On 8th February 2021, during a debate on the Domestic Abuse Bill, the Bishop of London spoke in support of an amendment tabled by Lord Kennedy of Southwark which would aim to prevent GPs who had a contract with the NHS from charging victims of domestic abuse for letters confirming their injuries which they would need in order to seek legal aid:
The Lord Bishop of London [V]: My Lords, I add my voice to this amendment simply because it should go without saying that some things need to be penned into law for there to be consistent access to justice. Amendment 161 has been tabled because it prevents GPs charging survivors of domestic abuse for letters which confirm injuries they have suffered—evidence which survivors need for their legal aid applications. The case for this amendment has been extremely well made by the noble Lord, Lord Kennedy, and the noble Baroness, Lady Bull. I agree with the statements they have made, so there is no need to add much to what has been said.
There should be no gatekeepers when we consider the path to justice, not least from those who are on the path to help facilitate it. As we have heard, the British Medical Association has recommended that patients should not be charged for medical evidence when seeking it for legal aid. I too stand by this, by virtue of calling for this amendment to be included in this Bill.
Extracts from the speeches that followed:
Baroness Bertin (Con) [V]: My Lords, I support Amendment 161 and thank the noble Lord, Lord Kennedy, for tabling it and for being so tenacious. It is an honour to speak after the right reverend Prelate the Bishop of London. We cannot on the one hand spend years putting together a great Bill like this that says to victims, “We hear you; we are there for you; we want to help you escape”, and on the other hand stand by and allow those same victims to be potentially charged £150—an extortionate amount for many people—for proof of that abuse.
Domestic abuse does not discriminate. You can be a victim of abuse whether you are rich or poor. Unfortunately, while this fee remains, it does and will discriminate against poorer victims. Many of them will go without legal representation, many will return to an abuser and many will be seriously injured or worse as a result of being unable to access the legal remedies that are supposed to keep them safe. I know that the Department of Health has a fair amount on its plate right now, but it should endorse this small change to the Bill. It could have an immeasurable impact on people’s lives when they are at their most vulnerable.
Lord Wolfson of Tredegar (Con): I am pleased that the noble Lord, Lord Kennedy, was able to meet with the Minister for Prevention, Public Health and Primary Care and representatives from the British Medical Association ahead of today’s debate to discuss the issue. I think it fair to say that everyone who attended this meeting was seized fully both of the issue and of its importance. As the noble Baroness, Lady Bull, said, we do not want to do anything to prevent or discourage victims of domestic abuse coming forward, and that includes questions of cost. That said, it is fair to say that there was some anecdotal evidence at the meeting which pointed to this perhaps being a diminishing problem, particularly since, as the right reverend Prelate the Bishop of London reminded us, the BMA issued advice to its members last year that they should not charge for this service, advice which they recently reinforced.
Following that meeting, the noble Lord, Lord Kennedy, graciously undertook to provide what evidence he had of this being a continuing issue so that we could consider the matter further. We look forward to receiving that evidence and continuing our discussions. However, as matters stand this evening, we remain to be persuaded that this issue needs to be resolved through primary legislation.
The position is that GPs can provide services in addition to NHS contracted services. They are classified as private services, for which they have the discretion to charge the patient. Letters of evidence to access legal aid is one such private service. It is therefore up to an individual GP practice to decide whether a charge should be levied and, if so, what it should be. However, as I indicated, as part of the 2020-21 contract agreement, the BMA recommended to all GPs that a charge should not be levied for letters of this kind. That is a welcome recognition by the BMA that, as was said, 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 that guidance, but it is a non-binding recommendation. As the noble Lord, Lord Kennedy, mentioned, we are informed of anecdotal examples where patients can be charged up to as much as £150 for that evidence.
Lord Kennedy of Southwark (Lab/Co-op): My Lords, I thank all noble Lords who have spoken—the noble Baronesses, Lady Bull and Lady Bertin, and the right reverend Prelate the Bishop of London—for their support. I also thank the noble Lord, Lord Wolfson, for his very careful and considered response. It was very welcome.
The noble Lord made reference to the meeting. It was a very good meeting. We actually had four Ministers from three departments on Zoom—I have never had that before—so in that sense I was very pleased. Clearly, Ministers are taking this seriously, and I appreciate that very much.
Obviously, the technical issues can be ironed out. I am not a draftsman, but I am sure that we can get that sorted out. We have been raising this issue since 2016. The negotiations have been going on for a very long time, but we do not seem to have gone beyond the fact that everybody is against it, no one wants to do it, but no one wants to do anything about it. We have not moved on much from that position today.
As I said, I hope that I will not have to push the amendment to a vote at a later stage. I hope that I can work with the noble Lord to resolve this issue but, if that does not happen, we will divide the House. However, at this stage, I beg leave to withdraw the amendment.
Amendment 161 withdrawn.
The Church of England in Parliament 
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