Time to scrap the £150 fee for victims of domestic abuse

[MumsnetGuestPosts]

Two women are killed each week by a current or former partner and one in four will experience domestic violence in their lifetime.

Legal Aid is a lifeline for women fleeing domestic abuse. It helps them to protect themselves, their children and secures their financial situation. One of the accepted forms of evidence is a letter from a GP.

Since 2016 I have been raising in the House of Lords the outrageous situation whereby GPs can charge the victims of domestic abuse up to £150 for legal aid referral letters that confirm their injuries are a result of abuse thereby enabling the victim to apply for legal aid.

Successive Ministers from the Despatch Box have expressed support for the charges to be waived, but have not taken the opportunity to end this practice. Some GP practices have voluntarily rewritten their charging policies when light has been shone on this little-known fact.

It is true that the majority of GPs do not charge for these letters, but the fact is that a significant minority do and despite all the calls for this to stop, expressions of support for victims, and even the British Medical Association having a policy that no victim of domestic abuse should be charged a fee for a legal aid referral letter. The practise continues to this day.

It was Wythenshawe Safespots, a campaigning organisation based in Manchester, that first alerted people to this dreadful situation and started the campaign to Scrap the Fee.

The Domestic Abuse Bill has recently started its passage through the House of Lords, and I am hopeful that the Bill will be improved during its passage through the Lords with many changes agreed before returning to the House of Commons.

On Monday I tabled a new clause to the Bill which will stop GPs who have a contract with the NHS from charging victims of abuse for legal aid referral letters.

To get this amendment passed in the House of Lords and to be accepted in the House of Commons we need a campaign both inside and outside Parliament to highlight how wrong these charges are, calling on members of both Houses to finally deal with this issue and commit to scrapping the fee once and for all.

It is everyone’s responsibility to play their part to stop domestic violence and abuse and this is the right thing to do on an issue that has been ignored for far too long. There just needs to be the will in Government and Parliament to do it.

[Swiftjogger]

@highame

In the middle of DV issues, the simplest way is to get a GP letter, initially it may be stop orders or other restrailt orders, or protections. The victim may not have been near a hospital or social services. Low level DV might have been livable with and then escalate. Why are there quibbles about this. These are women suffering domestic violence. Get a f*&%ing grip.

Just written to my MP

Exactly, it’s shameful.

[surelynotnever]

What sort of scumbag piece of crap would you have to be to charge for such a letter? It's not exactly like GPs live on the breadline. Greedy, grasping bastards extracting money from desperate and often low income women. Shame on them. Shame.

[stumbledin]

highame - it may seem that the GP is the obvious but if a woman hasn't been to her local GP, it is good to know there are other avenues as outline on the Government web page.

One of the concerns I expressed was whether in fact it is the lawyers who are claiming the only valid confirmation of DV is a Doctor.

But agree that irrespective of financial and time concerns GP surgeries should have in place an agreement that Doctors should write these letters for free.

Wonder if it also needs a campaign with NHS Trusts who could make it a condition of contracts etc., that GPs write these letters for free.

Also, if part of the purpose is to claim legal aid, not clear why anyone who has paid a GP isn't re-imbursed from the legal aid money. Part of it must cover costs as well as actual legal fees.

[ErrolTheDragon]

Also, if part of the purpose is to claim legal aid, not clear why anyone who has paid a GP isn't re-imbursed from the legal aid money. Part of it must cover costs as well as actual legal fees.

Reimbursement wouldn't help a woman who was in a controlling abusive relationship who couldn't lay safely lay her hands on £150 in the first place.

[AnneElliott]

Goodness I wasn't aware this was a thing? Is there any data on which ones do or have charged? I'd suggest making that info public.

[stumbledin]

ErrolTheDragon - if the case was about coercive control its unlikely that a Doctor would have been consulted. There needs to be real information sharing about this need for a victim of DV to have this validated by a third party to get legal aid.

How many people know about this much more extensive list of people who can "validate" someone's claim.

The root problem seems to be the system set up to gate keep legal aid. And then you hear of really unsavoury individuals who have been represented through legal aid.

It would be worth finding out if this "validation" letter is required of all people applying for legal aid, or is it only DV victims.

And even if it is the rule then there needs to be information about whether others who are on the list of those deemed worthy enough to be a validator also charge.

And if Doctor's are charging why it seems to come down to each surgery to make up the amount of money they charge.

Its a bit like the recent scandal over school lunches. Although some companies were clearly scamming, the real issue was why the Government had reversed the previously working voucher system.

Yes lets stop GPs exploiting DV victims but lets look at the system of how and on what basis people can or can not get legal aid.

[OHolyTights]

Of course this fee should be scrapped. If this is not deserving of being included in an NHS GP's role, I don't know what is.

[Thelnebriati]

It would be worth finding out if this "validation" letter is required of all people applying for legal aid, or is it only DV victims.

I was wondering about this and I can't think of another crime that requires the victim to pay a fee, that means they can access help that could save their lives.

DV disproportionately affects women, who are also less likely to be able to pay the fee. I think the fee could be in breach of The Equality Act.

[Thelnebriati]

Although having said that I'm now concerned that the Govts response will be the same as for the Tampon Tax when they quietly started taxing razors.

[stumbledin]

The validation letters seems very strange. The page I read about legal aid generally just gave a list of the type of cases could get legal aid. I couldn't see anything about needing validation letters, but maybe it is spelt out in individual papes as they have done on the DV legal aid page.

I dont see how this is just. A victim of domestic violence might never have spoken to anyone about what is happening to her. She may just one day decide enough is enough and go to a solicitor who says they take on legal aid cases.

Can you imagine having taken this huge step of challenging what is happening to you, actually disclosing this to a total stranger (solicitor) and they turn round and say who can verify you are telling the truth.

Wouldn't be at all surprised to find the patriarchal political system just assumes women lie, in the same they assume that anyone in receipt of welfare is going to fiddle money or spend it irresponsibly.

Women's rights in this country are really just a superficial veneer covering up the entrenched misogyny and sexism.

[BadTattoosAndSmellLikeBooze]

It’s shameful that they can charge for this and even worse that some do. This needs to be stopped.

I have an issue with some other letters that are chargeable too. People who are victims, vulnerable or ill do not need any added pressures.

[Iceskatingfan]

I’m a GP and also a victim of domestic abuse (yes we are human beings too) so I can see this from both sides. I understand the good intentions behind this campaign and I personally never charge for these letters as I do think it is immoral and unfair to do so, however I personally think the campaign is essentially aimed at the wrong target.

Firstly, nice to know that the majority of the public believe their doctors are despicable scumbags, great for morale in a pandemic so thanks for all the clapping guys.

Secondly as several people have pointed out there are many places which can provide evidence but GPs tend to get asked as they are 1. More accessible 2. Less likely to charge (do you really think your bank manager would write this letter for free for example) and 3. There is (deliberately in my view) not enough publicity about other sources as solicitors like to ask the “soft touch” GP about these things and hope it will be done for free.

Thirdly, domestic abuse by its nature is secretive and is unfortunately often not disclosed even to the GP until after the parties have separated. For the huge majority of women who have asked me for such letters, all I am actually providing is a statement to say “this patient tells me they have been subject to domestic abuse, I do not disbelieve them but I have no supporting evidence on file to confirm this, please can they have legal aid”. It’s a huge waste of time for something that could be accepted directly from the woman themselves if only women were ever believed by the authorities. Of course it’s different if I have witnessed injuries or if they previously disclosed abuse to me and I can’t imagine any doctor objecting to provide a free letter in these circumstances.

Fourthly these letters are NOT currently NHS work, they are private work and so should not be worked on in NHS time or paid for by NHS resources. I personally do feel that in general if I am sitting in my office at midnight still doing paperwork when I’m only officially paid til 6.30 then maybe I ought to be paid for my time if it’s not NHS work that I’m working on...and you’re all totally missing the point about charging for letters - the reason many doctors set fees high is in order to try to dissuade patients from requesting letters which often make not a blind bit of difference to whatever it is they want, so that we might occasionally get home to see our families and not have mental breakdowns from overwork and stress, and not to rake in the money. But hey seeing as so many of you think we should write not only these letters for free but all letters about anything for people who want support for benefits/housing/court appearances/court cases/fitness to fly/jury duty/parachuting fitness/marathon fitness/high altitude climbing fitness/seatbelt exemption/firearms licensing/taxi driver licensing/letters for the school about allergies or absences etc/insurance reports/passes for Disney for your autistic child/letters for the Home Office to confirm eligibility etc etc (really I’m not sure any of you have a clue quite how many not directly health relevant letters the average GP is asked to do in a normal working day, maybe google GANFYD sometime) for free, that’s great. I’m sure none of you will mind at all when I explain that I simply have no time to see your sick child today, or give any COVID vaccinations today, or visit your sick mother today because I’m busy writing letters all day for people who want to go to Disneyworld or criminals who are insisting their time in prison has left them far too depressed to work (but continue to smoke cannabis, drink alcohol to excess and will not contemplate taking antidepressants or speaking to a counsellor), or people who have rejected multiple properties shown to them by the council as not good enough for their needs but want me to write to get them higher up on the list. Of course all cases are not like that and many are very deserving (actually the letters for Disney for autistic kids are fair enough for example) but my point is it all takes time and there are simply not enough GPs in the country to manage the actual medical problems right now let alone trying to deal with all the social problems too - and does nobody think maybe it’s a huge waste of a medical degree and a doctor’s salary to spend all day writing such letters?

Ultimately as I say I am sympathetic to providing these letters for free and already do so, however look at my list of letters above and understand that the majority of such letters are being constantly requested by a section of society who have limited funds anyway, and who I need to maintain a therapeutic relationship with, so I don’t feel great about charging them either, and even the ones that are not are maybe doing parachute jumps or marathon running etc for charity and will ask can I not waive the fee “as it’s for charity doctor”, or have a disabled child etc etc. However I simply cannot afford to work for free all day myself. I am not a charity. And I have actual work to do that the general public is constantly berating us for not doing faster, better, more.

If an MP really wants to make a difference they could start by taking a long hard look at the society they have helped create while in government where people are constantly being turned down for meagre benefits and inadequate housing, and where we have a system where legal aid is not more widely available in the first place (it used to be available to ALL victims of domestic abuse without having to jump through such hoops you know). If they must put barriers in place perhaps they could say they will or will not accept a statement from the woman themselves rather than me having to write it on their behalf which is usually what it is, and only ask us to provide evidence where abuse has previously been disclosed to us prior to the legal aid request, where we might have something actually informative to add.

Finally I will say that even if you qualify for legal aid it is heavily means-tested and domestic abuse does not only affect the lower paid sector of society; it is in fact even across all classes and economic incomes. Is it ok for a woman not to have legal aid defence for what can be exceedingly costly difficult and protracted court hearings by nature of he character of the abuser and difficulty in proving a he said she said scenario because she earns enough money to live on? I qualified for legal aid under all criteria including a MARAC referral except my income as I am (clearly stupidly) a doctor. My ex punched me in the face and severed a nerve in my hand by pushing me through glass, pushed me around while pregnant, stole significant amounts of money from me, deliberately sped up in a car if I dared to argue with him to scare me, and has done untold damage to my mental health over the years with his coercive control including threats with a gun on Skype to my child and threats to take my child so I will never see him again (I have bipolar 1 disorder and so you can imagine that I am already vulnerable), which has limited my working and earning capacity as I simply cannot work full time due to the stress (especially when the job involves so many unpaid uncounted hours every day of life). We have been going through a prolonged child custody dispute for 9 years now despite an attempt at abduction of our child by him and it is still ongoing. I have spent well over 2 years of my take home salary at this point in legal fees simply to try to keep my child and myself safe from him. I would not have been able to afford that as I need most of my salary to meet living expenses as a single mother (he of course contributes nothing, even claiming child benefit when I was too frightened to challenge him in this for fear of repercussions). Fortunately I have parents who although not rich, have been just about able to help me pay these fees to keep us safe. But in a civilised society I would not be being asked to pay them just because on paper I earn more than minimum wage. Something to think on.

[Kb12]

Great post iceskatingfan

[cdtaylornats]

Who do you proposes pays for the GPs time?

[Swiftjogger]

The concern about ‘private time’ not nhs, does that extend to all areas?

Only we have a few surgeons in my nhs trust who were getting mightily confused before the pandemic and accidentally using nhs time and resources (such as admin staff) for private work.

The point about using a bank manager instead of a ‘soft touch’ GP is completely irrelevant.
It’s obvious that a bank manager could not write a letter with proof of injuries, I have no idea why people keep using this as an alternative.

As for clapping and hero worship- I really, really object to a fellow health professional trying to guilt trip anyone who is is perceived to criticise the holy NHS.
It’s wrong, it’s not forward thinking and it aids the cover up of mistakes.

But hey seeing as so many of you think we should write not only these letters for free but all letters about anything for people who want support for benefits/housing/court appearances/court cases/fitness to fly/jury duty/parachuting fitness/marathon fitness/high altitude climbing fitness/seatbelt exemption/firearms licensing/taxi driver licensing/letters for the school about allergies or absences etc/insurance reports/passes for Disney for your autistic child/letters for the Home Office to confirm eligibility etc etc

Straw man argument again, no one has said this.

[Swiftjogger]

Quite a few lawyers do pro Bono work too, they are not all money grabbing, evil profiteers off the back of vulnerable victims.

I am going to write to my MP and will hide this thread in case anyone thinks I am ignoring them.

[stumbledin]

In response to IceSkataingFan - I think this just illustrates the point I have been trying to make up thread.

Why is the "validation" needed. Surely legal aid requests should be based on income levels etc..

And is it just DV cases that are required to provide this validation? Because it seems to me, that like the school dinners scandal, we are not addressing the real issue.

That is the attitudes and prejudices of those who make this laws. Many of which are nothing to do with fairness, or even bureaucratic efficiency, but are about sending a "moral" message to those the law makers feel should eternally grovel for even the most miniscule of help.

Is anyone on twitter and can ask @LordRoyKennedy?

[JuliaMumsnet]

Thanks for your questions and comments on this. We've gone back to Lord Kennedy of Southwark and this is what he says.

"For those asking what you could do, a good place to start is to contact members of the House of Lords asking them to vote for my amendment to the Domestic Abuse Bill to scrap the fee. The bill is soon to go to House of Lords committee stage so peers will be voting on the amendment in a few weeks (it will then go back to the House of Commons later on).

Select a member or members to contact. You can see a list of all members of the House of Lords and their contact details here: Members of the House of Lords.

It seems that Labour, Liberal Democrat, and Green peers are supportive of the amendment so consider concentrating on Tory, Crossbench, and unaffiliated peers, and Bishops.

I know people were asking for a template letter but as parliamentarians often get lots of emails on certain topics that look exactly the same, it helps to make your email personalised. A handwritten letter is a nice change for them too. Here are a few points to include:

· Welcome the Domestic Abuse Bill.
· Ask the Peer to support proposals from around the House to improve the Bill.
· It is good to see from recent announcements that the Government are listening.
· Lord Kennedy of Southwark has tabled an amendment to stop GPs from charging patients for legal aid referral letters where fees of up to £150 have been charged. Only a minority of GPs charge but we have to stop this practice completely.
· The amendment only concerns legal aid referral letters and does not impinge on charges that are levied by GPs for other letters.
· Will you support the amendment to scrap the fee?

There may be other points you want to make. Try to keep your letter as unpolitical as possible. This is not about party political affiliation – it’s just the right thing to do.”

We hope that answers your questions.

MNHQ

[stumbledin]

@JuliaMumsnet

Thanks but this doesn't answer the question is it only DV victims who are asked for validation letters, or is this the case in any claim for legal aid. In which case the campaign should be about abolishing validation letters.

And why is it just GPs who are being told they should do this for free? Surely the issue is making sure that any victim of DV is aware of the range of people who cn supply validation letters (whilst these are still needed) and that none of them charge or only get paid once the legal is secured and is covered by that money.

And doesn't answer the question of how anyone who has no "witness" of someone suffering DV is able to get legal aid as no one, at any cost, can provide a validation letter.

Seems another of those knee jerk political respsonses that doesn't deal with the underlying cause of a problem but just goes for a symbolic aspect of that underlying cause.

[ArabellaScott]

Thanks for raising the issue, MNHQ.

Interesting thread. Iceskatingfan raises very interesting points (not least why are doctors being asked to do so much unpaid work).

I agree with other posters that suggest this seems to me to be more about the system in place - stumbledin is quite correct that 'seems another of those knee jerk political respsonses that doesn't deal with the underlying cause of a problem but just goes for a symbolic aspect of that underlying cause.'

Of course dv victims shouldn't have to pay £150 for a letter to acces s legal aid. But also doctors should be reimbursed for their professional work/time/effort.

There must be another solution.

[mindtheclegs]

@Thelnebriati

Will this thread be stickied on other boards?

Quite - this needs to be on other boards too

[FloraGreysteel]

Iceskatingfan thank you for such a a detailed and thoughtful post 👏

[WomenAreBornNotWorn]

This is shocking. Why has it not yet been overturned?

[MissLucyEyelesbarrow]

@dappledsky

Totally agree that the patient shouldn't pay themselves in this situation.

If legal aid solicitors get paid for their time and professional expertise working on the case, surely doctors should be paid for their time and professional expertise too?

The issue should be who pays the GPs (who pays the solicitors?) rather than expecting GPs to do this in their free time at evenings or weekends as mentioned above.

This. Do the lawyers who help victims of domestic violence work for free? Do the police or forensic scientists or court officials work for free? Does Lord Kennedy work for free, or will he be claiming his very generous HoL attendance allowance for the time he spends on it?

These reports are not NHS-funded. GPs who do them without a fee are subsidising the legal process in which no one else involved is expected to work for free, however noble the cause.