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A faulty production line

Do GPs have a duty to help needy patients get benefits? Yes

Dr Raymond Orr argues that supporting the welfare process is part of the GP role

GPs across the UK are struggling with the number of requests from patients for assistance in their battle with the welfare system. This strain has increased significantly in recent years as more and more claimants are forced to appeal refusals for benefits after being deemed ‘fit for work’ by ATOS assessments.

This is the situation faced by GPs in Glasgow, particularly the Deep End Group (of which I am a member).

In my area, chronic health problems related to poverty are most prevalent. As a result, the task of helping patients claim benefits related to these health problems falls disproportionately on our shoulders.

There have been attempts to address this increasing strain. Throughout the country, local medical committees (LMCs) are recommending that GPs should concentrate on our core tasks and not be distracted by requests for supplemental information regarding welfare benefits. This would reduce our workload and allow us to treat patients more effectively, but to me, this does a disservice to our most vulnerable patients.

Read the other side of the debate here:
Do GPs have a duty to help needy patients get benefits? No

Reasons to help

Ill doctors know that income inequality and poverty causes ill health. We should also know that alleviating the former is just as important as treating the latter. To this end, ensuring income maximisation for the poorest in the context of severe poverty is a reasonable approach to preventing ill-health.

For benefits claimants, writing them a sincere and authoritative letter to counteract an erroneous DWP decision will determine whether they have enough money to eat well, keep warm and pay their bills, or be forced to forego one or more of these.

It may not be a contractual requirement but it’s a key task in caring for patients.

So why assist a patient who is having an appeal tribunal heard against refusal of Employment Support Allowance (ESA) or Disability Living Allowance (DLA)? The knowledge that we helped a patient win their appeal helps us feel good about our daily work. We also realise that benefit appeals do not just affect the patient involved but also their children or other dependents.

We could think about the doctor-patient relationship as a bank account where goodwill is to be deposited (and withdrawn when things go awry). Missing the opportunity to ‘bank’ goodwill must be the actions of a brave doctor indeed.

Dr Raymond Orr is a GP in Glasgow. This personal opinion piece does not represent the views of the entire Deep-End Group

The full report “DEEP-END Report 21: GP experience of welfare reform in very deprived areas” can be found on:, October 2013.

Readers' comments (7)

  • There should be no question . Of course we should help people in need. Often the system is heavily loaded against them .

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  • Bob Hodges

    Unfortunately finite time meets infinite demand EVERY day for most GPs.

    If I do this work, for which I am not paid, then work for which I AM paid (and contractually obliged to do as a result) would go undone.

    I help where I can and time permits, especially where the DWP have commented positively upon the rude health of long since amputated limbs. However, I don't think that we can do this routinely or be expected to do it. In no time at all the complaints will roll in that we haven't done this, or that letter didn't achieve outcome 'x'.

    Obligated philanthropy is just another tax.

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  • If GP's and specialists had provided proper medical care, rather than making the type of facile judgements now attributed to Atos, I may have regained my health and returned to work, rather than being subjected to the humiliations first inflicted by a sick NHS, then by a sick government

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  • many of them do not have a medical problem that prevents them from working. they have personal and social difficulties but their medical problems are not an absolute bar to work. putting that into a report causes difficulties and is best avoided.
    sorry for being anonymous but some of the campaign groups are on a par with ME groups

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  • I have had crippling illness called ME for 20yrs after having a reaction to a vaccine. I have a supportive GP who knows about the hideousness of the illness.

    Due to the parallel universe in which DWP/ATOS live, there have been suicides due to Dwp's bungles, as well as food banks, where the GP has to meeter out a voucher because Esa has been stopped.

    Morally, the help and support should be there if requested for those who are struggling.

    Just to finish by saying, that ME groups are fighting for more medical research, as sufferers are left battling alone for many years.

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  • dear last poster me is real but to blame immunisation is simply wrong.i agree us gps should try to help people fighting against the disastrous incompetence and inhumanity of the system..and as for atos..........words fail class incompetence and callousness.

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  • " have had crippling illness called ME for 20yrs "

    ROTFL- says it all really!

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