GPs charging domestic abuse victims up to £150 to confirm injuries

GPs are charging domestic abuse victims up to £150 to confirm their injuries against guidance issued by the British Medical Association (BMA), their professional union, watchdogs and charities have revealed.

Victims abused by their partners are often unable to raise the funds to pay for the letters which they need to access legal aid in order to take action against their attacker and escape from them, according to the campaigners.

Nicole Jacobs, the domestic abuse commissioner, said the practice – which involves charges of between £50 and £150 – was “totally unacceptable”.

“When domestic abuse victims are financially and emotionally on their knees – often urgently needing to safeguard themselves and their children – it is totally unacceptable that some GP practices are charging for letters they need to prove they are victims in order to access legal aid,” she said.

“Without legal aid most are unable to challenge the perpetrator through the courts. In the vast majority of cases, many of these women who have fled their homes don’t have £50 or £150.

“GPs have been issued with template letters to make the process easy and fast. The BMA has also issued guidance that GP’s should not charge for these letters but many are ignoring this.”

Dame Vera Baird, the victims' commissioner, said it was "incredibly frustrating and disappointing" to find GPs were still charging. "This fee must be abolished – it’s as simple as that," she said.

"We should be taking action to help victims, not demanding payment for a letter they need to access justice. The government needs to scrap this fee by bringing the service under NHS funding or - better still - scrap the need for the letter entirely.

"Those suffering domestic abuse are already incredibly vulnerable and it is vital that nothing stands in the way of their safety.  Without legal aid some victims simply cannot afford court proceedings against their perpetrator. Help for victims of domestic abuse should never come at a price.”

The scandal emerged during the second reading of the Government’s domestic abuse bill in the House of Lords where Lord Kennedy, Labour spokesman on housing, revealed he planned  to introduce an amendment banning the practice.

He said: “I have great respect for doctors and GPs but I can’t believe they would charge someone in this terrible situation to say: ‘Yes, there are injuries.’ I don’t understand why the Government don’t just have a conversion and outlaw it.”

GPs can levy a fee for the service as it is classified as non-NHS private work that sits outside the core doctors’ contract. It first emerged as an issue in 2015 with the BMA subsequently acting about a year ago to advise GPs not to charge for such letters.

However, Medina Johnson, chief executive of IRISi, said doctors were essential because injuries could be “invisible” if an abuser was using coercive rather than physical control. She was concerned the system was “putting doctors in a situation where they need to charge even through they don’t want to”.

The proposed law change was backed by SafeLives, one of the biggest domestic abuse charities. “Removing this barrier could be the difference between a victim being able to access the legal support required to help protect her children from an abusive partner, or finding a safe place to live,” said the charity’s chief executive Suzanne Jacob.

A BMA spokesman said: “The BMA believes that there is no need for medical involvement in the process for gaining access to legal aid for domestic abuse victims.

"We feel that such requests can compromise the relationship between doctor and patient, and that legal aid agencies should take the word of victims without needing to consult a GP – who themselves may not be best placed to confirm whether domestic abuse has occurred.

"This is a position we continue to make clear through our input into the Government’s ongoing review into bureaucracy in General Practice.

“While these letters are not funded by the NHS contract and practices are able to charge patients a fee for their completion, the BMA recommends that they do not. Ultimately, however, this is at the individual practice’s discretion.”