My Lords, Amendment 161 in my name—and those of the noble Baronesses, Lady Bull and Lady Burt of Solihull, and the right reverend Prelate the Bishop of London—seeks to add a new clause to the Bill; its purpose is to deal with an issue that I have been raising in this House since 2016. Although I have had expressions of support from both inside and outside the Chamber, we just have not been able to deal with it.
The problem is that GPs are often asked by victims of domestic abuse to provide letters to a set text, which they need to access legal aid, and a GP can charge a fee for that letter. The vast majority of GPs do not charge and would never dream of doing so, but a minority do, and the charges can be anything up to £150 for such a letter. That is just wrong. The purpose of my new clause is to stop this happening in the future by finally putting an end to this practice, because even one victim being charged is one victim too many.
As I said earlier, this is not the first time that I have raised this issue in the House; I have raised it many times before. I want to give you a flavour of the engagement that I have had with the Government. On 24 January 2018, I moved an amendment on the issue. The noble Lord, Lord Bourne of Aberystwyth, responding for the Government, told me that it was
“far from an ideal situation”,—[Official Report, 24/1/18; col 1058.]
that the matter was being discussed by the Department of Health and negotiated with the GPs, and that it would be reviewed in April 2018. The noble Baroness, Lady Manzoor, from the Government supported me.
I raised the matter again on 6 March 2018, and was told by the noble Lord, Lord Bourne of Aberystwyth, that my amendment this time was too widely worded but that, in “early soundings”, the Department of Health had confirmed that it was an issue that needed “looking at”.
I raised the matter again on 22 March 2018. This time, I was told by the noble Baroness, Lady Williams of Trafford, that she was “shocked” to learn that some GPs would charge victims of domestic abuse for letters so that they could get access to legal aid. On 15 November 2018, I raised the matter with the noble Lord, Lord O’Shaughnessy, who told the House that
“the Department of Health and Social Care has put this important issue forward as part of the general practice contract negotiations for 2019-20.”
So, this was the second year running that they would be in the negotiations. He said that
“while the progress of these negotiations is not discussed publicly until agreement is reached, I can reassure the House that the Government are committed to dealing with this issue.”
He continued:
“I agree with the noble Lord. I feel uncomfortable with the idea of these letters being charged for. They have been identified by the Ministry of Justice and MHCLG as barriers to accessing support for victims of domestic violence. That cannot be right, and we are seeking to end that situation.”—[Official Report, 15/11/18; col. 1969.]
On 4 March 2019, I raised the matter again with the noble Lord, Lord Bourne of Aberystwyth. He recalled that I had raised the issue before but said again that the issue was part of contract negotiations, and that he was unable to update me or the House any further. I raised the issue again via a Written Question, which was answered on 29 April by the noble Baroness, Lady Blackwood of North Oxford. She said that the Government
“recognise the importance of tackling domestic abuse. General practitioners (GPs) can have an important role in supporting victims, including by providing evidence to enable them to access services.”
I was told:
“GP provision of evidence was discussed as part of the 2019/20 GP contract negotiations and work is ongoing to improve the process. Charges for provision of evidence of domestic abuse are not a specific requirement of the contractual relationship between GPs and the National Health Service. The Ministry of Justice and the General Practitioners Council are currently working together to clarify and improve the process for GPs and applicants in relation to evidence of domestic violence for legal aid applications.”
On 14 May 2019, I raised the matter again with the noble Lord, Lord Bourne of Aberystwyth, when he presented a Statement on domestic abuse and women’s refuges. He did not answer my questions that day but I accept that it was a wider Statement on domestic abuse.
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These are not the only times I have raised this issue; I also raised it with the noble and learned Lord, Lord Keen of Elie, and with other noble Lords who spoke on behalf of the Government. I hope that this gives the House just a flavour of my persistent efforts to raise what I believe is a great injustice. For women, there appears to be a postcode lottery: just because of where you live, you can be charged for a letter. That is totally wrong. The BMA has a policy that no GP should
charge for these letters. The Government have, through a variety of Ministers, recognised that this is wrong and that it should not happen, but for some reason they lack the political will to deal with it and put this issue to bed. No one supports this practice—everybody seems to be against it—but some GPs are still doing it, and the situation seems to be that we are not going to do anything about it. That is just wrong.
This is a most unsatisfactory situation and no Member of this House should be satisfied with it. Therefore, if we cannot get this resolved in the next few weeks, we are going to have a vote on Report—I can promise the House that. We are finally going to deal with this issue in this House. I hope that the Minister can give us some hope today about resolving this; otherwise, I will add him to my list of Ministers who have expressed support but have not actually done anything about it. I look forward to his response.