BMA to end patient charges for mental health debt forms

The Money and Mental Health Policy Institute (MMHPI) has welcomed a commitment from the British Medical Association (BMA) that GPs will stop charging for the form people with mental health problems need to get debt support.

The commitment by the BMA – the professional body for all UK doctors – is part of the new Five Year GP contract recently agreed with NHS England. It means that:

• GPs in England will stop charging for completing the Debt and Mental Health Evidence form – paperwork that people with mental health and debt problems can be asked to provide to creditors in order to receive additional support.
• The BMA’s commitment is made to be enacted when an agreed new shortened and simplified version of the form is introduced to make it easier and quicker for GPs to complete.
• UK Finance and the Credit Services Association – the membership bodies for banking and finance and debt collectors respectively – will continue to expect their members to use any suitable evidence as they currently do and only request the form as a last resort. In May 2018 the CSA went as far as to proactively change its Code of Practice to this effect.
• In addition, the BMA will continue to work with creditors and charities to support people to provide evidence of their mental health problems from their own medical records, which will be available online from April 2019.

There has been cross sector agreement to introduce a new shortened form to make this process easier – with organisations including the Money Advice Liaison Group (which oversees the form),  the BMA, Royal College of Psychiatrists, debt advice charities, UK Finance and the Credit Services Association all signalling they are in favour of this process. The government now just needs to coordinate putting that form in place, and to provide guidance to creditors, debt advisers and people with mental health problems about how to use it.

The announcement from the BMA comes in response to Money and Mental Health’s ‘Stop the Charge’ campaign, which was launched over two years ago following research by the charity which showed that:

• Around one in three people with mental health problems who asked a GP to complete the Debt and Mental Health Evidence form were charged for it.
• Charges usually amounted to £30-£50, but some people were asked to pay more in a few cases over £100.
• The charge is preventing some people from getting help to resolve their debts, while others are going without essentials such as food or heating in order to pay the charge.

In January 2017, the Prime Minister Theresa May responded to Money and Mental Health’s campaign by promising to address what she called the “unfair practice” of people with mental health problems being charged for this form, and launching a formal review to address this issue. Following this commitment, the government and organisations from across the health, debt and financial sectors set up a working group to make progress on ending the charge.

Recognising the increasing workload pressures GPs face, the working group committed to taking steps to reduce both the length of the form, and the demand for GPs to complete it.

The BMA’s pledge announced today reflects its support for these steps and its commitment to helping people with mental health problems to access debt support without charge.

Martin Lewis, Founder and Chair of the Money and Mental Health Policy Institute, said “We’re over the moon that the BMA has finally agreed to stop people with mental health and debt problems being charged for the paperwork they need to get help. These charges can play havoc with people’s financial and mental wellbeing, often when they are at their lowest ebb – leaving many avoiding asking for the help they desperately need.”

“Today’s announcement puts us in touching distance of ending this injustice. We have a momentous agreement from banks, doctors and debt collectors, who are all ready to play their part. Now the agreement is there, we just need the government to lead the coordination of all the groups involved to produce the new paper work. Then we will be able to stop these charges once and for all.”

Dr Richard Vautrey, Chair of the BMA GP Committee in England, said “The BMA, Money and Mental Health, NHS England and the Government have a shared concern about the impact that financial debt has on the mental health of many people. To that end, we want a solution that, where possible, empowers patients to provide their own evidence of their condition. As GPs, we know that most patients want to be in charge of their own care.”

“We want to maximise the use of self-certified declaration but where that’s not possible, we will explore how this can be done by an appropriate health and social care professional or support worker known to the patient. We want to reduce, as far as possible, the need for GP practice involvement. When involvement is necessary, using a newly designed much-simplified form, practices will not charge patients to complete it.”

“There may be times when a more complex health report is required by a bank or other lender, and in those rare circumstances, those reports need to be sought directly from the practice by a lender and the lender would pay an appropriate fee, not the patient.”

Peter Wallwork, Chief Executive of the Credit Services Association (CSA) said “We very much welcome this positive step by the BMA in helping consumers in financial difficulty, and the acknowledgment of the MMHPI of our industry’s involvement in finding a successful solution.”

“It has long been the policy of CSA members to accept any form of relevant evidence – from prescriptions to hospital letters – if it is appropriate and proportionate and helps to better understand the customer’s position. In fact, in May 2018 the CSA went as far as to proactively change its Code of Practice to reflect this and move away from the use of the DMHEF due to the charge.  It is unacceptable that someone with money and mental health problems should have to pay to evidence their condition, and while the DMHEF was a highly effective tool, we welcome moves to stop the charge and simplify the form, particularly if it alleviates an already stressful situation for the customer.”

“We look forward to working closely with the medical profession and Martin Lewis and his team in achieving the best outcome for those in debt.”

Chris Fitch, Money Advice Trust Vulnerability Lead and Research Fellow at the University of Bristol Personal Finance Research Centre, said “When we designed the form our aim was simple – give debt advisers and creditors the information they need to help people in often terrible situations. However, the charges levied by some GPs for providing this evidence often stopped this help being given.”

“Today’s announcement means that this charging should stop. This makes total sense. If you are already in financial difficulty, struggling with your mental health, how can you pay GPs for this evidence? And how can you recover from your mental health problems when you’ve got financial difficulty hanging over you?”

“This achievement is a testament to the Money and Mental Health Policy Institute’s tireless campaigning, and also to members of the Money Advice Liaison Group for creating the form in the first place.”

“The next step is to revise the form to make it easier and quicker for GPs and other professionals to complete, and then to see a similar end to GP charges in Scotland, Wales and Northern Ireland, too.”