Access to Health Records and Reports Act 1993

c i e
AT 10 of 1993

ACCESS TO HEALTH RECORDS AND

REPORTS ACT 1993

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c i e
ACCESS TO HEALTH RECORDS AND REPORTS ACT

1993

Index Section Page

1 “Health record” and related expressions .................................................................... 5
2 Right of access to health records ................................................................................... 6
3 Cases where access may be wholly excluded ............................................................. 7
4 Cases where access may be partially excluded .......................................................... 7
5 Correction of inaccurate health records....................................................................... 8
6 Duty of Department etc to take advice ........................................................................ 8
7 Applications to the Court .............................................................................................. 9
8 Avoidance of certain contractual terms ..................................................................... 10
9 Access to medical reports ............................................................................................ 10
10 Interpretation ................................................................................................................. 10
11 Short title etc .................................................................................................................. 11
SCHEDULE 13

ACCESS TO MEDICAL REPORTS 13
ENDNOTES 19

TABLE OF LEGISLATION HISTORY 19
TABLE OF RENUMBERED PROVISIONS 19
TABLE OF ENDNOTE REFERENCES 19

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c i e
ACCESS TO HEALTH RECORDS AND REPORTS ACT

1993

Received Royal Assent: 16 June 1993
Passed: 7 July 1993
Commenced: 1 July 1994
AN ACT
to establish a right of access to health records; to provide for the
correction of inaccurate health records; to establish a right of access to medical
reports prepared for employment or insurance purposes; and for connected
purposes.
1 “Health record” and related expressions

[P1990/23/1]
(1) In this Act “health record
” means a record which —
(a) consists of information relating to the physical or mental health of
an individual who can be identified from that information, or
from that and other information in the possession of the holder of
the record; and
(b) has been made by or on behalf of a health professional in
connection with the care of that individual.1

(2) In this Act “holder
”, in relation to a health record, means —
(a) in the case of a record made by, or by a health professional
employed by, a general practitioner —
(i) the patient’s general practitioner (that is, the general
practitioner on whose list the patient is included); or
(ii) where the patient has no general practitioner, the
Department;
(b) in the case of a record made by a health professional for purposes
connected with the provision of health services by or on behalf of
the Department under the National Health Service Act 2001, the
Department;2

(c) in any other case, the health professional by whom or on whose
behalf the record is held.
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2 Right of access to health records

[P1990/23/3]
(1) An application for access to a health record, or to any part of a health
record, may be made to the holder of the record by[,] where the patient
has died, the patient’s personal representative and any person who may
have a claim arising out of the patient’s death.3

(2) Subject to section 3, where an application is made under subsection (1),
the holder shall, within the requisite period, give access to the record, or
the part of the record, to which the application relates —
(a) in the case of a record, by allowing the applicant to inspect the
record or, where section 4 applies, an extract setting out so much
of the record as is not excluded by that section;
(b) in the case of a part of a record, by allowing the applicant to
inspect an extract setting out that part or, where section 4 applies,
an extract setting out so much of that part as is not so excluded; or
(c) in either case, if the applicant so requires, by supplying him with
a copy of the record or extract.
(3) Where any information contained in a record or extract which is so
allowed to be inspected, or a copy which is so supplied, is expressed in
terms which are not intelligible without explanation, an explanation of
those terms shall be provided with the record or extract, or supplied with
the copy.
(4) No fee shall be required for giving access under subsection (2) other than
the following —
(a) where access is given to a record, or part of a record, none of
which was made after the beginning of the period of 40 days
immediately preceding the date of the application, a fee not
exceeding the prescribed maximum (within the meaning of
section 5 of the Data Protection Act 2002); and4

(b) where a copy or a record or extract is supplied to the applicant, a
fee not exceeding the cost of making the copy and (where
applicable) the cost of posting it to him.
(5) For the purposes of subsection (2) the requisite period is —
(a) where the application related to a record, or part of a record, none
of which was made before the beginning of the period of 40 days
immediately preceding the date of the application, the period of
21 days beginning with that date; and
(b) in any other case, the period of 40 days beginning with that date.
(6) Where —
(a) an application under subsection (1) does not contain sufficient
information to enable the holder of the record to identify the
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patient or to satisfy himself that the applicant is entitled to make
the application; and5

(b) within the period of 14 days beginning with the date of the
application, the holder of the record requests the applicant to
furnish him with such further information as he may reasonably
require for that purpose,
subsection (5) shall have effect as if for any reference to that date there
were substituted a reference to the date on which that further
information is so furnished.
3 Cases where access may be wholly excluded

(1) and (2) [Repealed]6

(3) Where an application is made under section 2(1), access shall not be
given under section 2(2) if the record includes a note, made at the
patient’s request, that he did not wish access to be given on such an
application.7

4 Cases where access may be partially excluded

[P1990/23/5]
(1) Access shall not be given under section 2(2) to any part of a health
record —
(a) which, in the opinion of the holder of the record, would
disclose —
(i) information likely to cause serious harm to the physical or
mental health [or] of any individual; or8

(ii) information relating to or provided by an individual, other
than the patient, who could be identified from that
information; or
(b) which was made before the commencement of this Act.
(2) Subsection (1)(a)(ii) does not apply —
(a) where the individual concerned has consented to the application;
or
(b) where that individual is a health professional who has been
involved in the care of the patient;
and subsection (1)(b) does not apply where and to the extent that, in the
opinion of the holder of the record, the giving of access is necessary in
order to make intelligible any part of the record to which access is
required to be given under section 2(2).
(3) Access shall not be given under section 2(2) to any part of a health record
which, in the opinion of the holder of the record, would disclose —
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(a) information provided by the patient in the expectation that it
would not be disclosed to the applicant; or
(b) information obtained as a result of any examination or
investigation to which the patient consented in the expectation
that the information would not be disclosed.9

5 Correction of inaccurate health records

[P1990/23/6]
(1) Where a person considers that any information contained in a health
record, or any part of a health record, to which he has been given access
under section 2(2) is inaccurate, he may apply to the holder of the record
for the necessary correction to be made.
(2) On an application under subsection (1), the holder of the record shall —
(a) if he is satisfied that the information is inaccurate, make the
necessary correction;
(b) if he is not so satisfied, make in the part of the record in which the
information is contained a note of the matters in respect of which
the information is considered by the applicant to be inaccurate;
and
(c) in either case, without requiring any fee, supply the applicant
with a copy of the correction or note.
(3) In this section “inaccurate” means incorrect, misleading or incomplete.
6 Duty of Department etc to take advice

[P1990/23/7]
(1) The Department shall take advice from the appropriate health
professional before it decides whether it is satisfied as to any matter for
the purposes of this Act, or forms an opinion as to any matter for those
purposes.10

(2) In this section “the appropriate health professional” (except in relation to
the Department where it is the holder of the record by virtue of
section 1(2) (a)) means —
(a) where, for purposes connected with the provision of health
services by the Department, one or more medical or dental
practitioners are currently responsible for the clinical care of the
patient, that practitioner or, as the case may be, such one of those
practitioners as is the most suitable to advise the Department on
the matter in question;11

(b) where paragraph (a) does not apply but one or more medical or
dental practitioners are available who, for purposes connected
with the provision of health services by the Department, have
been responsible for the clinical care of the patient, that
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practitioner or, as the case may be, such one of those practitioners
as was most recently so responsible;12

(c) where neither paragraph (a) nor paragraph (b) applies, a health
professional who has the necessary experience and qualifications
to advise the Department on the matter in question.13

(3) In this section “the appropriate health professional”, in relation to the
Department where it is the holder of the record by virtue of
section 1(2)(a), means —
(a) where the patient’s most recent general practitioner is available,
that practitioner;
(b) where that practitioner is not available, a registered medical
practitioner who has the necessary experience and qualifications
to advise the Department on the matter in question.
7 Applications to the Court

[P1990/23/8]
(1) Subject to subsection (3), where the High Court is satisfied, on an
application by the person concerned within such period as may be
prescribed by rules of court, that the holder of a health record has failed
to comply with any requirement of this Act, the Court may order the
holder to comply with that requirement.
(2) Where the holder of a health record decides whether it is satisfied as to
any matter for the purposes of this Act, or forms an opinion as to any
matter for those purposes, the powers of the court under subsection (1)
include power to review that decision or opinion, and to make any order
incidental to such a review.
(3) The Court shall not entertain an application under subsection (1) unless
is it satisfied that the applicant has taken all such steps to secure
compliance with the requirement as may be prescribed by regulations
made by the Department.
(4) For the purposes of subsection (3), the Department may by regulations
require the holders of health records to make such arrangements for
dealing with complaints that they have failed to comply with any
requirements of this Act as may be prescribed by the regulations.
(5) For the purpose of determining any question whether an applicant is
entitled to be given access under section 2(2) to any health record, or any
part of a health record, the Court —
(a) may require the record or part to be made available for its own
inspection; but
(b) shall not, pending determination of that question in the
applicant’s favour, require the record or part to be disclosed to
him or his representatives whether by discovery or otherwise.
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8 Avoidance of certain contractual terms

[P1990/23/9]
Any term or condition of a contract shall be void in so far as it purports to
require an individual to supply any other person with a copy of a health record,
or of an extract from a health record, to which he has been given access under
section 2(2).
9 Access to medical reports

The Schedule shall have effect for the purpose of establishing a right of access
by individuals to reports relating to themselves provided by medical
practitioners for employment or insurance purposes.
10 Interpretation

[P1990/23/1, 2 and 11]
In this Act —
“application
” means an application in writing, and “apply
” shall be construed
accordingly;
“care
” includes examination, investigation, diagnosis and treatment;
“child
” [Repealed]14

“the Department
” means the Department of Health and Social Care;15

“general practitioner
” means a medical practitioner who is providing general
medical services in accordance with arrangements made under section 27
of the National Health Service (Isle of Man) Act 1948;
“health professional
” means any of the following —
(a) a registered medical practitioner (including any person who is
provisionally registered under section 15 or 21 of the Medical Act
1983 (an Act of Parliament) and is engaged in such employment
as is mentioned in section 15(3) or 21(3) of that Act);
(b) a registered dentist;
(c) a registered nurse or midwife;
(d) a member of a profession related or supplementary to medicine
and specified in regulations made by the Department for the
purposes of this definition, who fulfils such conditions (as to
registration or otherwise) as may be so specified.
“health record
” and “holder
” (in relation to a health record) have the meanings
given by section 1;
“information
”, in relation to a health record, includes any expression of opinion
about the patient;
“make
”, in relation to a health record, includes compile;
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“patient
”, in relation to a health record, means the individual in connection
with whose care the record has been made.
11 Short title etc

(1) This Act may be cited as the Access to Health Records and Reports Act
1993.
(2) This Act shall come into operation on such day or days as the
Department may by order appoint.16

(3) Regulations under this Act shall not have effect unless they are approved
by Tynwald.
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SCHEDULE

ACCESS TO MEDICAL REPORTS

[P1988/28/1-9] Section 9
Interpretation
1. (1) In this Schedule —
“the applicant
” means the person referred to in paragraph 3(1);
“employment purposes
”, in the case of an individual, means the purposes in
relation to the individual of any person by whom he is or has been, or is
seeking to be, employed (whether under a contract of service or
otherwise);
“insurance purposes
”, in the case of an individual, means the purposes in
relation to the individual of any person carrying on an insurance
business with whom the individual has entered into, or is seeking to
enter into, a contract of insurance, and “insurance business
” and
“contract of insurance
” have the same meanings as in the Insurance Act
2008;17

“medical practitioner
” means a registered medical practitioner;18

“medical report
”, in the case of an individual, means a report relating to the
physical or mental health of the individual prepared by a medical
practitioner who is or has been responsible for the clinical care of the
individual.
(2) Any reference in this Schedule to the supply of a medical report for
employment or insurance purposes is a reference —
(a) to the supply of such a report for employment or insurance
purposes which are purposes of the person who seeks to be
supplied with it; or
(b) (in the case of a report that has already been supplied) to the
supply of such a report for employment or insurance purposes
which, at the time of its being supplied, were purposes of the
person to whom it was supplied.
(3) References in this Schedule to giving an individual access to a medical
report or to a copy of it are to —
(a) making the report or a copy of it available for his inspection, or
(b) supplying him with a copy of it,
and where a copy is supplied at the request, or otherwise with the consent, of the
individual the medical practitioner in question may charge a reasonable fee to cover
the cost of supplying it.
Schedule
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(4) Any notification required or authorised to be given under this Schedule
shall be given in writing, and may be given by post.
Right of access
2. It is the right of an individual to have access, in accordance with this Schedule
to any medical report relating to the individual which is to be, or has been, supplied by
a medical practitioner for employment purposes or insurance purposes.
Consent to applications for medical reports
3. (1) A person shall not apply to a medical practitioner for a medical report
relating to an individual to be supplied to him for employment purposes or insurance
purposes unless —
(a) that person (“the applicant”) has notified the individual that he
proposes to make the application; and
(b) the individual has notified the applicant that he consents to the
making of the application.
(2) Any notification under sub-paragraph (1)(a) must inform the individual
of his right to withhold his consent to the making of the application, and of the
following rights under this Schedule —
(a) the rights under paragraphs 4(1) to (3) and 6(2) with respect to
access to the report before or after it is supplied;
(b) the right to withhold consent under paragraph 5(1); and
(c) the right to request amendment of the report under
paragraph 5(2),
as well as of the effect of paragraph 7.
Access to reports before they are supplied
4. (1) An individual who has given his consent under paragraph 3 to the
making of an application is entitled, when giving his consent, to state that he wishes to
have access to the report to be supplied in response to the application before it is so
supplied; and if he does so, the applicant shall —
(a) notify the medical practitioner of that fact at the time that the
application is made; and
(b) at the same time notify the individual of the making of the
application;
and each such notification shall contain a statement of the effect of sub-paragraph (2).
(2) Where a medical practitioner is notified by the applicant under sub-
paragraph (1) that the individual in question wishes to have access to the report before
it is supplied, the practitioner shall not supply the report unless —
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(a) he has given the individual access to it and any requirements of
paragraph 5 have been complied with; or
(b) the period of 21 days beginning with the date of the making of the
application has elapsed without his having received any
communication from the individual concerning arrangements for
the individual to have access to it.
(3) Where a medical practitioner —
(a) receives an application for a medical report to be supplied for
employment purposes or insurance purposes without being
notified by the applicant as mentioned in sub-paragraph (1), but
(b) before supplying the report receives a notification from the
individual that he wishes to have access to the report before it is
supplied,
the practitioner shall not supply the report unless —
(i) he has given the individual access to it and any
requirements of paragraph 5 have been complied with, or
(ii) the period of 21 days beginning with the date of that
notification has elapsed without his having received (either
with that notification or otherwise) any communication
from the individual concerning arrangements for the
individual to have access to it.
Consent to supplying report and correction of errors
5. (1) Where an individual has been given access to a report under paragraph 4
the report shall not be supplied in response to the application in question unless the
individual has notified the medical practitioner that he consents to its being so
supplied.
(2) The individual is entitled, before giving his consent under sub-
paragraph (1), to request the medical practitioner to amend any part of the report
which the individual considers to be incorrect, misleading or incomplete; and, if the
individual does so, the practitioner —
(a) if he is to any extent prepared to accede to the request, shall
amend the report accordingly;
(b) if he is to any extent not prepared to accede to it but the
individual requests him to attach to the report a statement of the
individual’s views in respect of any part of the report which he
declines to amend, shall attach such a statement to the report.
(3) Any request made under sub-paragraph (2) shall be made in writing.
Schedule
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Retention of reports
6. (1) A copy of any medical report which a medical practitioner has supplied
for employment purposes or insurance purposes shall be retained by him for at least 6
months from the date on which it was supplied.
(2) A medical practitioner shall, if so requested by an individual, give the
individual access to any medical report relating to him which the practitioner has
supplied for employment purposes or insurance purposes in the previous 6 months.
Exemptions
7. (1) A medical practitioner is not obliged to give an individual access in
accordance with paragraph 1(3) to any part of a medical report whose disclosure —
(a) would in the opinion of the practitioner be likely to cause serious
harm to the physical or mental health of the individual or others,
or
(b) would indicate the intentions of the practitioner in respect of the
individual.
(2) A medical practitioner is not obliged to give an individual access in
accordance with paragraph 1(3) to any part of a medical report whose disclosure
would be likely to reveal information about another person, or to reveal the identity of
another person who has supplied information to the practitioner about that individual,
unless —
(a) that person has consented, or
(b) that person is a health professional who has been involved in the
case of the individual and the information relates to or has been
provided by the professional in that capacity.
(3) Where it appears to a medical practitioner that sub-paragraph (1) or (2) is
applicable to any part (but not the whole) of a medical report —
(a) he shall notify the individual of that fact, and
(b) references in the foregoing provisions of this Schedule to the
individual being given access to the report are to his being given
access to the remainder of it.
(4) Where it appears to a medical practitioner that sub-paragraph (1) or (2) is
applicable to the whole of a medical report —
(a) he shall notify the individual of that fact, but
(b) he shall not supply the report unless he is notified by the
individual that the individual consents to its being supplied;
and accordingly, if he is so notified, the restrictions imposed by paragraph 4(2) and (3)
on the supply of the report do not have effect in relation to it.
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Application to the Court
8. (1) If the High Court is satisfied on the application of an individual that any
person, in connection with a medical report relating to that individual, has failed or is
likely to fail to comply with any requirement of this Schedule, the Court may order
that person to comply with that requirement.
(2) Where a medical practitioner forms an opinion for the purposes of
paragraph 7(1)(a), the powers of the court under sub-paragraph (1) include power to
review that opinion, and to make any order incidental to such a review.
Transitional provision
9. Nothing in this Schedule applies to a medical report prepared before the
commencement of this Schedule.
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ENDNOTES

Table of Legislation History

Legislation Year and No Commencement






Table of Renumbered Provisions

Original Current






Table of Endnote References

1
Subs (1) amended by Data Protection Act 2002 Sch 13. 2
Para (b) amended by National Health Service (Amendment) Act 1995 Sch and by
National Health Service Act 2001 Sch 4. 3
Subs (1) amended by Data Protection Act 2002 Sch 13. 4
Para (a) amended by Data Protection Act 2002 Sch 12. 5
Para (a) amended by Data Protection Act 2002 Sch 13. 6
Subss (1) and (2) repealed by Data Protection Act 2002 Sch 13. 7
Subs (3) amended by Data Protection Act 2002 Sch 12. 8
Subpara (i) amended by Data Protection Act 2002 Sch 13. 9
Subs (3) amended by Data Protection Act 2002 Sch 12. 10
Subs (1) amended by National Health Service (Amendment) Act 1995 Sch. 11
Para (a) amended by National Health Service (Amendment) Act 1995 Sch. 12
Para (b) amended by National Health Service (Amendment) Act 1995 Sch. 13
Para (c) amended by National Health Service (Amendment) Act 1995 Sch. 14
Definition of “child” repealed by Data Protection Act 2002 Sch 13. 15
Definition of “the Department” amended by SD155/10 Sch 4 and by SD2014/08. 16
ADO (whole Act) 1/7/1994 (SD188/94). 17
Definition of “insurance purposes” amended by Insurance Act 2008 Sch 8. 18
Definition of “medical practitioner” amended by Health Care Professionals Act 2014
s 14.