Trusts and GPs are imposing 'exorbitant' charges on patients seeking access to their medical records, according to a survey of 95 community health councils.
The charges are just one of the obstacles inhibiting access to medical records identified in the survey, which was launched at the annual meeting of the Association of CHCs for England and Wales this week.
Similar findings have emerged from studies by the Audit Commission and the Commons public administration committee.
The ACHCEW survey found GPs charging about£100 - on advice from the British Medical Association - 'just to explain the records to patients', although they are legally obliged to provide such explanations.
Peter Holden, chair of the BMA professional fees committee, said doctors were 'entitled' to charge for explanations over and above what was required in law.
The survey report says Luton and Dunstable Hospital trust asked£108 for access to records from a woman pursuing a complaint when her mother-in law died in hospital after contracting MRSA.
Hospitals and clinics in Oxfordshire were charging a minimum of£25 for the first 25 pages of a document until the CHC intervened. One patient was charged£159.
The report says ministerial advice is that the Access to Health Records Act 'provides only for an application fee of up to£10 and the cost of copying and postage to be charged'.
It claims that the trust argued: 'In order to photocopy records, it is necessary to dismantle them, feed them through a copier, taking special care with overlapping test results, x-ray reports etc, reassemble the records and then check the copies against the originals.
'The copies must then be put in a folder, labelled and sent or handed in sealed envelopes and in strict confidence to the addressee.'
Other obstacles to giving patients the access required in law include delays beyond the recommended maximum of 40 days, missing files, illegible notes and inaccuracies in the records. Many of the 107 trusts covered by the survey had failed to implement Audit Commission recommendations to improve hospital medical records.
ACHCEW director Toby Harris said: 'Many health workers are still genuinely confused about patients' rights - but some are just being downright difficult.'