The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951, and there are a number of other services for which fees are charged. Charges have to be made for services not covered by the NHS treatment, for example, medical reports for insurance companies.

It is important to understand that GPs are not employed by the NHS, they are self-employed, and they have to cover their costs - staff, buildings, heating, lighting, etc - in the same way as any small business. The NHS covers these costs for NHS work, but for non-NHS work the fee has to cover the doctor's costs. In recent years, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate. However, all this work requires time on the part of the doctors and their secretarial staff.

Examples of non-NHS services for which Aviemore GPs charge their NHS patients are:

• accident/sickness insurance certificates
• certain travel vaccinations
• private medical insurance reports

Whenever possible, we try to complete such forms and reports within two weeks of receipt. Sometimes this can take a little longer - the relevant GP might be away on holiday for example. The GPs have to find time to complete this sort of paperwork in amongst all their other duties and it can take time to read through a patient's set of notes in order to answer the questions raised.

Although it may seem that a form requires no more than a doctor's signature, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient's entire medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council or even the Police. The charge reflects either the time required to check information and/or the degree of responsibility signing the paperwork entails. If you require a form completed urgently (e.g. within 48 hours) then this will usually cost more.

In most cases, we can inform you of the likely charge due when you ask for the paperwork to be filled in. Remember though that not all documents need a doctor's signature, for example passport applications. You may be able to ask another person in a position of trust to sign such documents.