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GPs will be required to tell the employers of sick patients what tasks they can perform in a new “well note” designed to reduce the number of people on incapacity benefit, The Times has learnt.
Alan Johnson, the Health Secretary, will this week prepare the ground for controversial changes, saying that family doctors need to “change our sick-note culture into a well-note culture”. His aides acknowledge that the introduction of a new “well note” risks inflaming GPs, already angry over demands that they improve access, but insist they are not being asked to police Britain’s benefit system.
The Health Secretary is speaking before the publication of a report by Dame Carol Black, the National Director for Health and Work, that recommends a series of measures to keep workers in their jobs when they become ill. A new version of the sickness certificate used by doctors and recognised by benefits agencies and employers is being prepared. It “will encourage GPs to offer fitness-to-work advice to patients and employers,” Dame Carol has told occupational health professionals.
In a speech to the British Heart Foundation on Wednesday, Mr Johnson is expected to say that employers will come to recognise the need for a “work-health balance”, just as they have accepted the economic benefits of flexible working. He is to say that organisations should do more to assess and treat conditions at work, particularly those such as back pain or stress-related illnesses, which cost hundreds of millions of pounds each year in lost productivity.
But it is the Health Secretary’s call for GPs to issue “well notes” that is likely to cause the most controversy. “Incapacity benefit should not be a one-way street that starts in the GP’s surgery and stops at the dead end of a lifetime on benefits.
“The evidence shows that far from being bad for health, work is generally good for people’s health. In fact, staying in work or returning to work is often in a patient’s best interests. We want to explore what else GPs can do to change our sick-note culture into a well-note culture,” he is expected to say. Ministers, well aware that they risk angering doctors’ leaders, insist that most GPs are not aware of the evidence showing the health benefits of work. A new national education programme will help train them to offer advice to employees and employers.
A senior health official said: “Because those who aren’t in employment are likely to be in poorer health and use health services more, it is in the interest of GPs to do this too. We need to get better at identifying what those who have been signed off work can do, not obsess about what they can’t do.”
Action to reduce the 2.64 million Britons on incapacity benefit is becoming increasingly urgent for the Government in the face of the Conservatives’ welfare reforms. Last month the Tories announced their proposals to reassess claimants, weeding out those able to work.
A report by the Public Accounts Committee found that six out of ten of those on incapacity benefit have been living on it for more than five years.
Nine out ten of those going on to the benefit both want and expect to return to work. Officials say that many of those signed off sick have back or neck pain, depression or heart and circulatory problems. “They are serious conditions but not ones that make long-term unemployment inevitable,” one official said.
Half of workers signed off with back pain for six months return to their jobs, a figure that drops to 25 per cent after a year.
The CBI estimates that 175 million working days are lost to ill health each year. The Health and Safety Executive says that 36 million of these days are because of occupational ill-health.
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People like me who have had a brain injury and still have tumours are not fit to work in anyway. Sure I can stil walk and talk but I walk round with a permanant head ache. No company would be able to afford Insurance for someone in my situation.
simon north, leicester,
Thats a great idea as long as you work for a company who is prepared to accommodate the disability! Most people on IB would far rather work, the reduced income from going onto benefits is horrendous. And no you dont get free cars prescriptions or anything else, and you still have the same bills.
Carol Asacret, Cambridge, England
This is a greatest idea, second best to have GPs working side to side with Occupational Health Physicians.
Most of the sick notes issued, particularly in deprived areas, have nothing to do with physical health.
Edoardo, Southport,
Why not scrap the self certified sick note which allows anyone to take a week off work without a doctor's note. To those who are 'that way inclined' this is just an easy way to have week off work. Go back to 3 days off only then a sick note required. Surely this would stop employees being off work when they shouldn't be. I could never understand why this was introduced in the first place.
M Gooder, Leeds, England
Simple maths regarding private industry - statutory sick pay is standard rate of £72.55 per wk ( the first week 29.02 as the first 3 days are unpaid)
Compared that to minimum working wage is £220 pw (5.52 per hour) gives approx £880 pm as opposed to £245 sick income for the month, goes along way ?
Obviously you can see why people enjoy and voluntarily want to be signed off sick with higher heating, electric bills to pay for the time they have to spend at home - mainly due to illness they contracted in the work place.
So labour once again take a low punch at the poorest and sickest of society.
Has anyone asked industry whether they want to cater to providing alternate work for sick workers (who have probably been failed by health and safety in the first place) !!!!
Or should be be looking the government look at sick pay they are paying their own workers ?
Fedup Truth-seeker !!!!, Lancs, UK
NuLabour never gives the real reason for their ideas - e.g. "we're increasing duty on fuel to improve public transport, and encourage people to use it". Well, TB said without the duty, schools and hospitals couldn't be paid for.
So what's the real story behind this one?
Could it be that the long-term unemployed now move on to incap. benefits, because nuLabour have made it so they can't claim dole? And now nuLabour realise that, although by doing this they have reduced unemployment figures, they still have a massive bill to pay?
Who will this affect in the long run - probably worst off will be those who work and get ill - who probably will need genetic evidence of their illness to present to their employer.
Name Withheld, Manchester,
This is a problem of monumental proportions, about 6 million in the Uk ARE ECONOMICALLY "INACTIVE", from the start lets get it clear IM NOT TARRING EVERYONE WITH THE SAME BRUSH, when I was a Bobby years ago I noticed when we did the antecedance of prisoners, hardly anyone was "unemployed" they were mostly on "the sick", its more money and better still you dont have to look for work, this was when the Tories were in power, since then its what 4.5 million on "the sick"-thats a lot of voters, I dont think ANY Party will seriously tackle this problem.
Steve, west midlands, uk
A quick back of the envelope calculation shows that the reported profits last year of British Gas, M&S & Tesco alone would pay for the salary of the entire UK GP workforce. Isn't it time that big business accept that Occupational Medicine is their responsibility? If they wish sickness absence to be policed it should be by Occupational Health Specialists employed at their expense.
D Stokoe, Liverpool, UK
Do you know how many hoops you have to jump through to be able to claim incap'. Hoops I might add that the Government have put in place, independent doctor's assessment, a claim form that ties you up in knots with its complexity and furthermore, a continual review of your needs... Government review, not GP review.
Yes I agree that the 'workshy' should return, but those with long term illnesses and disabilities that prevent them from working should not be made to feel like spongers or scroungers.
Making people answer what you 'can do' rather than what you can't will open a can of worms. If a person can climb stairs, does it make him a mountain rescuer, if a person can paint his bathroom wall, does that make him a painter and decorator, or a spot of light gardening, does that make him a landscape gardener. If by what this Government is saying, well yes it does.
It's all too easy to pick on the most vulnerable, perhaps if this Government hadn't wasted so much of taxpayers money through the NR debacle, we might be hearing something other than this spin. This is a good day to bury bad news (more Government sleaze and scandals).
Bill, Lincs, UK
and there are a lot of lazy shiftless nutters who neither work nor want; they can find time and money to drink alcohol, entertain themselves on the web, whine and moan about their lot. But, in the main, those people are not unfit for all work which is supposed to be the test for eligibility for Incapacity Benefit. The time for getting something for nothing is long gone. In the absence of total incapacity, rare indeed, G.P.'s should be required to confirm the nature and extent of the abilities of their patienrs, not their levels of incapacity.
matthew reilly, stirling, scotland
I Know people, who are milking it.
my husband had a quadtruple bypass, but he would not claim for any bennifits what so ever.
And he was only anormal man, no moneys, no savings.
But had a lot of PRIDE.
Not every one with Back problems, milk the D<L>A,. but their are more that do. and pretend, to work for 15 hours, and still get thier D>L>A>.
pat, manchester, England
What a soft sick nation we've become ,if people put as much energy into telling everyone why they are "unable to work "and actually used it to lead a purposeful life and contribute to the tax system encouraged by the first line of contact their GP.
Why are the Doctors whining we pay them 100k a year plus for what to hand out sick notes without responsibility.
Stephen., Carlisle, England
I assume the reverse will apply - that patients with no medical complaint will be able to ask for a Doctor's note saying that they CAN'T do part of their regular job - that involves
a) huge amounts of stress ?
b) heavy lifting ?
c) operating machinery whilst tired ?
etc
I guess not - funny how these schemes operate in only one direction - against you, never in your favour.
Clive, Surrey,
The Govt continues to in an Orwellian way to abolish the notion of illness or sickness, in fact I am soon expecting them to raise the dead like Lazarus so they they can 'go back to work', 'A New Deal For The Dead' as it were. So no understanding that the lifestyle and work culture in the UK may be making people very ill in the first place. Once sick people were sent to convalescence homes to recover, now they are to put on a 21st version of the treadmill, where in fact, they might become worse.
Further the reporting in the media on welfare benefits, etc is very poor indeed. Where are on earth does the Times get these figures from, have they consulted all of these people? did the DWP ring them up and ask them. Of course, most people want to work, benefits are minimal and claimants face a very coercive system but many can't , they are just too ill.
'Nine out ten of those going on to the benefit both want and expect to return to work.'
John Rogers, sheffield, Uk
If I wanted to advice patients back into work I would have chosen occupational health not primary care. This is a cheap way of offering occupational health by incorporating it into primary care not to mention that we have not got insight in what jobs on the workfloor entail and so are not in a position to judge.
M.Brugman, Stevenage, Hertfordshire
If I could get people seen, diagnosed and treated in a timely manner in the NHS, then I might have a hope of getting them back to work within a reasonable space of time. However as I am often signing people off for months or even years whilst they wait for appointments for scans, opinions, nerve conduction studies and the like, the chance of an early rehab are negligible. When will this Government learn that flogging people harder is not a substitute for proper capacity of services.
I presume he is going to want the cooperation of GPs like myself in yet another whacko scheme. He may find it useful to look up what the word means as he seems to have no concept of what it involves. I feel more antipathy to this administration than I even did to Kenneth Clarke.
tuxman, Notts,
It takes a good many patients all their time to get an early appointment to see their GPs by placing tyhis extra burden (of proof?) upon them may lead to further delays whlst the doctor has his longish chat with his 'working patients' to discover what work they are capable of doing.
Rodney, Lincolnshire, England UK
The inevitable consequense of care in the community.Many long term sick are mentally ill ,lovely people but not easy to place in unsupervised work .Also many physical injuries take longer to rehabilitate than allowed even if rehabilitation and retraining facilities had not been closed to svae money.Save money on rehab lose it in benfits,the goverment has only itself to blame.
G.P.EDlin, london, uk