South Africa's Medical Practitioners and Patient Information Access: A Clarification by the Ministry of Health

The right for families to access information about their loved ones in critical care units across South Africa has been a topic recently addressed by the Ministry of Health. In a parliamentary query, Mrs M. O. Clarke brought forward concerns regarding the potential mandate for medical practitioners to use specific documentation processes when interacting with families in the intensive care unit, particularly with the use of forms provided by the Critical Care Society of Southern Africa (CCSSA).

The Health Department clarified that there is no existing agreement that binds medical practitioners to use the CCSSA's counselling session forms, nor is there a requirement for family members to sign any documentation, such as a blank form or a separate hard-cover notebook. This practice aligns with the notion that patient files should be detailed and personalized, containing all relevant patient details.

Regarding the record-keeping process during counselling sessions, it was confirmed that all patient management information should be captured directly in the patient's ICU file, eliminating any need for external notebooks. This standard ensures that all relevant data is contained within the proper medical records.

Family members who participate in counselling sessions with the patient's medical team have the right to review notes that pertain to their loved one's health status. The Ministry underscored that the Promotion of Access to Information Act supports this constitutional right, granting access to pertinent information held by both the State and private entities.

Medical practitioners are expected to grant access to a patient's medical information upon request, adhering to the specific processes stated in the Promotion of Access to Information Act. This means that while families should not be outright denied access to medical records, they must follow the protocols in place to procure such information lawfully.

In cases where there is a perceived or real violation regarding access to a patient’s medical history or records, families are advised to consult the provisions of the Act for proper redress. Additionally, they are encouraged to contact the Health Ombud’s Office to file a complaint or request an investigation into any perceived infringement on their right to access a patient's information.

The Health Department's response reflects South Africa’s commitment to transparent healthcare practices and ensuring the rights of patients and their families are upheld within the framework of existing legislation.