I was pleased to read Carolyn Regan’s commitment to constructive dialogue in reviewing the operation of fixed fees in mental health and including the role of ‘exceptional payments’ (see [2009] Gazette, 19 March, 11). She also indicates that nearly 90% of such exceptional cases are paid as asked.

However, figures released by the Legal Services Commission (Phase 1 Fixed Fee Scheme Review – Final Report) indicate that, in the first year of operation, exceptional claims in mental health matched hardly 25% of what should have been paid, based on previous years before the fixed-fee system, with actual agreed payments to practitioners in the last year around 10% of what was expected.

Any percentage increase in fees is welcome, as noted by Ms Regan. However, this must be seen in the context of a drop of close to a third in the real value of the work in the past 10 years, and the continued exodus of specialist panel members from the field – again down by about a third since 2000.

It is reassuring to know that the commission values our work and our skills, but it must demonstrate this by substantial reform of the operation of the new fee system. Returning ‘exceptional cases’ to the pre-fixed-fee payment procedure would be a significant start, or we might at least see a reduction of the exceptional payment threshold from three times to twice the fixed-fee level. The £3m-£6m savings they are already making under the new scheme must be the basis for such a change.

Richard Charlton, Chair, Mental Health Lawyers Association