GPs say legal aid cuts damaging patient health
Doctors report seeing an increase in the number of their patients who need social welfare law advice, and warn that this is having a bad effect on people’s health. Steve Hynes outlines the findings from research published by LAG.
The link between health and access to legal advice is well known. The English and Welsh Civil and Social Justice Survey, spanning 2006–2009, for example, found that half of respondents who had experienced a legal problem suffered an adverse health consequence, including physical conditions and stress-related illnesses. Some 80 per cent of those whose health was affected by their legal problem visited their GP or other health service, as a result. These findings are consistent with research published by the Legal Services Commission (Civil Justice in England and Wales 2009, LSC (2010)).
Citizens Advice has led the argument for a link between ability to obtain advice on civil legal matters and better health outcomes. Five years ago, a longitudinal study by Bangor University, in association with Citizens Advice Cymru, showed significant improvements in health outcomes for bureau clients. Citizens Advice published research in 2012 which shows that a large percentage of medical professionals believe people who receive its advice have better health outcomes (An overview of possible links between advice and health (March 2012)).
The opinion polling evidence from GPs1Healthy legal advice; Findings from an opinion poll of GPs
is part of research commissioned by LAG, with funding from the Law Society, to quantify the impact of the Legal Aid Sentencing and Punishment of Offenders Act, and other cuts in social welfare law (SWL) services. LAG commissioned research company ComRes to undertake the field work for the report. It has assisted us in formulating the questions to put to GPs, and the results are summarised in the box (right).
The GP responses reflect their belief that patient inquiries had increased across all areas, but in particular in the area of benefits advice: 67 per cent of GP respondents said they had patients who lacked advice in this area. This was followed closely by their having patients with worries about debts/financial problems, and issues at work (65 per cent of GPs saw an increase in patients affected in each case since last year). Some 54 per cent of GPs reported an increase in patients with housing problems, and 55 per cent an increase in community care cases.
A total of 88 per cent of GPs questioned believed that being unable to access legal or specialist advice about problems would have a negative impact on patients’ health, either to a great extent (48 per cent), or to some extent (40 per cent).
GPs in urban practices were more likely than those in other areas to report an increase in the number of patients needing legal advice in the past year. Some 73 per cent of urban GPs had seen a rise in patients needing benefits advice (compared with 67 per cent of all GPs); 41 per cent had seen a rise in those needing immigration advice (compared with 30 per cent of all GPs); 71 per cent, debt and other financial advice (compared with 65 per cent); and 61 per cent, housing advice (54 per cent).
LAG is surprised at how conclusive the results of the opinion poll are. We initiated the research after anecdotal evidence that GPs had noticed an increase in patients who might benefit from legal or specialist advice on SWL problems. We had no idea before obtaining the results just how extensively this opinion was held.
We believe that the reductions in public funding for SWL services have contributed to this situation. The government’s impact assessment undertaken before the LASPO changes concluded that sick and disabled people would be more adversely affected by the cuts than the general population. The findings of the opinion poll are, therefore, a reflection of the government’s own prediction.
This research adds weight to the argument that the government should reinstate funding support for SWL, either by restoring civil legal aid, or by implementing one of the key recommendations of the Low Commission, which is the establishment of a national advice and legal support fund to develop the provision of SWL in local communities.