The charge for a letter is excessive!

[Dilbertian]

We are applying for Special Consideration for ds in his A-level assessments, as he was ill for most of the spring term. Obviously the school know (and they have been brilliant ) but we have to provide supporting evidence in the form of a letter from the GP. The letter will cost £72.

Ironically, we were in the same situation with dd three years ago. She was discharged from hospital the day before her first exam. But in her case all we had to do was submit a copy of her hospital discharge note, which was, of course, free.

We expected to pay for the GP letter, but £72?! Surely that's unaffordable for many families? Is it fair? We can afford to pay it, and will. But it feels wrong.

AIBU to think that such letters for children and young people in education, particularly for situations that can have a massive effect on their futures, should not be so expensive?

@inlectorecumbit

The recommended amount to charge is set by BMA These letters are not part of the GP's contracted services to the NHS so can really charge whatever they like

I don't believe this. 2 surgeries locally have drastically different pricing structures. 1 is clearly taking the piss because of the area it is in, which is shit for those of us that don't have the income to afford it. Example - rip off surgery wanted almost 4x as much for the same letter as the other (£90 rather than £25)

But that’s in keeping with the statement that they can charge whatever they like. As can anyone who works privately, in any field.

Agree with pp, just do a SAR, medical records should be enough.

An acquaintance once asked my dad to sign off their passport forms 'because the GP charges for it'.
'Maybe I should start charging,' quipped my dad.
'Ah, but the doctor's time is VALUABLE'.

A solicitors letter would be more.

It’s not NHS work, it’s private so the GP can charge appropriately for their time and the time of their staff. They are not just ticking a few boxes but providing their professional opinion. My solicitor charged £300 an hour, why should a doctors time be free?

The thing is that the letter is required by the education authority. The op’s son doesn’t have a choice about asking for the letter. He also doesn’t have a choice about who provides the letter, he can’t shop around different GP surgeries to find the cheapest option he can only get it from the surgery he is registered to.

If medical letters are required by one branch of public service but the other branch of public service, in the form of GP surgeries, aren’t obliged to provide them the public are stuck in the middle.

@Avenueofcherryblossom

The thing is that the letter is required by the education authority. The op’s son doesn’t have a choice about asking for the letter. He also doesn’t have a choice about who provides the letter, he can’t shop around different GP surgeries to find the cheapest option he can only get it from the surgery he is registered to.

If medical letters are required by one branch of public service but the other branch of public service, in the form of GP surgeries, aren’t obliged to provide them the public are stuck in the middle.

I agree Avenueofcherryblossom. In general I agree that GPs aren't paid to produce letters for your visa application or whatever, and should therefore be paid for their time in doing so, but actually, in this case I think it sucks. I don't blame the individual GP, because that is how the system works, but that sucks.

The thing is that for a GP to write a non nhs commissioned letter on nhs time using nhs resources is fraud against the nhs. The nhs does not pay for letters for schools, exams, insurers etc so if a GP is to write one they are committing fraud against the nhs as they should be doing nhs work in that time. It’s not the GP wanting to line their own pockets but the GP trying not to defraud the nhs.

Of course the GP could write it in their own time but they get multiple requests a day so it’s not just a quick thing when they add it up. And of course they were being totally honest they should pay for the use of the computer, building and secretaries time back to the nhs. In non medical terms it’s like moonlighting. If say you are a hairdresser and you are paid to cut hair by the salon but decide to cut your friends hair for free using the salons resources in time that could be used for a paying appointment the salon would be justified in being pissed off. The nhs is the salon. Some GPs are partners and so own the building and pay the admin staff themselves so they are not defrauding to the same extend, but the main source of income is to the practice is still the nhs tariffs so they would have to keep careful accounting to ensure they are not charging the nhs for this work. NHS fraud are becoming more and more interested in this and are cracking down.

Personally I feel that letters for schools and exams should be a commissioned service like med 3 for adults are, however GPs don’t tell the government what the nhs to fund - this annoyance should be aimed at your MP.

In summary asking for a free letter is asking the GP to use that time and resources fraudulently defunding paid for nhs services that should be going to others

GPs asked the passport office to be taken off the list for authorised signatures other than those they have a relationship with outside of work because so much nhs time was being taken up with passport applications.

Patients would book and appointment saying it was for a “private” reason and then whip out a passport form, using an nhs paid for appointment which could be used for a sick patient. Charges were introduced to deter people doing this but it didn’t work and people were still using appointments for passport forms when that time could be used to see a child with asthma or a lady with a breast lump.....every appointment or letter or form using the nhs for non nhs work means that a corresponding piece of nhs work isn’t done, be that a referral letter for a new hip for your granny or an urgent review of a baby with a temperature. It’s a Finite system and I think that I would prefer GPs to do healthcare rather than facilitate people’s holidays

@canary1

The Op hasn’t answered whether he/ she is happy to work for free? As you and some others on this thread are expecting the GP to work for free, what to do you for a living, and when do you provide that for free?

No? Shocker. How dreadful of you!

How about actually reading what I wrote in my OP?

But I read it. You have decided that the letter should cost significantly less than is being charged,.
They’ll have all sorts to consider, as detailed by other posters, in working out what to charge for this service.
So you are, in effect, asking for them to do some of the work for free, as you only want to pay the small amount you decide yourself is reasonable .

Of worse than free if they are not a partner in their own GP practice they cannot choose to do it for free. They are being paid by the nhs to do x and y with the nhs provided resources. Doing something else for you is using nhs money for a non permitted activity - I E fraud. If a partner and they don’t charge enough to cover overheads such as building costs, staff wages, printer costs, medical records systems then they are defrauding the nhs to fund a private service by using nhs resources to fund private letters - again fraud.

You may think that it’s only one letter but if they are asked for 10 a day or so every day that would be a significant amount of money stolen from the nhs. Your not asking the dr for a favour you are asking them to steal funds from the nhs. They are not being mean by saying no but actually trying to stop theft of nhs resources

Can you just ask for a copy of his medical records? They shouldn't be charged for, but if they are it should only be administrative fees and not consultant time.

Sorry if the above is non sympathetic- I do feel that letters for schools should be covered, maybe not by nhs but by having some sort of set fee paid by the education department to the nhs or certificate like the med 3 for adults. This isn’t up to individual GPs tho, they can’t choose this to be funded work so they have to charge at a cost that covers their overheads (that will vary GP to GP) to make it not fraud

No, canary, I did not say any of that. I said that I expected to pay, and would pay, but that such a high cost could make it inaccessible to those who could not pay. The damage to their education would widen the gulf of opportunities between those with money and those without. The very gulf that education seeks to narrow!

If asking a GP to glance back at a handful of interactions in the last 5 months - all of which are immediately visible on their database - and make a note about them, is an outrageous demand, how much more so to ask for a full history? And not pay for it! Why is asking for an SAR reasonable in this case? Besides, submitting his full medical history would be a huge invasion of ds's privacy, as well as irrelevant. And we have 10 days in which to make the submission. We cannot wait for 1-3 months for this, even if we wanted to.

I do not object to paying for services rendered. I object to having those essential services restricted to only those who can afford to pay for them. This isn't about a visa or a gun licence - this is about young people's futures.

Because providing a set of notes via a SAR is a commissioned service - IE it’s something the nhs pays for. Writing a letter is not. That’s illogical I know but that’s the current rubbish way nhs services are paid for.

Because providing a set of notes via a SAR is a commissioned service - IE it’s something the nhs pays for. Writing a letter is not. That’s illogical I know but that’s the current rubbish way nhs services are paid for.

Also providing a set of notes is not asking for that particular doctors opinion. Someone

Aren’t schools assessing internally? I don’t get why the exam board would need a letter?

It’s the MP you should complain to, not the GP. It’s down to whether the service is commissioned by public money or not. And right now, sadly, it’s not.

YABU.
Unfortunately GP's are inundated with work. Any time they spend doing a letter for you is time that could be spent looking after a patient.
If you think the time spent by a highly qualified professional isnt worth £70 then it's not obligated for you to spend it.

A lot of GP's flat out refuse this work in the first place.

@Dilbertian YANBU!

@Dilbertian YANBU!

@Souther
Exactly, GPs get so many letter requests and it takes up valuable time.