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Gold, incentives and meh

John McArdle

  • Analysis: GPs take the strain of ‘Austerity Britain’

    John McArdle's comment 02 Apr 2014 7:46pm

    The solution is staring you in the face. All that is required is for the BMA to reach out and educate GPs on how to flag up substantial risk in a simple, time-efficient manner thereby discharging a duty of care and saving the GP all this hassle:

    Black Triangle Campaign's Submission to the Westminster Work and Pensions inquiry into #ESA #WCA has now been published:

    http://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/inquiries/parliament-2010/esa-wca-inq-2014/?type=Written#pnlPublicationFilter

    Link to submission (Pdf):

    http://data.parliament.uk/writtenevidence/WrittenEvidence.svc/EvidencePdf/7721

  • Benefit request refusal letters are proving 'valuable' for local GPs, says LMC

    John McArdle's comment 11 Oct 2013 6:47pm

    See you in court! http:/:blacktrianglecampaign.org

  • 46. Dr Stephen Carty

    John McArdle's comment 03 Oct 2013 10:36am

    Congratulations, Doctor Carty!

    You are a very great credit to a proud profession.

    All power to your elbow!

  • LMC leaders plan campaign to encourage GPs to 'just say no' to benefit requests

    John McArdle's comment 23 Aug 2013 5:16pm

    In light of the above Black Triangle and DPAC are now planning legal action against the LMCs

    Black Triangle Campaign Anti-Defamation Campaign in Defence of Disability Rights

    1. Doctors’ Letter

    TEXT

    On 24th June last year at the BMA’s Annual Representative Meeting (ARM) doctors from every discipline voted overwhelmingly to demand that the DWP-Atos Work Capability Assessment end ’with immediate effect’.

    Through their Medical Adviser, the patient-led Black Triangle disability rights campaign originated the motion which became BMA national policy. Part (iii) of the ARM motion called upon the BMA to engage with disability groups to change public policy. To date, the only ”official” communication their campaign has received has been a short statement via Facebook.

    As doctors on the front line witnessing daily the enormous avoidable suffering of many of our most vulnerable patients caught up in this Kafkaesque system of ‘disability assessment’, we find this failure to meaningfully engage unacceptable. More critically, we fully share in the dismay with which sick and/or disabled people have greeted the failure of the BMA’s leadership to give any meaningful effect to the unanimous wishes of its members: that this dreadful assessment régime should be immediately terminated.

    The GMC’s own publication ‘Good Medical Practice’ states that:

    ‘… a doctor must (overriding duty or principle) take prompt action if he feels that “patient safety is or may be seriously compromised by inadequate… policies or systems.’

    ESA Regulations (2013) 29 & 35 deal with flagging up a substantial risk of harm to patients if they were to be found ‘fit for work’ or to have ‘limited capability for work’ and placed in the Work-Related Activity Group (WRAG) where:

    ‘the claimant suffers from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work.’

    Regrettably, it remains the case that only DWP and ATOS staff are aware of these regulations whilst GPs remain ignorant of their existence and those performing the WCA and DWP Decision Makers continue to make complex risk assessments based on grossly inadequate patient information.

    Until the current system is entirely revised, there remains no safety protocol for the assessment of risk and the avoidance of harm to patients. There are no formal reporting mechanisms for GPs to report significant adverse events such as self-harm and suicides which many of us have witnessed.

    Black Triangle have led the way in campaigning for the uptake of Regulations 25 and 31 and their legal Counsel has advised that they should be applied in every case where harm would be more likely than not to occur as a result of erroneous DWP decisions regarding patients’ fitness for work.

    We are also fully aware of the fact that numerous conflicts of interest exist between the ethical versus contractual duties placed upon GPs arising out of the DWP-Atos contract. In balancing a doctor’s duty of care to provide supporting information for Tribunal appeals and contractual conflicts with the DWP over the issue of fees and workloads, we submit that the only ethical solution must be the one that causes the least harm to patients.

    Black Triangle’s simple campaign for the appropriate application of these regulations utilising one side of A4 has proved highly efficacious in this respect. It has saved General Practitioners a substantial amount of time and expense and has meant that unnecessary, costly and stressful tribunal appeal hearings have been rightly avoided.

    We now call upon the BMA leadership to urgently publicise and make known to every GP in the country the existence and lawful application of these regulations without any further delay in order to prevent further avoidable harm to our patients. Any failure to do so would in our opinion amount to negligence.

    Dr Stephen M. Carty, GP and Medical Advisor, Black Triangle Campaign.
    Dr John Budd, GP Edinburgh Access Practice
    Dr Roy Robertson, GP Muirhouse, Honorary Clinical Reader
    Dr Ian McKay, GP Rose Garden Medical Practice, Leith
    Dr Oliver Aldridge, Edinburgh
    Dr Guy Johnson, GP Sighthill Health Centre, Edinburgh
    Dr Helga Rhein GP, Sighthill Health Centre, Edinburgh
    Dr Elizabeth Morton, GP Challenging Behaviour Practice, Edinburgh
    Dr Kate Burton, Public Health Practitioner
    Dr Margaret Craig, GP, Allander Surgery, Possilpark, Glasgow
    Dr Nick Treadgold, GP, Pollok Health Centre, Glasgow
    Dr Christine Grieve, GP Drumchapel Health Centre Glasgow
    Dr Chris Johnstone, GP Paisley
    Dr Donald MacIntyre Consultant Psychiatrist Edinburgh
    Dr Sarah Houston GP
    Dr Ros Wight GP
    Dr Robert Young, Glasgow
    Dr Nora Murray-Cavanagh GP Medical Education Fellow
    Dr David Nicholl, Consultant Neurologist, Birmingham
    Dr Jonathon Tomlinson, GP The Lawson Practice N1 5HZ
    Dr Anita Roy, GP, Yorkshire
    Dr George Farrelly, GP, London
    Dr Peter English, Consultant, London
    Dr Robert Cheeseman, Ophthalmology Registrar, Liverpool
    Dr Ray Noble, Medical Ethicist, UCL Institute for Women’s Health
    Dr Margaret McCartney, GP , Glasgow


    2. Supporting Letter from Trade Unions and Civil Society


    TEXT

    As trade unionists, organisations and campaigners from across civil society who collectively represent millions of citizens we write in support of the letter by doctors in the British Medical Association about work capability assessments.

    We firmly believe the current assessment régime is unfit for purpose and poses a real risk to the health and lives of disabled people and those with life threatening conditions. This is because the government’s regulations, which ask whether substantial risk or harm would be caused if the claimants are found ‘fit for work’ or with limited capacity for work, are not being applied consistently.

    Information obtained through freedom of information requests shows that between January and August 2011, 1,100 claimants died after they were put in the work-related activity group – the equivalent of 30 deaths a week.

    We are hopeful for a successful outcome to discussions between disabled people’s organisations and the BMA, following its conference decision last year to call for the current assessment régime to be scrapped.

    We send our solidarity to these groups and the BMA and hope you will join us in a united campaign to bring an end to the disgraceful treatment of ill and disabled people.

    John McArdle, David Churchley and Dr. Stephen M. Carty Black Triangle Campaign

    Linda Burnip Disabled People Against Cuts DPAC
    Mark Serwotka General Secretary Public and Commercial Services Union PCS
    Len McCluskey General Secretary Unite the Union
    Christine Blower, General Secretary National Union of Teachers NUT
    Bob Monks, General Secretary of United Road Transport Union URTU
    Sally Hunt, General Secretary of University and College Union UCU
    Michelle Stanistreet, General Secretary National Union of Journalists
    Phil Gray, Chief Executive, Chartered Society of Physiotherapy
    Richard Evans, Chief Executive Officer Society of Radiographers
    Bill Scott, Manager, Inclusion Scotland
    Gordon McFadden, Policy Director, Limbcare
    Dr Simon Duffy, The Centre for Welfare Reform
    Dan Moreton, Social Work Action Network (SWAN) and SWAN (London)
    Mary Olaniyi Coordinator/Family Adviser Lewisham Mencap
    John McDonnell MP (Lab, Hayes and Harlington)
    Deborah King Co-founder Disability Politics UK
    Paul Smith – Founder Atos Victims Group
    John Burgess Branch Secretary Barnet UNISON
    Gill MacDonald Psychiatric Nurse Lothian NHS

  • It is not up to GPs to decide which patients are ‘deserving’ or ‘undeserving’

    John McArdle's comment 20 Aug 2013 11:10pm

    Come on, Doctors! SPEAK OUT!

  • It is not up to GPs to decide which patients are ‘deserving’ or ‘undeserving’

    John McArdle's comment 20 Aug 2013 4:52pm

    Leading doctors protest at ‘cruel’ disability assessments ~ Letter

    Black Triangle Campaign Anti-Defamation Campaign in Defence of Disability Rights


    info@blacktrianglecampaign.org

    1. Doctors’ Letter

    TEXT

    On 24th June last year at the BMA’s Annual Representative Meeting (ARM) doctors from every discipline voted overwhelmingly to demand that the DWP-Atos Work Capability Assessment end ’with immediate effect’.

    Through their Medical Adviser, the patient-led Black Triangle disability rights campaign originated the motion which became BMA national policy. Part (iii) of the ARM motion called upon the BMA to engage with disability groups to change public policy. To date, the only ”official” communication their campaign has received has been a short statement via Facebook.

    As doctors on the front line witnessing daily the enormous avoidable suffering of many of our most vulnerable patients caught up in this Kafkaesque system of ‘disability assessment’, we find this failure to meaningfully engage unacceptable. More critically, we fully share in the dismay with which sick and/or disabled people have greeted the failure of the BMA’s leadership to give any meaningful effect to the unanimous wishes of its members: that this dreadful assessment régime should be immediately terminated.

    The GMC’s own publication ‘Good Medical Practice’ states that:

    ‘… a doctor must (overriding duty or principle) take prompt action if he feels that “patient safety is or may be seriously compromised by inadequate… policies or systems.’

    ESA Regulations (2013) 29 & 35 deal with flagging up a substantial risk of harm to patients if they were to be found ‘fit for work’ or to have ‘limited capability for work’ and placed in the Work-Related Activity Group (WRAG) where:

    ‘the claimant suffers from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work.’

    Regrettably, it remains the case that only DWP and ATOS staff are aware of these regulations whilst GPs remain ignorant of their existence and those performing the WCA and DWP Decision Makers continue to make complex risk assessments based on grossly inadequate patient information.

    Until the current system is entirely revised, there remains no safety protocol for the assessment of risk and the avoidance of harm to patients. There are no formal reporting mechanisms for GPs to report significant adverse events such as self-harm and suicides which many of us have witnessed.

    Black Triangle have led the way in campaigning for the uptake of Regulations 25 and 31 and their legal Counsel has advised that they should be applied in every case where harm would be more likely than not to occur as a result of erroneous DWP decisions regarding patients’ fitness for work.

    We are also fully aware of the fact that numerous conflicts of interest exist between the ethical versus contractual duties placed upon GPs arising out of the DWP-Atos contract. In balancing a doctor’s duty of care to provide supporting information for Tribunal appeals and contractual conflicts with the DWP over the issue of fees and workloads, we submit that the only ethical solution must be the one that causes the least harm to patients.

    Black Triangle’s simple campaign for the appropriate application of these regulations utilising one side of A4 has proved highly efficacious in this respect. It has saved General Practitioners a substantial amount of time and expense and has meant that unnecessary, costly and stressful tribunal appeal hearings have been rightly avoided.

    We now call upon the BMA leadership to urgently publicise and make known to every GP in the country the existence and lawful application of these regulations without any further delay in order to prevent further avoidable harm to our patients. Any failure to do so would in our opinion amount to negligence.

    Dr Stephen M. Carty, GP and Medical Advisor, Black Triangle Campaign.
    Dr John Budd, GP Edinburgh Access Practice
    Dr Roy Robertson, GP Muirhouse, Honorary Clinical Reader
    Dr Ian McKay, GP Rose Garden Medical Practice, Leith
    Dr Oliver Aldridge, Edinburgh
    Dr Guy Johnson, GP Sighthill Health Centre, Edinburgh
    Dr Helga Rhein GP, Sighthill Health Centre, Edinburgh
    Dr Elizabeth Morton, GP Challenging Behaviour Practice, Edinburgh
    Dr Kate Burton, Public Health Practitioner
    Dr Margaret Craig, GP, Allander Surgery, Possilpark, Glasgow
    Dr Nick Treadgold, GP, Pollok Health Centre, Glasgow
    Dr Christine Grieve, GP Drumchapel Health Centre Glasgow
    Dr Chris Johnstone, GP Paisley
    Dr Donald MacIntyre Consultant Psychiatrist Edinburgh
    Dr Sarah Houston GP
    Dr Ros Wight GP
    Dr Robert Young, Glasgow
    Dr Nora Murray-Cavanagh GP Medical Education Fellow
    Dr David Nicholl, Consultant Neurologist, Birmingham
    Dr Jonathon Tomlinson, GP The Lawson Practice N1 5HZ
    Dr Anita Roy, GP, Yorkshire
    Dr George Farrelly, GP, London
    Dr Peter English, Consultant, London
    Dr Robert Cheeseman, Ophthalmology Registrar, Liverpool
    Dr Ray Noble, Medical Ethicist, UCL Institute for Women’s Health
    Dr Margaret McCartney, GP , Glasgow


    2. Supporting Letter from Trade Unions and Civil Society


    TEXT

    As trade unionists, organisations and campaigners from across civil society who collectively represent millions of citizens we write in support of the letter by doctors in the British Medical Association about work capability assessments.

    We firmly believe the current assessment régime is unfit for purpose and poses a real risk to the health and lives of disabled people and those with life threatening conditions. This is because the government’s regulations, which ask whether substantial risk or harm would be caused if the claimants are found ‘fit for work’ or with limited capacity for work, are not being applied consistently.

    Information obtained through freedom of information requests shows that between January and August 2011, 1,100 claimants died after they were put in the work-related activity group – the equivalent of 30 deaths a week.

    We are hopeful for a successful outcome to discussions between disabled people’s organisations and the BMA, following its conference decision last year to call for the current assessment régime to be scrapped.

    We send our solidarity to these groups and the BMA and hope you will join us in a united campaign to bring an end to the disgraceful treatment of ill and disabled people.

    John McArdle, David Churchley and Dr. Stephen M. Carty Black Triangle Campaign

    Linda Burnip Disabled People Against Cuts DPAC
    Mark Serwotka General Secretary Public and Commercial Services Union PCS
    Len McCluskey General Secretary Unite the Union
    Christine Blower, General Secretary National Union of Teachers NUT
    Bob Monks, General Secretary of United Road Transport Union URTU
    Sally Hunt, General Secretary of University and College Union UCU
    Michelle Stanistreet, General Secretary National Union of Journalists
    Phil Gray, Chief Executive, Chartered Society of Physiotherapy
    Richard Evans, Chief Executive Officer Society of Radiographers
    Bill Scott, Manager, Inclusion Scotland
    Gordon McFadden, Policy Director, Limbcare
    Dr Simon Duffy, The Centre for Welfare Reform
    Dan Moreton, Social Work Action Network (SWAN) and SWAN (London)
    Mary Olaniyi Coordinator/Family Adviser Lewisham Mencap
    John McDonnell MP (Lab, Hayes and Harlington)
    Deborah King Co-founder Disability Politics UK
    Paul Smith – Founder Atos Victims Group
    John Burgess Branch Secretary Barnet UNISON
    Gill MacDonald Psychiatric Nurse Lothian NHS

    http://blacktrianglecampaign.org/2013/05/05/leading-doctors-protest-at-cruel-disability-assessments-letter/

  • It is not up to GPs to decide which patients are ‘deserving’ or ‘undeserving’

    John McArdle's comment 20 Aug 2013 4:47pm

    Joint Response by DPAC and Black Triangle on Dr Phil Peverley’s Shameful Comments published in Pulse Magazine, The Daily Mail and The Daily Telegraph Posted on August 5, 2013

    http://blacktrianglecampaign.org/2013/08/05/joint-response-by-dpac-and-black-triangle-on-dr-phil-peverleys-shameful-comments-published-in-pulse-magazine-the-daily-mail-and-the-daily-telegraph/

  • Peverley’s attack on benefit claimants was wrong-headed - and having worked for Atos, I should know

    John McArdle's comment 20 Aug 2013 4:45pm

    Joint Response by DPAC and Black Triangle on Dr Phil Peverley’s Shameful Comments published in Pulse Magazine, The Daily Mail and The Daily Telegraph
    Posted on August 5, 2013

    http://blacktrianglecampaign.org/2013/08/05/joint-response-by-dpac-and-black-triangle-on-dr-phil-peverleys-shameful-comments-published-in-pulse-magazine-the-daily-mail-and-the-daily-telegraph/

  • Save me from the unworking well

    John McArdle's comment 04 Aug 2013 0:43am

    http://dpac.uk.net/2013/08/joint-response-by-dpac-and-black-triangle-on-dr-phil-peverleys-comments/

    Please read comrade doctors and understand that solidarity cuts both ways. We need each other.

  • GPs experiencing rising workload after benefit changes, warns LMC

    John McArdle's comment 11 Jun 2013 0:32am

    Doctors and patients must unite in support of each other.

  • GPs experiencing rising workload after benefit changes, warns LMC

    John McArdle's comment 11 Jun 2013 0:26am

    BMA must condemn work assessments Pulse 6th June 2013

    As frontline doctors, we share the view of many sick and/or disabled people that the BMA
    leadership has failed to give any effect to the unanimous wishes of its members: that the
    work capability assessment be scrapped immediately.

    It is unsafe, causes avoidable harm, lacks meaningful risk assessment and has no formal
    reporting mechanism for adverse events such as suicide.

    According to the GMC’s Good Medical Practice, a doctor must take prompt action if patient
    safety is being compromised.

    Employment support allowance exceptional circumstances regulations 25 and 31 are a way of
    highlighting substantial risk of harm to claimants, yet despite this, most GPs are unaware
    of them.

    We call on the BMA to publicise the lawful application of these regulations in order to prevent further avoidable harm. Failure to do so would in our opinion amount to negligence.

    From Dr Stephen Carty, Edinburgh, and 17 GP co-signatories

    http://www.pulsetoday.co.uk/views/letters/bma-must-condemn-work-assessments/20003184.article#.UbXnyjBBkgo

    http://www.pulsetoday.co.uk/views/letters/welfare-reform-conflicts-with-our-duty-to-do-whats-best-for-patients/20002495.article#.UbXloTBBkgo

    ‘GPs need more guidance on their role in supporting patients as well as their ethical
    responsibilities’ says Dr Graham Kramer

    As a GP, I’m emotionally struggling to witness what some of my patients are experiencing
    with welfare reform.

    This is not specifically a deprivation issue, although GPs working in deprived areas will
    face greater fallout arising from welfare reform.

    The duty of GPs is to promote the health of their patients as a prime concern. It is well-recognised that employment for many people can be therapeutic and so we try to actively
    promote work as a means to achieving health.

    However, for some people – many of whom are struggling to overcome daily disability and
    complex mental and socio-emotional issues – work is a far-away prospect, particularly where adapted flexible employment is unavailable. Forcing people off benefits and into work can seriously destabilise their health.

    Some patients on benefits find they can devote some of their capacity to helping others and try to give to their community through volunteering. But this valuable peer support is being eroded by the reforms and risks undermining networks of support for self-management.

    In my experience there is little meaningful communication between GPs and the Benefits Agency, making it impossible to develop collaborative approaches that best meet the needs
    of patients.

    ATOS assessments seem one-dimensional and assessors’ decisions necessarily involve a conflict of interest with the principle to ‘first do no harm’.

    There is a need to evaluate how these reforms are affecting people’s physical and mental health. There also needs to be an evaluation of how the reforms are affecting GP workload.

    GPs need more guidance on their role in supporting patients as well as their ethical responsibilities.

    Dr Graham Kramer is a GP from Montrose

  • GPs experiencing rising workload after benefit changes, warns LMC

    John McArdle's comment 11 Jun 2013 0:24am

    To: Members of the Scottish Parliament Health and Sport Committee

    From:

    John McArdle, Campaign Manager, Black Triangle Campaign

    and

    Dr. Stephen M. Carty, MB ChB MRCGP DRCOG, Member and Medical Adviser, Black Triangle Campaign

    Subject: Health and Sport Committee 19th Meeting, Tuesday 11 June 2013 Welfare Reform – Impact on GP Services

    Dear Convenor; Deputy Convenor; Committee Members

    We write with reference to our submission which the Assistant Senior Clerk, Rodger Evans, has informed us is now with all members in advance of tomorrow's session.

    In particular, we would like to ask you to use our submission as the basis of questions to the witness from the BMA, Dr Alan McDevitt, Chairman, Scottish General Practitioners Committee, BMA Scotland.

    We note that is has not been possible for Glasgow Local Medical Committee to send a representative to give evidence at the meeting.

    We would, therefore, request that written questions be addressed to them: specifically how they propose to address the morally, ethically, legally and professionally untenable position (as stated in our submission) of maintaining a blanket instruction to GPs not to provide Further Medical Evidence to patients undergoing the ordeal of the DWP-Atos Work Capability Assessment regime.

    Secondly, we would also like to invite them to hold discussions with us as to how to implement a simple remedy to this situation that will save GPs considerable time and expense whilst also fully fulfilling a doctor's duty to act where there are systems and policies in place that cause avoidable harm to some of the weakest and most vulnerable people in society.

    The present situation is untenable. We propose a solution that will work for doctors and their patients equally pending a satisfactory resolution to outstanding contractual issues.

    The Mental Health Resistance Network's legal team are currently preparing an application for a High Court injunction to stop the reassessment of patients pending a resolution of the issues of the absence of any risk management or reporting mechanism in the WCA testing regime whilst the DWP's lawyers prepare and appeal against the decision in MM & DM v Secretary of State for Work and Pensions [2013] UKUT 0260 (AAC) .

    In the interim, it is now incumbent on the Scottish medical profession to take concrete action to prevent avoidable harm and discrimination to their patients.

    We are clear that this catastrophic situation is by no means the fault of GPs and the blame must be firmly laid at door of the DWP in Westminster and ultimately the Coalition Cabinet.

    We are deeply sympathetic to the enormous strain that our doctors are now under thanks to this unacceptable burden that the UK Government has placed upon them. We seek to assist our doctors in resolving this.

    We have trialed the use of ESA regulations 29 and 35 by doctors in flagging up substantial risk and, as the signatories to the letter to the BMA leadership all attest, this is a solution that has been conclusively show to work.

    We look forward to a successful resolution and outcome to these discussions.

    Yours sincerely,

    John McArdle, Campaign Manager, Black Triangle Campaign and Dr. Stephen M. Carty, MB ChB MRCGP DRCOG, Member and Medical Adviser, Black Triangle Campaign

  • GPs experiencing rising workload after benefit changes, warns LMC

    John McArdle's comment 11 Jun 2013 0:23am

    Black Triangle Campaign submission to the Scottish Parliament Health Committee open evidence session on the role of GPs and the DWP-Atos Work Capability Assessment regime

    http://blacktrianglecampaign.org/2013/06/05/black-triangle-campaign-submission-to-the-scottish-parliament-health-committee-open-evidence-session-on-the-role-of-gps-and-the-dwp-atos-work-capability-assessment-regime/