Ministers seek to stop GPs charging victims of domestic abuse for information

BMJ 2018; 361 doi: (Published 16 April 2018) Cite this as: BMJ 2018;361:k1684
  1. Gareth Iacobucci
  1. The BMJ

The government is considering recommending changes to the GP contract to block practices from charging victims of domestic abuse for letters to help them access legal aid or housing, The BMJ has found.

The move comes after MPs and peers raised concerns about the issue with the Department of Health and Social Care, after reports that some practices charge people £100 (€116; $143) to confirm to authorities that they were a victim of domestic violence.

The general medical services contract does not currently fund general practices for issuing such letters, and practices are permitted to charge patients.

But MPs and peers said that charging a vulnerable group of patients in this way was unacceptable on moral grounds. The issue has been raised repeatedly12 during the passage of the Secure Tenancies Bill,3 a proposed piece of legislation designed to guarantee secure housing for victims of domestic abuse.

A department spokesperson told The BMJ that the government was taking the issue seriously, saying, “The provision of letters to patients is outside of the contractual terms agreed between the general practitioners committee of the BMA and NHS England and, as such, GPs are free to make a charge for such services.

“However, we are currently considering the remit for changes to contracts in 2019-20 and will look at ways of stopping GPs from charging victims of domestic abuse for information.”

The response came after Nick Bourne, Conservative minister for housing, communities, and local government in the Lords, who is sponsoring the bill, wrote to the department calling for action after hearing cross party support from peers and MPs.

Roy Kennedy, Labour shadow spokesperson on housing, communities, and local government in the Lords, said that it was “completely wrong” for GPs to charge for the letters. “I accept that it is a minority of GPs, but it is wrong for any GP to charge it,” he said. “We should be very clear that no victim should ever be charged for a letter or any other form of evidence to say that they are a victim of domestic violence.”

Melanie Onn, Labour’s shadow housing minister, also condemned the charges.4 “Women’s Aid tells us of occasions where people have been charged £100 for this sort of evidence,” she said. “I do not understand how that can be justified, in any sense of the word. It seems to me a crass and opportunistic charge, and [something] of a money making exercise on the back of quite vulnerable people. Should we not just say that, particularly with GPs, there should be no charges?”

Andrew Lewer, Conservative MP, also called for action,5 saying, “Even if much less than [£100] is charged, I think that it would be seen as wrong. It may be within the letter of GP contracts as they currently stand, but it is wrong nevertheless.”

The BMJ asked the BMA to comment on possible changes to the contract. In response, Richard Vautrey, chair of BMA’s GP committee, said, “The BMA already provides guidance to GPs on what to do in instances when they are approached to confirm whether a patient is the victim of domestic violence, which includes explaining the reason behind any fees.

“While a GP can confirm health conditions, including mental health conditions, consistent with domestic abuse, often other agencies are better placed to make an informed representation in such sensitive cases.”


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