GPs should 'not sign off long-term sick'


Prof Carol Black says an independent assessment service would enable more people on long-term sickness to return to work

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People should be signed off for long-term sickness by an independent assessment service and not GPs, a government-backed review says.

The review also suggests tax breaks for firms which employ people who suffer from long-term conditions.

It is estimated the changes would send 20% of those off sick back to work.

A Department for Work and Pensions spokesman said: "The government is committed to supporting more people with health conditions to work."

Around 300,000 people a year are absent from work due to long-term sickness.

The review also calls for a new government backed job-brokering service, to find work for people cannot stay in their current job because of their condition.

A survey suggested 77% of GPs had signed people off sick for reasons other than their physical health, the report authors told the BBC.


The authors of the independent review believe that one in five of people currently on "the sick" could be back at work if their recommendations are accepted.

That is the kind of change that David Cameron and Work and Pensions Secretary Iain Duncan Smith want to see if they are to deal with a welfare dependency which they believe has spiralled out of control.

There's talk of tax incentives for firms to take on or retain staff with long-term conditions and government-backed help to find a more appropriate job for those who can no longer do what they have been doing could also be on offer.

Both the prime minister and Labour's Ed Miliband have talked recently about a "something for something" society.

The emphasis is on putting in if you want to get something out.

But there will be concern, particularly among the most vulnerable, especially those who suffer fluctuating illnesses, about how stringent and flexible any new assessment could be.

The government asked Professor Carol Black and the former head of the British Chambers of Commerce David Frost to consider radical changes to deal with the human and financial cost of sickness absence in the workplace.

Tax breaks

If the recommendations are accepted people who are signed off sick would also be put on to Job Seekers' Allowance, instead of Employment Support Allowance, for a period of three months.

They would receive less money and have to prove they were looking for work.

Tax breaks for firms which employ people who suffer from long-term conditions are also being suggested.

Prof Black said the current system was not working for anyone.

"What the GPs say is they don't have time to do an in-depth functional assessment and nor have they had any training in occupational health so we think it's providing a new unique service that both employers and GPs need."

Mr Frost said when people were away from work for periods of over four weeks it started to morph into something more.

"You start to lose the will to work and what we've got to do is to find a way of actually working with them, encouraging them and providing real, practical help. And that's what the assessment service would do," he said.

'Punitive process'

And welfare reform minister Lord Freud said: "We just don't get adequate help for people early enough when they need it and what we are creating in there is an incubator for lifelong idleness for far too many people."

BBC political correspondent Robin Brant said the new service was likely to assess people "more quickly and more stringently".

The report authors estimate the changes could save taxpayers at least £350m each year.

The deputy chair of the British Medical Association's GPs committee, Dr Richard Vautrey, said the changes could be a good thing for patients.

He said: "If what is being described is a proper health, occupational health assessment at an earlier stage in the patient's illness then that would be helpful.

"But if it turns out to be a punitive process just to try and save money without the best interests of the patient at the heart of the process then it will fail."

The DWP spokesman said: "The economy loses £15bn in lost economic output each year due to sickness absence and we cannot continue to foot this bill."


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  • Comment number 892.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 891.

    Well well, have another go at the sick and disabled. I am in a Wheelchair, not my fault. My back and legs are in a Brace, yes I have depression and a serious problem with my memory. All Those comments before this one, you have NO IDEA do you, what it's like to have a group of people who DO NOT KNOW YOU tell You to do things you CANNOT DO. JUST ANOTHER GOVERNMENT MONEY MAKING SCHEME.

  • rate this

    Comment number 890.

    I'd be interested in what psychological qualifications and or training the Former Head of the British Chamber of Commerce, Mr Frost, has that enables him to say that, 'when people were away from work for periods of over four weeks it started to morph into something more" and the implication that this is work-shyness and not a psychological health problem?

  • rate this

    Comment number 889.

    ok sign them off as fit for work, what work?? there is no work for the fit never mind any body else. This country has been on the slide for years thanks to Tory and Labour MPs getting it wrong.

  • rate this

    Comment number 888.

    Utterly stupid - and the wailings of a government in trouble. If GPs can't be trusted, strike them off, otherwise they are the most competent to summarise and act on a patient's history/injury etc

    Oh, and there's this other matter. Are there enough suitable jobs? If there aren't then this is simply more noise-making by a dictatorial minister

  • rate this

    Comment number 887.

    So 20% would go back to work? What about the other 80%? We need to create jobs for the people already desperate for work, not more mindless soundbites designed to appease the tabloid readers. Abolish National Insurance contributions for everyone earning under £30k, and abolish it entirely for employers.

  • rate this

    Comment number 886.

    Sounds like another quango that I thought this coalition were abolishing.

  • rate this

    Comment number 885.

    This week I've been told of these two examples.
    1 A Filipino nurse wanted her leave over Xmas when she didn't get it she was upset and then her father in law died. She went sick immediately, the doctor gave as the reason 'bereavement', she went back to the Philippines and has now sent a sick note from a Filipino doctor giving her a month off (typhoid fever) followed by a month recuperation. cont.

  • rate this

    Comment number 884.

    As an employer, it isn't long term sickness that bothers me or affects my business as much as short term sickness. GP's are far too quick to sign people off for very little reason. A great GP told an employee of mine that she was ok to return to work and wouldn't get a sick note.

    She just changed to a new GP.

  • rate this

    Comment number 883.

    I don't agree - the government had to change to private practitioners as pressure was being put on those who were employed by the government to limit times.
    What SHOULD happen is that if there is any doubt, the person should be referred to a MEDICAL panel, not politicians or an "independant panel to decide

  • rate this

    Comment number 882.

    Hurrah ! make sure you vote Tory next time too ! This Govt is doing a brilliant job. I have private healthcare, just like Dave, me and my family will be fine, just like Dave, I'm not really fussed about you lot. You scroungers need to be punished. If you didn't want this, you shouldn't have voted Tory, you obviously did, and you did. So stop whining eh?

  • rate this

    Comment number 881.

    Any idiot can see this is ideological and wildly impractical. Whatever possessed people (albeit nowhere near a majority) to vote Tory? An inner selfishness? Elitism? I would be very interested to see what would happen if Cameron got sick although on reflection he's set for life thanks to daddy's inheritance.

  • rate this

    Comment number 880.

    last year i had a complete knee replacement, i was back at work part time in 5 weeks and full time 4 weeks after that, because my employers made accomodation for my disability and my physical therapy appointments, that is what is needed and i hope that it what this is bringing, it is true the longer you are off work the less desire you have to return.

  • rate this

    Comment number 879.

    Re: 872

    If a person is in court for bashing a banker (not physically of course), do you think their defence could be 'Blame the abusers of the system'.

    No? Then don't make stupid bloody statements!

  • rate this

    Comment number 878.

    I work as a psychiatric nurse on an elderly challenging behaviour ward. The patients are mainly physically aggressive. I attended Dame Carol Black's lecture at Northumbria University in Newcastle and described my working conditions to her. She was shocked at some the things I described, then said, "This report will help the majority of people." Worrying for me.

  • rate this

    Comment number 877.

    as a disabled person i perhaps have more right to comment?

    actually was sent to an independent doctor for exam - in my case the x-rays etc provided all the proof necessary
    was this morning with a retired doctor friend - yes, they 'signed' people off in dubious circumstances beause they feared legal redress in the event of a 'problem'

    too many 'mental' issues - stress for example

  • rate this

    Comment number 876.

    I have a friend who has ms everyday is a struggle symptoms fluctuating from day to day some days worse then others. Been found fit to work, been made to feel like there is no illness. Horrible situation because which employers are going to put up with somebody who feels ill tired dizzy against a fit and able. Thanks for everything why cant we give better support.

  • rate this

    Comment number 875.

    And here's a question for ya.... who's going to pay for the independent panel? NHS... already strapped.... employers sign up for a service... too expensive.... where's the money going to come from?

    Leave the GPs to it...

  • rate this

    Comment number 874.

    "My bosses have been wonderful in allowing me time off for the treatment needed - you CAN work with an illness and you WILL feel better for it!"

    Yes, but most people don't have understanding bosses like yours. Most other companies would have let you go - then you would be at the mercy of the 'assessment' centre - who would put you on JSA and treat you like a leper. Is that what you want?

  • rate this

    Comment number 873.

    I know from experience that assessors send people back to work who aren't really fit for it. They can't make the proper determinations. Your GP is the only person qualified to do this because they know your history. Are we being told now that some form-filler in an office knows better than our doctors whether we're fit to work?


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