The BMA General Practioners Committee is aware that many GPs are prioritising their NHS workload over producing private medical reports.
When a court orders a GP to produce a report, however, GPs are essentially required to undertake non-NHS work where they have no obligation to do so - potentially to the detriment of their NHS work.
Refusing to provide a report
Although a GP can refuse to provide a medical report in principle, this could be viewed as being in breach of professional obligations in certain circumstances, such as a fostering report, or a safeguarding report.
A GP may also fall foul of a court if they refuse to provide or facilitate access to the full medical records that would enable completion of the report by another medical practitioner. It does not follow, however, that they can not or will not be the subject of a court order requiring the production of such a report.
Although GPs are not under a statutory or contractual obligation to produce such reports, a court might be inclined to make an order that the relevant authority obtain the medical report from elsewhere. This could therefore place the onus back on the GP to proactively find another health professional with the capacity to produce it.
Medical reports of this nature are not contractual and there is no obligation on GPs to provide them. If a GP does choose to provide one, the GMS contract allows the contractor to "demand or accept (directly or indirectly) a fee or other remuneration".
When a GP may be asked to produce a report by a court
There are a number of reports that GPs are routinely asked to produce, often in collaborative arrangements with local authorities in education, social services and public health.
Collaborative arrangements enable local authorities to secure primary care medical services essential for the provision of education, social services and public health at no charge to the patient. They can include:
- family planning
- psychiatric work
- reports for adoption
- reports for fostering
- children in care and priority housing
- community service certificates for offenders who fail to attend
- visiting medical officers to local authority-maintained establishments
- attendance at case conferences arranged by social services.
Our current guidance sets out that, with the exception of family planning, there are no other nationally-agreed fees for collaborative arrangement work.
Services provided under 'collaborative arrangements' depend on the needs of an area and should be decided at a local level. GPs are therefore advised to set and agree their own fees for this work.