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Domestic Abuse: General Practitioner Charges

Volume 793: debated on Thursday 15 November 2018


Asked by

To ask Her Majesty’s Government what progress they have made in the general practitioner contract negotiations for 2019–20 to end charges for the provision of evidence of domestic abuse.

My Lords, the Department of Health and Social Care has put this important issue forward as part of the general practice contract negotiations for 2019-20. While the progress of those negotiations is not discussed publicly until an agreement has been reached, I can reassure the House that the Government are committed to dealing with this issue.

My Lords, survivors often need to provide evidence of abuse when applying for legal aid and for anonymous registration, and a letter from a GP is an acceptable form of evidence. GPs are able to charge survivors for this letter—in some cases over £150—and this is unacceptable. Can the Minister confirm, without question, that it is the official position of the Government to stop charges for these letters being made and that, either through the current negotiations or legislation, these fees will be banned?

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. GPs are independent contractors and therefore have that freedom unless it is specifically prohibited in their contracts, and that is what we are seeking.

My Lords, while supporting the concerns of the noble Lord, Lord Kennedy, perhaps I may point out that next week sees the International Day for the Elimination of Violence against Women. Will the Government celebrate the day and the end of austerity by funding more refuges and services for victims of domestic violence? This is necessary because during the recent years of austerity many refuges, which offered hundreds of safe places for women and their families, have been closed.

I can reassure the noble Baroness that we will celebrate that day. I think this Prime Minister has done more than any to clamp down on domestic violence and to support victims. That was shown in the £100 million that was set aside to support victims of domestic violence in a number of innovative ways. I can further reassure her that, as I understand it, the number of beds in refuges has increased over the past few years.

My Lords, it was good to hear the recent government announcement that they would ask the Law Commission to consider whether offences against older victims should be recognised as hate crimes, and of course the charges in this respect are important. The Times has recently shown that crimes against the over-65s increased between 2013 and 2017 by 31%; and violent and sexual crimes against them increased by a similar amount. I agree with Action on Elder Abuse that the figures are symptomatic of a failure to recognise the signs of this kind of abuse. What action are the Government taking as the Law Commission considers hate crime as a potential offence? Can the Minister give an idea of the timescale in which he expects it to come to a conclusion on this matter?

I join the noble Baroness in condemning this type of crime, and it is disturbing that violence against older victims has risen. That is precisely the reason the Government have asked the Law Commission to look at the issue and bring forward suggestions on how to give the authorities greater powers to clamp down on those who perpetrate such crimes.

My Lords, is the Minister concerned that the treatment of these abuse issues is under serious threat, given that many surgeries in the north of England no longer have a single permanent doctor?

I do not think that it is an issue of staffing per se, because it is not only doctors but other healthcare professionals who are able to provide letters of this kind. The evidence that has been gathered through consultation and indeed through the progress of the secure tenancies Bill is that the charges for these letters act as a barrier. That is the issue we are trying to address.

My Lords, does the Minister agree that evidence of domestic abuse is important not only in respect of the adult who is the victim but also in respect of the children? It is the children who are often the most innocent victims in these situations. Given that, GPs have an important role to play in producing evidence of the well-being of children in these households.

The noble Lord speaks with great wisdom on this subject. That is precisely why the domestic abuse Bill is looking to provide stronger sentences where a child has been involved or has witnessed this kind of abuse, and why some of the money I mentioned earlier, around £8 million this year, has been put aside to support children in these situations.

My Lords, is the Minister aware that during the time of the Labour Government, our noble and learned friend Lady Scotland of Asthal, when she was a Home Office Minister, took legislation through the House that provided for independent domestic violence advisers in courts? Those positions were abolished by the coalition Government. Will he consider reinstating them?

The noble Baroness will appreciate that this is not a matter for the Department of Health and Social Care, but it is something that I will be happy to look into. What I do know is that the draft domestic abuse Bill is looking to establish a domestic abuse commissioner. It may be that it is through that route that support of that kind may be made available.

My Lords, do we have any special reception facilities for men or women who have been abused? When I served on the United Nations Commission on the Status of Women, we had an opportunity to consider the excellent procedures in place in Brazil, a country which has taken this matter very seriously indeed. Over the years, this issue has been raised quite often, but do the police here pay any special attention to it, and do they protect those men or women who say that they have been attacked?

My noble friend is right to say that domestic abuse can affect anyone, although of course it happens predominantly to women. The police, local authorities and the third sector are there to provide support for both men and women when they are abused.

My Lords, further to the question put by the noble Baroness, Lady Greengross, I understand that it is becoming more common for some general practitioners to see older people with a similar illness in groups. Would this not be quite prejudicial to the idea of having a confidential interview with one’s GP if abuse has been threatened?

This would be for the discretion of the GP. I would be amazed if any GP would want to see someone who has come to them with a confidential matter, such as saying that they have been the victim of domestic abuse, in a group situation. That seems to be quite wrong. There is a role for group GP appointments for totally different issues, and indeed some of the emerging evidence shows that, for certain illnesses, they can be quite successful.