Medical confidentiality?

Discussion in 'Professionally Qualified, RAMC and QARANC' started by Green_Homer, Mar 20, 2006.

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  1. Just a question on how medical confiedentiality is treated in the forces.
    I am currently serving in the TA and feel that I am suffering from acute depression from my civvy life. I do not feel that I present any danger to myself or others when on training weekends as I tend to feel like I am being productive although I do sometimes remain silent which I feel has led to me being overlooked for promotion which is thus further contributing to my condition.

    I would like to get professional help or at least advice however I am worried that if I contact my GP then it will be recorded on my medical files which the Army can then see, which may then either brand me as not being caperble and further overlooked or worst case medically discharged.

    Can anybody advise me on this matter?

    I hope that it is appreciated that this was not easy for me to ask, but this seems to be the best way to get advice on this specific matter without going official.
  2. Don't hesitate in seeking appropriate support from your GP. In a lot of cases of depression, a lot can be achieved by simply talking things through, and this should have no impact on your medical records. Making the first move is often half the battle.

    There are a few issues surrounding medical confidentiality within the Army which you should be made aware of, so please feel free to PM me.

    Good luck.
  3. It is supposed to be treated very seriously in the forces, but whether or not units actually lock away F/Med/4's etc is an other issue. Could you not just see a civy doc about it and not tell the TA? If you or your Doc feels that there may be a need to tell your unit then tell them, if not, and if you are dealing with it with your Doc, then I can see no need to tell your unit. But I'd definatly ask your Doc or who ever it is that you see whether they think it would be apropriate. Explain to them why you feel it may be a good idea and a bad idea and talk it throuh with them.
    Hope this helps.

    T C
  4. Percy_Pigeon

    Percy_Pigeon War Hero Book Reviewer

    Just a point from a manager’s point of view.

    In my last posting I was a WO2 employed as a troop commander (large troop of around 90 bods). There were a number of soldiers suffering from depression mental illness and severe injuries.

    These soldiers were sent to work with no details on how I could employ them, this I found unacceptable and requested some details on what they can and cant’s do.

    The sick chits were at best vague. In this I had the support of the SSM, OC RSM Adjt and the CO and the practice manager.

    But still the doctor hid behind the Medical in confidence rules. I had a chat with the doctor and expressed my concerns and my intention to challenge his decision as part of my duty of care.

    As it turns out I was under employing 2 soldiers and over employing 5 these were reviewed and a little more detail was forthcoming in there employability.

    In essence managers require some details on how to manage/employ ill soldiers to ensure they are not put in further danger. Sometimes you need this information to save an ill soldier from themselves.

    Clinical governance rules are not as clear as they should be and manager's need more help than the no marching no PT no duties that is being provided at the present time
  5. If you think you are unwell, the priority is to get help. Your GP is the best starting point; discuss your concerns about the TA with him. The initial treatment in most depression is with medication, and this may impact upon what you can do with the TA. Identifying that you may have a problem and asking for help is often the hardest part - and you've done that.

    I would not advocate concealing the situation from the TA; just as they have a duty to respect your confidentiality (within guidelines), so you should disclose information that will help them to help you - see Percy's post above. I cannot imagine that you would want to be put in a position where you or others are put at risk, however unwittingly. A letter from your GP detailing any restrictions may help.

    If you want to know more about depression, treatment and so on, have a look at
  6. Good job, Percy P. A lesson to LMs everywhere.

  7. Thanks for all the replies,

    All points taken aboard including telling the TA. Just returned from a drill night where I broached the subject with a friend to guage the reactions and it went pretty positivly.
    I have also taken steps within my civvy "job" (student) so as to see what help I can get on that front.
    As far as officially telling the TA I am going to wait out on that one just a bit longer untill I have spoken to my GP but I do see the need to tell them.

    I remember reading an article in Soldier Magazine about physcological help within the forces and the official line seemed to be that it does not neccesarily mean being downgraded in anyway. However I have also seen about how it seems to be a lot different with the TA due to the part time nature, does anybody know if the TA can get the same welfare support as the regulars in sitiutations like mine?

    Overall I really mean the thanks, your replies have given me the confidence to start actually taking action albeit a bit slowly to start with!
  8. Green homer,
    The Army employ numerous amounts of CPNs, who are trained in such cases as yours. They are military mental health nurses with military training and are there to help our soldiers. They will treat you and your problem as they would any regular soldier. Medical in confidence is a strict rule in the AMS, and if it is breached, it can result in discharge.
    I'm glad you are seeking hel. Please do not be afraid to approach your unit MO or medic about this. They will be helpful and point you in the right direction.
  9. Its not uncommon to suffer from depression as a student, so I am sure the Army will be ok with that. And I bet there are more than a handfull of officers who would have suffered the second year blues - so your main priority is to get help.

  10. You don't get the same unless you are mobilised or on FTRS or similar. What kind of welfare support do you think you might need? PM me, in confidence, if you like. I should be able to point you in the right direction - as may others working in the med/welfare field.
  11. If it gets that bad, you can always contact your local crisis team/mental health team who can help you - without a GP's referal.

    Also, you can get this sorted without involving your GP - get in contact with your student counseling service who may be able to help you.
  12. As far as I'm aware the Army can't view your records (especially if you are TA), all the TA is bothered about is your vacination records (if I am wrong then please shoot me down). However that will change over the next few years if you are mobilised the Forces will through 'Connecting for Health and DMiCP' have access to your medical records.
  13. Thanks again all

    Am going to see one of the student counselers once Iv got a few things out of the way, hopefully they can help by maybe helping with my workload which is a rather unpleasent distraction on top of all this!! I thought that maybe if I went via the TA then it might get handled a bit better when dealing with my unit (?) Don't think I can easily get hold of our MO as Im a in a detachment platoon away from Coy and Battalion HQ, though we do have a civvy Dr that comes over to do medicals occasionally.

    As far as the Army reading my medical records, I remember having to sign something giving them permission to see them or something (Can't remember too much was just over 4yrs ago!!). Im just worried that they may see it as black and white rather then something that I can work out of
  14. It isn't a question of hiding. You have to remember that the MO has to answer not only to the chain of command, but to the Civil Courts and the GMC as well, and Breach of Confidentiality can be punishable by being struck off the medical register with the attendent loss of livelihood.

    MOs are in a pretty much unique position of being not only GPs (pukka or de facto) to the individual, but also the Occupational Health doctor for the Unit, and as such are often caught between 2 conflicting requirements. Needless to say the guidelines to help resolve this issue are as good as useless where they exist at all. Technically a soldier's informed consent, preferably in writing, is required before divulging any information beyond the absolute basics. The sick-chit does not, and cannot, cover all eventualities, especially if the MO may only have a passing familiarity with all the possible duties that a soldier can be employed on.

    Most good MOs will have absolutely no problem with a phone call or an office call to discuss the duties that the soldier in question can and cannot undertake. That way, you know what he can do, and the MO doesn't have to put his arse above the parapet to have it shot off if the soldier in question takes umbrage or goes for a compensation claim.

    Again, most good MOs appreciate the difficult balance between the medical needs of the individual and the operational needs of the Unit, but this IS an aquired skill, and only comes with time and practice, especially if the MO is a GDMO fresh out of Sandbags. Don't be too quick to blame the MO if you don't know how you can employ a biff soldier. As a man-manager it is YOUR job to find out, and it is the MOs job to help you come up with appropriate duties to keep the soldier healthily and appropriately employed until such time as he is fit to return to full duties, permanently downgraded, or P8 discharged.