Russia: Information on medical booklets; procedures to obtain medical records from within Russia and abroad; whether medical records can be obtained through a proxy; if so, requirements and procedures

Medical booklets

According to an ordinance on the provision of primary medical care issued by Russia's Ministry of Public Health and Social Development, "when a citizen turns to a primary medical care institution, the registration office creates a Medical Out-Patient File or a Child Development History" file (Russia 2004). The out-patient file is also referred to as a "medical booklet" (Lawyer 23 Sept. 2011; Russia 27 Sept. 2011) or as a "File" (ibid. 2004). The medical booklet is the "primary medical document of a patient receiving treatment at an out-patient clinic [known as a polyclinic] or at home" (ibid.). The polyclinic keeps just one booklet "for each patient, regardless of the number of physicians from which (s)he receives treatment," in its registration office (ibid.).

In an interview with the Research Directorate, the Head of the Consular Division at the Embassy of the Russian Federation, in Ottawa, indicated both that the booklets are "generally" stored at the polyclinic and that they are organized by a patient's place of residence (ibid. 27 Sept. 2011). The primary care ordinance also specifies that the booklets are classified at the polyclinic according to "healthcare precincts and, within the precincts, by streets, street numbers and apartments; in central district hospitals and rural outpatient clinics, they are classified according to villages and then alphabetically" (ibid. 2004).

The title page of the booklet is completed at the registration office of the health care facility during the patient's first visit (ibid.). It should include information such as the facility's officially registered complete name, a file number based on the file registry system adopted by the facility, and the patient's full name, insurance information, date of birth and permanent address in Russia (ibid.). If a patient does not have a permanent place of residence in Russia, the registered address at which he or she is staying while in Russia is indicated instead (ibid.).

After the booklet has been created by the registration office, it is completed by the "medical practitioner (precinct physician, specialist physician, assistance physician at a healthcare station, general practice physician) who is providing care" (ibid.). According to an official at the Canadian embassy in Russia, "the appearance of medical booklets (with a person's medical history details) can vary from one medical institution to another" (Canada 21 Oct. 2011). He added that although they share some "general requirements," "they can look rather different due to different letterheads [and] paper quality" (ibid.).

The booklets will be transferred from one medical institution to another when an individual moves to a new place of residence (Russia 2004). Moreover, in case of hospitalization at a hospital linked administratively with the polyclinic, the booklet

is transferred to the hospital division and is kept inside the in-patient file. Upon release from the hospital…the [booklet], containing the detailed conclusion from the attending hospital physician, is returned to the polyclinic. (ibid.)

Obtaining medical records from within Russia

Article 31 of the Federal Law 5487-1 of 22 July 1993 on the protection of citizens' health states that

[a] citizen has the right of direct access to medical documentation reflecting his/her health status and to receive consultation on such a documentation from other specialists. At the demand of the citizen, (s)he shall be provided with copies of medical documents that reflect his/her health status, unless interests of a third party are affected in such documents. (Russia 1993, Art. 31)

In order to obtain medical records, an individual must contact a hospital or a clinic personally (Lawyer 23 Sept. 2011; Russia 27 Sept. 2011). The consular head stated that a person can ask for the medical booklet directly from a polyclinic, but only to make a photocopy of the document at his or her own expense (ibid.). Similarly, in correspondence with the Research Directorate, a lawyer from a Kaliningrad law firm stated that a person will only be given a copy of his or her medical records from a polyclinic or a hospital because all the originals are kept at the facility (Lawyer 23 Sept. 2011).

According to the lawyer, a person must first submit a written request before the facility will authorize the release of the records (ibid.). If the request is made to a polyclinic, it has to be addressed to a family doctor (ibid.). If a person needs a copy of the medical records from a hospital, the written request must be addressed to the head physician of the hospital (ibid.; Russia 27 Sept. 2011). The request must include the personal information of the patient, such as his or her full name, date of birth, address, and passport information (ibid). Requestors can grant a relative or other person the authority to act on their behalf through a power of attorney (ibid.). Such authorization must be drafted and signed by a public notary in Russia (ibid.).

Obtaining medical records from abroad

Without providing further details, the lawyer noted that if a person making the request is outside the country, he or she can formally grant another person access to the medical records through the Russian embassy (Lawyer 23 Sept. 2011). The consular head stated that an individual living in Canada can arrange for power of attorney in Russia through a public notary in Canada (Russia 27 Sept. 2011). He explained that after the public notary creates a power of attorney document in Canada, it must be "legalized" by the Department of Foreign Affairs and International Trade Canada (DFAIT) and then forwarded to the Russian embassy for authentication (ibid.). He indicated that the Russian embassy will verify the DFAIT authentication by placing an apostille stamp on the document in accordance with the Apostille treaty drafted by the Hague Conference on Private International Law (ibid.). The document can be picked up at the Russian embassy or the embassy can mail it back to the person provided that a self-addressed envelope is included with the request (ibid.).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of sources consulted in researching this Information Request.

References

Canada. 21 October 2011. Embassy of Canada, Moscow. Correspondence from an official to the Research Directorate.

Lawyer. 23 September 2011. Correspondence with the Research Directorate.

Russia. 27 September 2011. Embassy of the Russian Federation in Canada, Ottawa. Interview by the Research Directorate with the Head of the Consular Division.

_____. 2004. Ministry of Public Health and Social Development of the Russian Federation. "Record Form # 025/Y-04, Medical Out-Patient File: Completion Guide." Translated by the Translation Bureau, Public Works and Government Services Canada. [Accessed 14 Sept. 2011]

_____. 1993. Federal Law 5487-1 of 22 July 1993. Excerpts translated by the Translation Bureau, Public Works and Government of Services Canada. [Accessed 20 Sept. 2011]

Additional Sources Consulted

Oral sources: Attempts to contact representatives from the following organizations were unsuccessful: Health Committee of St. Petersburg; Health Committee of Moscow; Kirov Medical Academy in St. Petersburg; Ministry of Health and Social Development; Mariinkiy Hospital in St. Petersburg; Moscow Helsinki Group; Pirogov Clinic in St. Petersburg; polyclinics in St. Petersburg and Moscow; Radio Free Europe/Radio Liberty (RFE/RL); Russian law firms; Russian State Medical University; and St. Petersburg City Medical Centre.

Internet sites, including: Argumenty i Fakty; Amnesty International; American Medical Center in Moscow; European Country of Origin Information Network; Factiva; Freedom House; Health Committee of St. Petersburg; Health Committee of Moscow; Kirov Medical Academy; Kommersant.ru; Medichelp.ru; Medinfo.ru; Mednorma.ru; Medotrade.ru; Ministry of Health and Social Development; Moscow Helsinki Group; Pirogov Clinic in St. Petersburg; Pravda; Red Cross in St. Petersburg; Rossiyskaya Gazeta; Russian State Medical University; St. Petersburg City Medical Centre; United Nations (UN) - UN Development Program, UN Women; Zdrav.ru; Zentrmedspravok.ru.