Does anybody at the Department of Work and Pensions ever bother to open a medical textbook?

The opening line of the chapter on fitness for employment in the standard GP reference reads: “Whenever possible, suggest work adjustments rather than signing the patient off work.”

To suggest that GPs are not aware of the evidence showing the benefits of an early return to work, both in terms of physical and mental health, is as laughable as the idea that we will all troop off to remedial classes on Saturday mornings for training in occupational health. You may have noticed that your GP is a bit hacked off with the Health Secretary at the moment, being the victim of the out-of-hours-opening stitch-up.

The week after he’s stuffed most of us with a six grand pay cut probably isn’t the best time to ask us to act as policemen for a failing incapacity benefit system.

If we’d wanted to work for the Government we really wouldn’t have worked quite so hard at medical school.

For every patient I see who’s angling for time off on dubious grounds I see a dozen pressurised to return to work prematurely, either as a result of veiled threats of dismissal from their employer or because they can’t afford to run their household without two pay cheques coming in.

Simply redesigning the medical certificate will change nothing. There’s already a section labelled “Doctor’s Remarks” but anything written there carries no legal weight. My scribbling ‘Fit for light duties’ on a sick note doesn’t place any obligation on an employer to organise them. Most bosses don’t want their employee back to work until they can do the job they were trained for.

That’s the law as it stands. For the first 28 weeks of any illness I am required to certify a patient unfit for their usual employment, not fit to make tea and run errands. As I may have no real idea what a patient’s job actually involves I have to rely on their own assessment. If a yarn-mercerizer tells me that by virtue of his broken wrist he cannot perform the duties in his job description – “shaking skeins of cord to vanish tangles and loading same on wave blazonry” – then who am I to argue?

Besides, am I my patient’s advocate or not? The regulations currently stipulate that a medical certificate is issued by a GP who knows the patient.

Fat chance of that when we’re consulting in impersonal polyclinics in supermarket car parks. Until then, the DWP can do its own dirty work.

Dr Martyn Lobley is a GP in South East London

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