£350 for doctor's note, so that daughter can be in school play

A mother has been charged £350 for a doctor's note. It's just one example of the absurd sums some NHS GPs are charging for medical letters, says patient watchdog, Healthwatch.

The case was reported in Pulse, the magazine for GPs. A mother was asked by her daughter's school to provide a doctor's note confirming that she was well enough to appear in the school play. She went along to her GP, and was stunned to discover there was a £350 charge for the service.

The report didn't uncover why the school should have asked for the note in the first place, but Healthwatch says it demonstrates the huge sums some GPs impose for a wide range of medical letters.

It also highlighted the case of a man who needed his medical records in order to appeal against the suspension of his Employment and Support Allowance: his GP charged him £110. Then there was one GP who charged £250 to sign Power of Attorney letters of support.
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Is this fair?

GPs are perfectly within their rights to charge for services that they are not contractually bound to provide. Doctors argue that it costs a great deal to run a surgery and cover all the overheads, so they need to be paid for their time. If they are writing a letter, or digging out and copying records, they need to be paid in order to cover their costs.

However, the level of these charges can raise questions. As independent contractors, GPs are free to charge whatever they like for these services: there's no nationally imposed price. The BMA offers guidelines for some charges, but GPs have freedom within those guidelines to charge some eye-watering fees.

Citizens Advice has warned that some excessive fees are being charged to those who can least afford it. Sick and disabled people who need medical evidence to appeal a ruling over whether they are fit for work, are being charged between £25 and £130.

The watchdog wants to see these services become part of the 'contractual duties' that GPs have to take on for free. It has argued that given the Government wants NHS services to be transparent, and patients to be empowered, it is wrong to charge people to get hold of their own records. However, Pulse reported that NHS England has already ruled this out.

The watchdog will now be visiting practices it feels are overcharging.