'Copying letters to patients is coming to a clinic near you'

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1330
  1. Charles Essex (, consultant neurodevelopmental paediatrician
  1. Child Development Unit, Gulson Hospital, Coventry

    According to the NHS Plan, from April 2004 patients will automatically receive copies of correspondence between health professionals. Although such correspondence would include letters from health visitor to speech therapist, physiotherapist to occupational therapist, and so on, most arguments about the issue have centred on communication between doctors. I suppose that shows who does the work, who carries the can, of whom patients have the highest expectations, and who does most of the things that make a major difference in the care of patients.

    Most of the objections to copying letters to patients have come from three groups: administrators, providers of health services to adults, and mental health professionals (OK, so I generalise, but you get the picture). These are people who have difficulty regarding parents and patients as adults who have autonomy and who can and should take personal responsibility.

    Administrators have lost sight of what our core business is—in my case, to deliver services to children and their families. Professionals in health services …

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