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HMRC internal manual

Compliance Handbook

How to do a compliance check: establishing the facts: asking for information: medical records

Medical information in itself is not normally relevant to a compliance check. However, some medical professionals keep mixed medical and financial records despite advice from their professional bodies to keep them separate.

Medical records do not include appointment diaries or other records which merely name the patient or client.

You cannot use information powers to obtain medical records, see CH22180.

Any record which contains medical information is very sensitive. Medical information is afforded special treatment under the Data Protection Act 1998 and under Article 8 of the Human Rights Act 1998. It follows that there is a strong presumption in favour of medical privacy.

However, there can be circumstances when in order to make progress in a check into a medical professional’s tax affairs you will require access to documents which contain medical details. For example, financial information may be included on the patient record card which doubles as both a medical and prime financial record.

HMRC’s view is that in principle such records may be required subject to the normal conditions being satisfied. In particular, the documents must be reasonably required. This means that full account must be taken of the sensitivity of the medical information such documents contain.

Therefore such documents should only be considered for production to you if you have established that there is no other effective way in which you could be satisfied that the professional’s tax position is correct. You must not use any medical information that you receive for any other purpose than the check into the professional’s tax return.

Normally you might only request access to patient record cards (or any other documents containing medical information) when you have

  • reason to believe that fees earned and received have been omitted from the professional’s tax return, for example, you have identified weaknesses in the books and records that may have led to an understatement of fees
  • established (at a meeting if necessary) that the patient record cards are prime income records of the practice and the way in which they are used by the business, and
  • established that the patient record cards are the most effective way of working out the true amount of liability.

Given the sensitivity of medical records, before issuing any notice requiring documents containing medical details you should consult and (if required) submit the case to (This content has been withheld because of exemptions in the Freedom of Information Act 2000) . Your submission should give a brief background to the case, including what other steps you have taken to establish the liability, why the documents are vital to your check and an indication of the potential amounts at stake.