this information is in the best interests of the welfare of the adopted person a GP of the natural parent could disclose this information. The GP would seek the consent of their patient prior to disclosure, however, if this is not forthcoming, and the disclosure of this information is required for the welfare or treatment of the adopted person then this information can be disclosed without consent.
We have not included this regulation in the set of regulations due to the routes already available in terms of disclosing information. Given the established guidance and practice in this regard it is hard to see how the information can be withheld where the welfare and treatment of an adopted person is being considered. In balance it is felt that the consent of the natural parent to the disclosure of any relevant information should be sought first and that the public interest test should be carried out if consent is not forthcoming. It is not our intention to create legislation which could cut across current practice and potentially damage doctor patient relationships and confidentiality. We consider that strong guidance and possibly the issuing of a joint practice note informing GMC members of the new legislation would sufficiently address any issues currently experienced with respect to access to information after an adoption order has been granted.
Q3 - Bearing in mind the current guidance and practice for GPs and the right to patient confidentiality that everyone is entitled to, should this additional regulation be considered for inclusion, or would a joint guidance and/or practice note issued to GMC members be sufficient?