THE Holyrood and local governments have recently been promoting the arranging of powers of attorney and reinforcing the desirability of having one in place.

I presume this is, along with the general desirability of individuals arranging a power of attorney (POA) to cater for unforeseen circumstances, in recognition of the increasing diagnoses of dementia and the problems that can arise when a person can no longer look after their own affairs.

This is laudable. However, it will make very little progress unless something is done to cap the fees which GPs can charge for signing the certificate necessary to confirm the capacity of someone entering into a power of attorney.

It is highly desirable and recognised in legal circles that the best person to sign a certificate, certainly in cases where capacity is impaired to a degree, is the individual’s GP. But the signing of such certificates falls outwith the standard GP contract and instead comes under “private practice”. Therefore, in theory a GP can charge whatever they like to sign such a certificate. At the moment it is a postcode lottery.

The charge can be as much as £160 and I am aware of two instances of this recently. In one case the individual was 70 and in the other they were in their eighties. For both there was no question that arranging a power of attorney was highly desirable given their state of health.

For some GPs to charge elderly patients of limited means what is the equivalent of a week’s pension is outrageous, unjustified and short-sighted. Putting in place a power of attorney removes pressure from the social services and gives peace of mind to the individual concerned and their family, which in turn can only lead to enhancement of their wellbeing, which reduces pressure on the GP’s resources. The arranging of a POA for the elderly or those in the early stage of dementia is not “elective”. It is often essential for the financial, physical and emotional wellbeing of the patient.

If the GP contract cannot be renegotiated and the signing of these essential certificates remains outwith the basic contract (which it should not), the BMA should issue guidelines as to a generally affordable maximum. Presently they are unwilling to do so. Failing this, GPs should show goodwill by agreeing informally a modest maximum charge to ensure that excessive charges are not perpetrated on one of the most vulnerable sections of our community at a very stressful time in their lives for a service which should be provided free in the first place.

If some GPs can treat their patients fairly, so can they all.

William Thomson,

25 Lithgow Place, Denny.