The sceptic's guide to diagnosis

First Edition

HUNDREDS of patients have rung a helpline set up in the wake of the Birmingham cancer misdiagnoses.

Callers are being advised to discuss their worries with their GPs. Surveys have frequently shown that doctors are among the most trusted of public servants. But as the Birmingham case shows, they can make mistakes.

What should patients do if they are worried about the accuracy of a diagnosis? We asked doctors, patients' groups and Community Health Councils for their advice.

1. Ask to see your medical files. Pin-point where you are in terms of treatment and what has been discovered.

The Access to Medical Records Act 1991 allows patients only to see files written after 1 November 1991. Information written before that date can be seen only if the details have been logged into a computer. Doctors have the right to withhold sections of your records without telling you if the information might be 'medically damaging'.

2. Ask your GP for a second opinion. If you are still concerned, ask your GP to speak to the doctor who made the diagnosis.

3. Go to your local Community Health Council if your GP is not supportive. Officers will also advise you on how to get copies of your records from the hospital.

4. If you are still not satisfied, go to the Director of Public Health for your region and invoke the clinical complaints procedure. Two independent consultants will be brought in to look at the medical records and meet you. Patients are not entitled to see an unedited version of their report.

5. As a last resort write to Action for Victims of Medical Accidents for the name of a lawyer experienced in medical negligence litigation. Once proceedings start, you are entitled to full access to all medical records.