"Family doctors could be offered cash bonuses for cutting the number of long-term sick notes as part of the government's radical drive to slash the high levels of incapacity benefit (IB) that cost the taxpayer £12.5bn a year.
Glasgow, the sicknote capital of Britain where one in five of the working population is on IB, is in line to become one of the pilot areas where government money will be injected into schemes to help reduce dependency and get people back into work.
Ahead of tomorrow's green paper on welfare, John Hutton, work and pensions secretary, said of cash bonuses: "This is something we would like to talk to the GPs about."
But Dr Crippen (in his admirable blog here) points out some of the practical difficulties:
"I have five patients, all under the age of 45, who have severe sciatica and have been off work for nearly a year. They have "slipped discs". Bad ones. They cannot work. They can barely walk. Opening their bowels is agony. They need disc decompressions. This relatively minor surgery could have them back to work in a few weeks.
To get this surgery, they need to have an MRI scan. The government does not allow me to get an MRI scan directly. So I refer them to the "back clinic". The waiting list is seventeen weeks. When they get to the back clinic, they see the "nurse specialist" who is cleverer than I and so is allowed to order MRI scans. After a two minute assessment she orders the scan. The waiting list for the waiting list is three months and the waiting list is another three months. The MRI scan will then confirm that they need an operation, which I already know (before we had the advantage of MRI scans, they just had the operation). They then go on the waiting list to have the operation. That will be another six months or so. Thank God it is a Three Star Hospital.
During all this time, they have to be signed off work. And they are off so long they end up on invalidity benefit.
How is the certificate commissar going to advise me on this?"
Dr Crippen's whole post is well worth reading.
1 comment:
Im a GP. To police the sickness absence service you need to be independent of the patient. GPs are not they are the patient's advocate. It is difficult to be an advocate and a policeman. Being a policeman can damage on the ongoing relationship which is therapeutically essential. We cant do it!
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