This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GP contract may ban charging for domestic abuse reports

The Government is looking to ban GPs from charging patients for domestic abuse letters, the health and social care minister has said.

Health minister Lord O'Shaughnessy told the House of Lords last month that the 'Government are committed to dealing with this issue'.

And he said it would be considered as part of the GP contract negotiations for 2019/20.

At present, the GMS contract does not fund practices for issuing such letters, meaning that unless GPs charge for the related work they are providing the service pro bono.

The Lords debate on 15 November heard that victims of domestic abuse often need to provide evidence when applying for legal aid and that in some cases GPs charge over £150 for such a letter. 

Lord O'Shaughnessy told the House of Lords: 'I feel uncomfortable with the idea of these letters being charged for. They have been identified by the Ministry of Justice and Ministry of Housing Communities and Local Government as barriers to accessing support for victims of domestic violence.

'That cannot be right and we are seeking to end that situation.'

The issue of GPs charging for the letters was previously raised by Labour's deputy leader Tom Watson in September 2016.

He launched a petition to stop the practice - after hearing about it on a visit to a women's refuge - which claimed charging was 'immoral' and 'has to stop'.

Meanwhile, in February 2017, 16 police and crime commissioners wrote to the then-health secretary Jeremy Hunt asking for him to ban GPs charging for the letters.

The BMA's GP Committee said it could not comment on ongoing contract negotiations.

Readers' comments (7)

  • These poor people have to apply for legal aid? You mean the legal profession are charging them for their services. Don't they know what these people have been through? The b**tards! It is so immoral.

    Unsuitable or offensive? Report this comment

  • As a freebie what quality will they get!

    Unsuitable or offensive? Report this comment

  • If lawyers will fight their cases free of cost we won’t mind doing these reports free . How does Lord O’ Shaughnesy feel about lawyers can charge their fees? Or he is comfortable for lawyers to charge their fees but Nit with GP charging for their report.

    Unsuitable or offensive? Report this comment

  • "As a freebie what quality will they get!" - Well Mr Watson is quite use to freebies (maybe that is where he gets the idea from) but I am guessing the quality will be lower. Wimbledon tickets with lunch, Wembley tickets, Cure concert tickets, Brit awards etc etc. Nice work if you can get it.

    Unsuitable or offensive? Report this comment

  • Why does the woman need a gp letter? Or do MPs believe these women are liars?

    Unsuitable or offensive? Report this comment

  • Just emailed Lord S:

    Dear Lord O’Shaughnessy

    I note from the medical press that you are keen to include the writing of letters to support domestic violence legal aid as a core part of the NHS GP contract.

    I am a GP, and strongly support the need for women (or men) who allege domestic violence to receive the appropriate legal aid.

    My concern is that the thinking around the provision of GP letters is an example of ‘peak bureaucracy’ that is making the NHS GP job impossible and intolerable.

    If a woman alleges domestic violence there are 2 scenarios:
    1. They have medical evidence (e.g. from visiting and A/E department, hospital or GP practice)
    In this case they are able to request their records themselves, for free, under current legislation, without the need of a GP to write a supporting letter. This should be enough to support their application for legal aid, even if the notes themselves need to be subsequently requested as more formal evidence in a possible legal case.

    2. They have no medical evidence but allege domestic violence
    In this case there should be no need to get evidence from a GP. Under current rules the woman has to see the GP to tell the GP she is a victim of domestic violence then request a letter. This is a waste of valuable medical time and resources as the GP is not making a judgement, only relaying what the woman has said.

    In essence the requirement for a medical letter to support legal aid is the state calling the woman a ‘liar’ unless a medical practitioner says otherwise, valuing the medical repetition of the woman’s claims above the woman’s word herself. This undermines the victim as well as the broader NHS.

    A more logical approach to GPs charging for letters is not to legislate this valueless activity, but instead to remove the requirement for it in the first place.

    The current requirement only makes sense as part of a Keynesian make work scheme which, I assure you, is not needed for NHS General Practitioners, who have enough naturally occurring holes to fill in!

    I hope you are able to consider the absurdity of the current system.

    Yours sincerely

    (Dr BigandSmall etc)

    Unsuitable or offensive? Report this comment

  • Cobblers

    Spot on BigandSmall.

    Practically irrefutable logic.

    100% chance it will be ignored and the dictat imposed.

    Am readying the "This patient says they are a victim of domestic abuse" letters as we speak and will hand them out on request.

    Unsuitable or offensive? Report this comment

Have your say