My Lords, when we debated the amendment tabled in Committee by the noble Lord, Lord Kennedy of Southwark, which intended to prohibit GPs from charging domestic abuse victims for legal aid evidence letters, I made clear my intention to try to reach a satisfactory conclusion on this matter. I was also clear that the Government wholeheartedly agree that vulnerable patients should not be charged for evidence to support them in accessing legal aid. That remains the Government’s position.
In Committee, I gave an undertaking to give this matter detailed consideration before Report, while, I hope helpfully, pointing out some technical defects with the amendment tabled but ultimately withdrawn by the noble Lord. The current position is that GPs can provide services in addition to NHS contracted services. These are classified as private services for which GPs have discretion to charge the patient for their completion in lieu of their professional time. The provision of letters of evidence to enable access to legal aid is one such private service.
A GP is one of many professionals to whom a vulnerable person can turn for a letter to provide evidence of domestic abuse for access to legal aid. It is up to the discretion of an individual GP practice as to how much any charge for private services should be and, indeed, whether a charge should be levied at all.
As part of the 2020-21 contract agreement, the British Medical Association recommended to all GPs that a charge should not be levied for letters providing this evidence. That was a welcome and important step forward, and a recognition by the BMA that vulnerable patients with limited means should not be expected to pay for such letters. We recognise and commend the vast majority of GPs who are following this guidance, but we recognise that this is a non-binding recommendation from the BMA, so we now move with this amendment to remedy this gap, having considered the matter carefully since Committee.
Amendment 66C achieves our aim. It will provide that no person may charge for the preparation or provision of evidence demonstrating that a person is, or is at risk of being, a victim of domestic abuse for the purpose of obtaining legal aid. The “relevant health professionals” listed in subsection (4) of the proposed new clause are those providing services pursuant to any of the general medical services, personal medical services, or alternative provider medical services contracts. A “relevant health professional” who has assessed the patient in the course of providing services under any of those three contracts will be prevented from charging for such a letter.
Importantly, the same amendment also prohibits charging for this letter through any vehicle, the health professional themselves or the practice, be it a company or a partnership. Nobody who seeks evidence from such health professionals demonstrating that they are a victim of domestic abuse, or are at risk thereof, for the purposes of obtaining access to legal aid, may be charged under the government amendment. With the agreement of the Welsh Government, this amendment will extend to England and Wales, subject to a legislative consent Motion which is being debated in the Senedd tomorrow.
In these respects, Amendment 66C will go further than Amendment 71 tabled by the noble Lord, Lord Kennedy. As I observed on a previous occasion, that amendment relies solely on the definition of a general medical services contract in Section 84 of the National Health Service Act 2006, therefore covering only one of those three types of GP contracts, and would not apply to almost 30% of practices. Obviously that was not his intention, but it is an important drafting point.
We have also taken the opportunity to future-proof this prohibition through the two regulation-making powers in proposed new subsections (3)(b) and (6). Proposed new subsection (3)(b) enables the Secretary of State to extend the scope of the prohibition beyond legal aid, should a health professional’s evidence of domestic abuse ever be relevant in other contexts, while proposed new subsection (6) enables the Secretary of State, or the relevant Welsh Ministers, to alter the lists of professionals and contracts caught by the
prohibition. Should a change in the delivery of health service necessitate a change in the scope, we can do that with the appropriate regulations.
The remaining government amendments are largely consequential on Amendment 66C. Amendment 89A amends Clause 73 to provide that the Secretary of State can issue guidance about the prohibition. Amendment 103A provides for commencement on the first common commencement date following Royal Assent. Government amendments 95A to 95C, 98A to 98C and 99A to 99C make consequential amendments to Clauses 74, 75 and 76 respectively.
I remember well that in Committee the noble Lord, Lord Kennedy of Southwark, read out an impressive list of occasions when he had raised this matter. He went so far as to list the names of my illustrious predecessors with whom he had engaged, and I know that they worked hard to resolve this matter. On that occasion, I said that I hoped to escape the horrid fate of being added to his list, and I hope that I have achieved that very modest ambition. However, delighted as I am to be the Minister standing today at the Dispatch Box, moving these amendments to bring this very long-running problem to a close—I hope—I am conscious that many other Ministers, present and previous, have worked on this matter, and without their efforts we would not have got to where we are today.
We have listened carefully to the points made by the noble Lord, Lord Kennedy, and other noble Lords, on this important matter. I am pleased that this Government have been able to table these amendments. I look forward to the contributions of other noble Lords, and I beg to move.