What are you asked on the medicals
It makes sense that prospective adoptive parents need to be both physically and mentally fit. It would be completely detrimental to place a child with someone who will not live to see them into adulthood.
According to the adoption and fostering regulations for England, Northern Ireland, Scotland and Wales, you need to provide the Adoption Agency with proof of your health. Other countries also require medicals to satisfy their adoption regulations. To this effect you will each be asked to have a medical form filled in by you and your GP. This may mean having blood tests and chest x-rays.
The purpose of the report is to obtain accurate and up to date information on your current physical and mental health conditions. This is based on medical examination and medical facts from records, on you and your partner's individual and family health history.
The medical Form AH (2007) from BAAF is the one that it usually used. for prospective adoptive parents. Your social worker may be able to provide you with this form, otherwise you may purchase it here. for £1. It might be a good idea to purchase a couple of forms as you will need to do this medical several times, as it has to be current for 1. Your Homestudy, 2.. The submission of your documents in country 3. The court case in country and 4. The court case in the UK (may not be necessary). Depending on which country you are adopting from, the medical report has to be up to date and not older than 6 months or 1 year depending on country.
I hope you have a good relationship with your GP. If so then they will be happy to fill in the medical form on a double NHS appointment. Other doctors will charge a fee, as they consider filling in a medical for adoption as a non NHS service. 20% VAT will also be charge, so check that it is included in the fee. One doctor has quoted £88.63 for filling in the form. Multiply this by 3 and it is a considerable expense.
Need for the medical
The child who is usually available for adoption will have a history of neglect, abuse, parental substance abuse, dysfunctional families, institutionalisation, and social and behavioural issues. Because of their circumstances, these children have a higher incidence of development delay, may have attachment issues and behavioural issues.
To parent these children you will have to be both mentally, and physically, robust. By providing a medical report the Adoption Agency is able to ascertain if the future well-being of the child is secure.
Health information will form only one part of the process and will be included in the Homestudy. Health issues alone should not prevent approval although it depends what the health issues are. Diabetes and Depression are two areas that the Agency's medical advisor will want to take a closer look.
I know of two potential adopters who have diabetes. One only discovered it though the medical in the process. In the one case the couple were not approved and the other they were approved but with conditions. Depending on the state of the disorder and the way it is managed can make all the difference.
Health related lifestyles will have more impact than your age. If you are a fit and healthy 45-year-old you may have one over a 36-year-old who drinks a lot and hasn't done any physical activity for 5 years. Factors that will be considered are smoking, alcohol consumption, gross obesity, diet and exercise. Your health and lifestyle will be taken into consideration when the adoption agency is assessing you for the demanding role of parenting a child with needs on a daily basis, and the possibility of your retaining good health and vigour until your child reaches adulthood.
The Adoption Agency's Medical Adviser will summarise your medical information which will be included in your Homestudy report and be presented to the panel.
What do they want to know?
The medical report is definitely looking at the interests of the child over that of the adult. The Medical Advisor will be looking out for anything that they feel could have implications for the child. These include any chronic conditions, psychiatric history or treated cancer. They also want to know about your infertility, any reproductive technology attempts, any perinatal loss, or termination of pregnancy.
This is a bit of a Catch 22, as a large proportion of people come to adoption, after all other attempts to bear their own children have failed. Thus, coming into adoption, you have already experienced many years of loss, and being on an emotional roller coaster. Marge and Saun had tried 3 attempts at IVF, each had failed and at this point they started to seriously discuss the idea of adoption. But they thought that they would give the IVF 'one last chance', before they took the plunge with adoption. And when that failed, they called their local authority to start the adoption process - only to discover that they had to wait for the magical 6 months before they start the Homestudy 'as they had experienced loss' and had to overcome that.
Essentially, what is important is that your physical and mental health is good enough to handle the difficulties of bringing up a child, and being able to live until that child is in adulthood. Of course, no one knows what will happen in life - but for the adoption process they have to take a snapshot of the present and a look into the pass to assess suitability.
Mental Health
This is a very tricky area and there seems to be little standardisation about it.
Sheena fest up that she got so depressed at the end of her marriage that she started taking Prozac. She did not think anything about talking about this as the experience had turned her life over and she started a new career as a psychologist. This event had happened 24 years before and she had long since come to terms about the depression, had been off the drugs for 22 years, and considered it a positive event in her life.... She was asked to provide photographs of her arms, so the Medical Advisor could 'see the track marks'. This complete maligning of her character so radically upset her she gave up on her adoption dreams.
The Medical advisor may consult with an adult psychiatrist if they feel that there is a need. They will also refer back to your social worker because they feel she will have an understanding of you through the Homestudy and her interviews with your referees. Any issues of mental health requires careful assessment and further information may be seeked if needed.
In cases of complex health issues, the Medical Advisor or the Social Worker will need to ask you for written permission for further information to be sought.
Who completes the form?
Your agency will fill in Part A and pass it onto you. You will then fill in Part B and give the whole form to the GP. The GP will then fill in Part C and send the entire form to the agency Medical Advisor.
You will required to provide information about your health and lifestyle which will be considered with the information provided by your GP.
Usually your GP will complete section C, unless there are special circumstances and another doctor has more knowledge of your case. Sometimes, it may be necessary to get a supplementary report from a specialist if you have had problems in the past, and want to prove that this will not affect your adoption.
The role of the GP is not to make a decision on your suitability, but to provide enough information for the Agency's Medical advisor to make a judgement on your long-term suitability to adopt a child.
If there are issues that need to be discussed, the GP and the Medial Advisor may need to communicate to clarify issues.
Interpretation of Report by Medical Adviser
The Medical Advisor of your Agency will assess your current health, your lifestyle and your medical history, evaluating them carefully and advising the Agency on the implications of your health history. If you have a condition this does not automatically exclude you, it is the impact on your daily living that will be considered.
Confidentiality
Your Health Report is part of your case record and thus under Regulations should be treated as confidential. You will be reassured that information obtained about you will be kept in the strictest confidence and will only be used for the process of assessment for approval of adoption.
Let me though give you a warning about this - your information will go through the hands of everyone who is involved in your adoption and even some who are not directly involved. From translators, to assistants, to court orderlies. You will hear your 'confidential' information mentioned at the panel meeting, and in a foreign court. When I was concerned about how my son's private information was openly spoken about in the UK court, the judge turned around and said 'Oh don't be so precious, everyone who works in this court can have access to your information' . Warning given - confidential is not really confidential. The only people who are not allowed to see it are likely to be you and your partner! In fact, even though you give permission to the adoption agency to have medical information about you and they are 'permitted' to share this information with anyone on a need to know basis - they are not allowed to share it with your partner. 'The information regarding one applicant is confidential to that applicant and this confidentiality must be respected.' If the information that you provide is of concern to the Medical Advisor as to your suitability he will discuss this with the agency.
Even though Medical reports and all information about you, is subject to the Data Protection Act 1998 (which under section 7, grants you the right to see personal information held about you), this does not apply in the case of adoption. This is because adoption agency records are exempt from the provisions in section 7 about subject access, in terms of the Data Protection (Miscellaneous Subject Access Exemptions) Order 2000 and the Data Protection (Miscellaneous Subject Access Exemptions) (Amendment) Order 2000 (as further amended in 2005).
However, good practice suggests the sharing of as much information as possible, including medical reports.
Medical Sections
Part A
Your details and reason for the medical report ie. adoption as well as the name and address of the Agency and Medical advisor - this is filled in by your adoption agency.
Part B
To be filled in by yourself. Apart from your contact details it asks about:
1. Marital status and relationship history
2. Various questions regarding your health - such as are you on medication? Are you seeing a specialist about anything? How much do you drink? Do you take drugs? What health problems have you had in the past? Have you suffered anxiety, depression, stress? Details of previous. Have you seen any professionals in regard to mental health? Details. Are you on benefits in relation to health?
3. You family and any health or genetic problems.
4. Your exercise, diet, lifestyle. Smoking, drinking and drug history
5. Your consent to use your medical information to assess your suitability for adoption.
PART C
To be filled in by your GP who has to review and comment what you have written in Part B. He also has to give details of how long he has known you and for what he is treating you for.
1. Your medical history going through the body and organs ie. respiratory system, cardiovascular system, nervous system, glands etc. Here they will also ask you about your infertility and any treatment.
2. Your mental health, any visits to specialists, any psychiatric or psychosexual problems, emotional and relationship problems. Your mental and emotional status at the moment and your long-term prognosis.
3. Any other information ie. hospital visits, complaints, injuries, accidents.
4. Investigations that you have had ie x-rays, scans blood tests etc
5. Specialist consultations who have you consulted with, when and why.
6.Physical examination - the doctor will have to give you a through examination. Measurements, pulse, urine and blood samples, chest x-ray, respiratory system, nervous system etc.
7. The GP will be asked if any further medical information or investigation is needed.
8. If relevant a function assessment where the GP will comment how you cope physically and mentally with chronic conditions and how this may impact on parenting capacity.
9. The GP's opinion will be asked if they feel there is something in your lifestyle which might affect your capacity to care safely for a child or which will put a child's welfare at risk.
10. The GP will be asked to comment on your health and lifestyle which might impact on a child. They are not asked to assess suitability - rather to provide accurate information the Medical Advisor can use to inform the agency on your application.
The report will be forwarded to the Medical Advisor who will go through the report and write a summary of your health and lifestyle issues with comments on the significance for adoption. This summary will be recorded in the Homestudy report for the panel.
