Letter calls on GP body to denounce DWP’s ‘fit for work coercion’

By John Pring  Disability News Service 26th April 2018

The national membership body for GPs is facing calls for it to denounce government attempts to persuade doctors to “coerce” patients with serious health conditions back into work.

More than 90 campaigners and concerned health professionals have sent a joint letter to the Royal College of General Practitioners (RCGP), asking the organisation to distance itself from the latest move by the Department for Work and Pensions (DWP).

DWP already sends a form – known as an ESA65B – to GPs to let them know when their patients have been found fit for work through the controversial work capability assessment (WCA).

The previous version of the form – headed “Help us support your patient to return to or start work” – already told GPs that they should stop providing the patient with the “fit notes” that detail the advice they have provided to them about their fitness for work*.

But DWP has now updated the form, by adding the line: “In the course of any further consultations with… we hope you will also encourage [the patient] in [their] efforts to return to, or start, work.”

Disabled activists and campaigning health professionals – led by the grassroots group Disabled People Against Cuts (DPAC) – say the move will “gravely impact” the relationship between doctors and benefit-claiming disabled patients.

Among those who have signed their letter are members and representatives of the Mental Health Resistance Network, Psychotherapists and Counsellors for Social Responsibility, Black Triangle, Inclusion London, Recovery in the Bin, and the Alliance for Counselling and Psychotherapy, and more than 50 psychologists, psychiatrists, psychotherapists and GPs.

The campaigners who have signed the letter say the addition to the form adds to DWP’s continued insistence – based on “the thinnest veneer of evidence”, which was commissioned by DWP itself more than 10 years ago – that work is good for health and should be recognised as a “health outcome” (a measure of whether a patient’s health has improved).

They point to cases such as that of James Harrison, whose GP was told by DWP through an ESA65B form in 2016 to stop providing him with fit notes, after he was found fit for work.

His GP then repeatedly refused to provide him with new fit notes, even as his health deteriorated, and he died months later.

Dr Jay Watts, a consultant clinical psychologist and activist, says in the DPAC letter that health professionals will be “horrified at this latest interference from the DWP”, which “undermines clinical expertise and threatens the safety of patients”.

She says the new paragraph places the expertise of DWP’s contracted WCA assessors above that of GPs, “despite the fact GPs are more qualified to assess mental health, and can do so with the benefits of having known the patient for years, often decades (as opposed to in a one-off assessment)”.

She says the form also ignores research that shows that work can damage mental health, with “poor work environments a frequent trigger to mental breakdown”, and she adds: “Economic evidence shows that rushing people back into work increases the likelihood of long-term illness.

“How then can it be right to encourage GPs to coerce patients back to work, a pressure likely to increase the feelings of shame, despair and anxiety at not working that have been exacerbated by the government’s relentless and damaging campaign to associate worklessness with worthlessness?”

The letter to RCGP says the new version of the form risks a situation where disabled people are unwilling to make appointments with their GPs, with “damaging and potentially life-threatening effects on the physical and mental health of claimants”.

And it calls on RCGP to tell its members about the risks to patients from the new version of the form and to ask them to “use caution and discretion when following DWP instructions”.

Neither RCGP or DWP were able to comment on the letter by noon today (Thursday).

*Further fit notes can be issued if the claimant appeals against the result of the WCA, or if they make a new claim because their health condition or impairment has deteriorated or they develop a new medical condition

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