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Friday 25th May 2018

GPs shouldn't police the system

30th March 2008

GP Ann Robinson explains why asking doctors to police their patients' return to work is a bad idea.


It is admirable that the government have stated their intentions to "encourage" the population to hold down jobs. Having a job usually has a positive impact on health.

However, the idea that GPs should push ill people back to work is not right. The sick note system does not work as it should, with many doctors signing a sick note for any patient
who asks for one. The difficulty is that many of the common illnesses which GPs sign notes for - such as depressive illness or back problems - are very hard "to prove or disprove."

The majority of people who take days off from their job do so because they are truly ill and will return when they are better. It is preferable for a person to take time off if they have an illness which could infect their colleagues.

However there are people who could be working who choose not to do so and cost the economy £100 billion annually.

Currently the Department for Work and Pensions (DWP) is responsible for the benefit system. The DWP will examine every claimant's case, ask the patient's doctor for more data and then decide whether or not to grant incapacity benefit.

Doctors should not be responsible for policing this system. We have no training and it would interfere in the "primary relationship...between patient and doctor".

Dame Carol Black, the national director for health and work, has put forward proposals to suggest GPs give out "fit notes" to say when their patients can return to work.

She has also said that discovering preventable illness is key and stated: "But we have nothing in place at the moment that gives us early intervention and prevention."

As a GP this is a statement I object to - I aim to prevent illness every day. I also object to being asked to act as a policeman to make patients return to work when the majority do not want to end up without a job and claiming benefits.

Dame Black should take some time to visit a typical GP surgery to see that this preventative ethos is already well in place.


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