New report says GPs "rubbish".. « Singletrack Forum

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New report says GPs "rubbish"..

32 posts & 16 voices | Started 6 months ago by althepal | Latest reply from cinnamon_girl

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althepal - Member

Well, not exactly rubbish.. But not the best folk to sign off the long term sick apparently..
http://www.bbc.co.uk/news/mobile/uk-15801515?psdata=11_3Cf17_8_4__JG9_10CfCD11__CK12_14_15_

I'm not saying that the benefits system doesnt need changing, but surely GPs are the best ones to judge a patients health/long term ability to work.
The report states that an independent (private?)assessment service should do it instead.. Would this service not be relying on reports from GPs anyway? And do we not already have an independent agency that deals with these issues- ie, DWP?

Posted 6 months ago #
djglover - Member

I agree. Gp is just a fix the basics / referral service. Isn't it?

Posted 6 months ago #
doctornickriviera - Member

I would love to not do this any more!

There are so many blaggers out there who feel incapacity is a right. I saw someone yesterday who asked me if i could go on the sick so they could get some extra cash! I ignored their request

Lots of my colleagues never challenge their claims for an easy life

Savvy patients know exactly what to say to us to get signed off! The implications to myself of calling a patient a liar simply arent worth it - even vexatious complaints are a mare to sort. Its very hard to prove a patient isnt depressed for example.

Stems back to the 80s when millions were put on the sick to massage down unemployment stats!

I aggree though- take it off our hands, id rather deal with real medical probs than skivers!

I also see alot of people who genuinely cannot work due to sickness getting refused help!

I imagine any replacement service will cost more to the taxpayer than it saves!

It does seem to me though that most of my colleagues Rarely challenge sick note requests to avoid patient upset and confrontation.

Posted 6 months ago #
althepal - Member

Your point about genuinely sick folk getting turned down for benefits is a big worry for me..
But then, the amount of work-shy skivers getting away with it I see at work every day properly annoy/scare/depress me!
I love the fact that we have a welfare state, amongst other things our great country has, but the abuse of it really does get to me sometimes..

Posted 6 months ago #
doctornickriviera - Member

I aggree! Abuse is rife! These peple arent stupid and know how to play the system! If one doc says no they will go and see another! Impossible to police. Good luck to whoever takes on this role!

Posted 6 months ago #
Stoatsbrother - Member

Please Please take this away from us.

We are meant to be the patients advocates 99% of the time, but then we have to step in to an enforcement role.

I'm lucky - not something I get from many patients, but I can think of 2 people I saw last week where I have been actively resisting giving them certificates, trying to get them independently assessed, but they play the tribunal/appeal system for all it is worth... and the DWP etc give in.. and they end up back on benefits...

Djglover - not true for many years. Most people with chronic diseases are now largely managed in primary care. For instance - only about 15% of our diabetic patients go near a hospital clinic. We run it all and actually provide services for the hospital sector. Has increased our work load hugely, but it's good. I think if I wrote a list of what I saw/did in a day you'd be surprised. But I hope you don't have to find out.

Posted 6 months ago #
winstonsmith - Member

So, you gp's really think that this is that large a problem that it requires an entirely new system?

Posted 6 months ago #
Stoatsbrother - Member

Depends what you want...

It is difficult to spend ages supporting someone through a chronic depressive illness, or low back pain problems, and to be sympathetic, pointing out that they would probably get better faster if they went back to work - and then have to turn round and say you are effectively cutting off their benefits...

BUT - the current system was already meant to have fixed this with compulsory assessments by independent Drs - often employed by private companies, and not GPs - who were assessing long-term fitness. There have been at least 2 attempts to fix this in the last 10 years - but each time the system doesn't work, and people seem to drift back to us being told by the DWP or BA that they should get certificates from us. And we are not good at it.

Will the system save any money? Dream on. And what jobs are these people going to do?

Posted 6 months ago #
doctornickriviera - Member

Hear hear stoatsbrother!

Being the benefit police and being an empathic and supportive doc are not 2 roles which a gp can provide!

As for the independent dwp assessments, i cant imagine that job attracts a high calibre of applicants. Would you really want to spend all day assessing someones ability to work? Nightmare job! Thankless task! If anyone on here does this for a living im sorry if ive caused any offence.

And i aggree, exactly who is going to employ someone who has been on the sick for 10-20 years. Loads of these folks are unemployable! Must be some people who run private businesses on here. Would you take on someone who is 45 and never worked?

Posted 6 months ago #
Woody - Member

What the docs say makes sense. The system is NOT working.

On a daily basis I see total scroats abusing the system and living the life of Reilly and genuinely ill people struggling to get help in coping with the very basic necessities.

GP's have limited time and resources and cannot possibly be expected to be able to carry out the basic tests and checks needed to sort out those who abuse the system.

Edit: To clarify - a system in which GP's can be happy to deal with those they know (or at least are as certain as they can be) are genuine can be dealt with as they do at the moment and others, where there is doubt, can be referred for further checks/2nd opinion/further tests.

Savvy patients know exactly what to say to us to get signed off! The implications to myself of calling a patient a liar simply arent worth it - even vexatious complaints are a mare to sort. Its very hard to prove a patient isnt depressed for example.

That typifies the problem. If the patients' GP cannot decide, or fears repercussions for making a decision, maybe an 'outside' agency is needed to review 'difficult' cases.

Posted 6 months ago #
doctornickriviera - Member

I dont think an outside agency could sort difficult cases any better than gps! If you are that determined to mislead professionals to obtain benefits , then you will beat the outside assessor/appeal the decision/develop a new condition and go back on the sick etc. this all costs loads so the role will remain with gps!

Posted 6 months ago #
Woody - Member

Drnick

There will always be those who can beat the system but if you take responsibility away from the patients GP in certain cases where the GP is in doubt, or doesn't have the time, inclination, expertise, or resources to carry out proper checks, then you have a better chance of stopping those abusing the system.

You are right though, it wouldn't save any money, probably the reverse, but at least it would prevent some long term criminal abuse of the system.

Posted 6 months ago #
benjamins11 - Member

The other side to this is as well, whilst yes Gps are best placed to know whether a patient is sick or not, the new system requires fit notes, i.e. a note to say what a patient can do - Gps are not employment experts. How on earth are they meant to say what a patient is able to perform at work. I think a specialist service would be far better.

Posted 6 months ago #
docrobster - Member

Whatever system is in place, those who want to abuse it will continue to do so.
If what I heard on radio 4 this am is correct, all they are saying is do the independent assessment at 4 weeks instead of 28 weeks.
Currently if you are signed off sick for 28 weeks you have to go for a benefits medical- you'll be seen by a Dr employed by the government (through a private firm) whose job is to throw all but the worst cases off the sick. The patient then appeals. Two thirds of appeals are upheld. Tribunals take months to arrange and the patient keeps getting sick notes while waiting for it to happen.
This new system will save the govt money cos it will save 24 weeks sick pay from the ones that it will chuck off the sick as this happens quicker, but may cost more as many many more people will have to go through the system, many of whom were never going to be off long term anyway.
As Drnick says- who is going to do these assessments?
Retired gps?
Gps who can't get a "proper job"?
You get the picture.
If patient's reports are anything to go by the benefits medicals are cursory and I gues that's why the majority of their decisions are overturned.
ho-hum

Posted 6 months ago #
jools182 - Member

I'd like to make a complaint about the amount of exclamation marks in this thread.

Posted 6 months ago #
doctornickriviera - Member

**** off!!!!!!!!!!!

Posted 6 months ago #
jonba - Member

As Drnick says- who is going to do these assessments?

The company is called Atos.

Posted 6 months ago #
doctornickriviera - Member

Yep and their decisions are cursory and often wrong!

Posted 6 months ago #
docrobster - Member

The company is called Atos.

Indeed, the company that is making such a good job of it already.
What I was getting at was where they find the individuals?
They will need many many more people to make these assessments.
There just isn't a huge pool of under employed occupational health specialists waiting to do this work.

Not sure what the answer is, but this latest tweak to the system doesn't look like it.

Posted 6 months ago #
Woody - Member

Whatever system is in place, those who want to abuse it will continue to do so.
True but to continue with the same system is allowing those guilty of abuse to continue obtaining money by deception and the sooner this culture of 'passive acceptance' is stopped, the more care and assistance can be given to those in genuine need.

Posted 6 months ago #
project - Member

So youre on the sick, got your mobility car, and your rent and council tax paid for you and your family,then some guy in a suit says youre fit for work, so every job you apply for you just point out youve been on long term sick for anxieety/depression/mental health issues, bad back/epilepsy/and quite a few more problems you could pick from,none that should stop you working,but your new employer will think never will employ him/her

So who the hell is going to employ you, and if they did would you be happy to lose your mobility car and pay your rent and council tax.

Posted 6 months ago #
TandemJeremy - Member

A friend of mine with MS who is clearly not fit for work was assessed as fit for work by ATOS as she was able to walk that day. the fact hat the majority of the refusals from ATOS win on appeal as she did shows here is something fundamentally wrong with that approach -of having an outside agency doing the assessments. What the right answer is I don't know? Reduce the differential between unemployment and invalidity benefit? Our basic benefit rates are very low in comparison to many countries

Tricky one - interesting to see the GPs view

Posted 6 months ago #
doctornickriviera - Member

Its a bloody nightmare tj tbh. It sounds like a simple prob to fix, but not easy to do so.People cheat all kinds of stuff. Blue badges, council tax rebates etc.! If i feel a patient is trying to defraud the system i let them know about it. Many dont.

Posted 6 months ago #
DrP - Member

I've always thought that chronic (read, perhaps not genuine) sickies souls be provided by ANOTHER gp, not the patients own and probably from another practice.
That way they can resist giving out dodgy ones, but yet the relationship between the patient and their own gp remains savoury....

Short term notes/post surgery etc can still be dealt with by your own gp...

Good plan??

DrP

Posted 6 months ago #
kimbers - Member

drPs plan sounds good to me

certainly cheaper than an outside agency being newly created and undoubtedly costing more money than it saves
while making camerons private healthcare chums a nice profit

Posted 6 months ago #
TandemJeremy - Member

Makes some sense DrP

Posted 6 months ago #
winstonsmith - Member

This recent report is nothing to do with benefit claimants 'on the sick'. As noted above, they are already assessed strictly by a private company, on behalf of the DWP. The recommendation in this report us that those still in employment will not be assessed by their own gp, rather that some alleged expert will do it.

I've seen a lot of the ATOS reports for sickness benefit and they are not done by occupational health experts - they are done by gp's, nurses and physios who have attended a one week training course.

I've seen reports on people with mental health problems who were assessed by a physio. eh? What experience and expert knowledge do they have in this area...

Posted 6 months ago #
cinnamon_girl - Member

Where are all these jobs then?

Posted 6 months ago #
Elfinsafety - Member

In India and China, CG...

Posted 6 months ago #
cinnamon_girl - Member

Just goes to show that this country really hasn't learned anything despite the different Governments that have been in power.

Why not spend resources on chasing those who are defrauding in a mega way, ie the business world.

Frankly I'm just sick of these gestures that successive governments come out with.

Posted 6 months ago #
Elfinsafety - Member

Because it's easier to target those who have little or no political voice, or the resources to challenge government actions effectively.

Taking on the likes of Vodaphone, with enormous wealth and fantastic legal resources not to mention significant political and economic influence, is a very different story...

Posted 6 months ago #
cinnamon_girl - Member

Agree with you there Elf.

Far too much self-serving going on without accountability and totally devoid of any compassion.

Posted 6 months ago #

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