Tuesday, 1 November 2011


The news that the government is insisting that GPs encourage people on long term sick benefit troubles me for several reasons.

As an ex GP I had to dissuade far more people from working than the other way round.
Nowadays perhaps there is a perverse incentive for people who are unemployed to register as sick as to do so brings more in the way of benefits. In addition there are fewer jobs and those available so low paid as a result of competition from Eastern European workers living ten to a house making it impossible for a British worker to keep his household going on the wages offered.

The new instruction also supposes that most GPs do not encourage their patients back to work.
GPs already do this.

Many of those off sick are the result of the decimation of heavy industry and the jobs on offer are more of a clerical or scientific nature which their previous work did not prepare them.

If you are thrown out of a factory job at the age of 50 as a result of the business being moved abroad you are unlikely to be able to land a job paying a living wage. In other words many who have tired their bodies out with heavy but not very intellectual requirements are being asked to compete with fit young Poles who are well educated and computer literate.
You can not really ask our people to learn a new trade at 50 or do heavy work with their already abused bodies. These older people, prone to disease have paid in to the system while working and are less able to cope with any work available.

A GPs job is dependent on a good relationship with his patients and this new "advice" hinders that relationship. It would encourage the doctor to label their patients as workshy. In addition the doctor would take responsibility if the diagnosis was wrong and could end up in court if for instance a patient died after being told he was fit for work.

There are of course many people who are scroungers, usually young people, neurotic public employees who play the system to say nothing of third world immigrants and these people should work (or be thrown out), but the GPs should not be the gate keepers, and have the responsibility.
This duty should be performed by doctors working for the social security who can impartially assess people and give a second opinion without jeapordising the GP patient relationship.

The system I agree is a shambles and has been created by governments over the last decades to massage the high unemployment rates and now the state is paying the price.

A system should be devised, hard on young scroungers and immigrants who have not paid in but compassionate to the older people who HAVE contributed but lost their livelyhoods owing to government mis management.

It should be changed but it is the responsibility of the State and not the doctors.

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