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Independents' Day

'Bedroom tax' and other benefits requests pile pressure on GPs

GP practices are seeing a rising number of patient requests to supply information to back their benefits claims, with the so-called ‘bedroom tax’ proving particularly problematic.

LMC leaders have been forced in one area to produce a leaflet for local practices that tells patients GPs are ‘not in a position to adminster or police the benefits system’ and that they will not reply to requests for letters of support.

Birmingham LMC have also supplied a letter for patients to give to any agency that requires a GP letter to tell them that they are not contracturally obliged to do so, after requests rose due to benefit cuts introduced this month for those in social housing with a spare room. Click here to download the poster and letter.

Birmingham LMC executive secretary Dr Robert Morley said the leaflet was based on material orginially produced by Glasgow LMC.

He said: ‘This has always been a problem but the recent changes have brought about an increase in numbers, and specifically regarding the bedroom tax.’

The GPC reminded GPs that it is not part of their job to solve benefits disputes, even if they are asking about medical conditions - such as sleep apnea - that could mean they are protected from benefit cuts.

GPC deputy chair Dr Richard Vautrey said: ‘We are concerned that many patients are having benefits withdrawn inappropriately. That is demonstrated by the large amount of claims that are successful in the appeals process. But, that said, it is unnecessary for benefits agencies to encourage patients to see their GP, because the evidence that a GP can provide is not what they need to determine whether to withdraw their benefits or not.’

‘[Sleep apnoea] could be one reason but there could be a variety of reasons why carers find it very difficult to sleep in the same room as their partner. But that is not necessarily something which would require a GP letter.

‘GPs can provide a diagnosis and information about a diagnosis, but what they should not be asked to provide is an assessment of how that affects that particular person, because that becomes a subjective view. That is for the medical assessors to do as part of the benefits assessment.’

Dr Vautrey said that should they decide they wanted to write a letter on their patient’s behalf GPs could demand a fee for doing so.

‘That has always been the case, because it is outside of the contractual arrangement, that you can make a charge for anything beyond that. But GPs are not wanting to do that, they don’t think it is necessary for them to do this work in the first place.’

But he advised against doing so, adding: ‘GPs would routinely end up writing a supportive letter by the very nature of a GP being an advocate of their patient. They are very biased in that process. The key thing about assessing benefits is that it should be an independent process so they get a fair hearing.’

Readers' comments (5)

  • From a patient's perspective this approach by GP's is problematic to say the least! If GP's have a problem with the inadequacies of the 'independent assessment process' how do they imagine their sick and vulnerable patients feel? They should take this up with the government, it is not appropriate for them to deny help to patients when by doing so their patients mental and physical health will suffer as a result.

    Neither is it appropriate to charge patients on low incomes for a simple statement of the likely or potential impact on someone's health of being denied help to stay well through the benefits system. Doing so simply facilitates the impoverishment of those who are already vulnerable.

    Patients are supposed to be at the heart of the new NHS and GP's cannot work in isolation, not without consequences for their credibility as well as patient care.

    I appreciate that the system is dysfunctional, that workloads have increased etc. but Dr Vautrey's views on this matter will not inspire patient confidence. It is obvious that views on what some GP's think is the role of primary care and what patients think it is are not necessarily the same.

    The truth is that the NHS will end up dealing with the mental and physical consequences of 'welfare reform' and this will be particularly the case in Primary Care. Patient Groups made this point repeatedly during the debate over both health and welfare reform, they were ignored. The government simply did not acknowledge the consequences of the link between them.
    However, refusing to help vulnerable patients or charging them is not the answer, it will undermine the doctor patient relationship and is not cost effective. Patients denied help to stay well through the benefits system will end up in GP Surgeries or in hospital in a worse state.

    I urge any HCP in Primary Care considering this approach to think again; poverty kills and it would be most unfortunate if GP's were also considered to have the 'compassion deficit' identified as a problem in nursing. Instead of denying help the best way to proceed is to consider it part of 'prevention' and act accordingly.

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  • What a callous 'not my business gov' response from R Vautrey who seems to be in the wrong jo if he considers a letter describing health problems is not the concern of a GP.whoever is requesting it.How can he claim to be a person's advocate with such an attitude/.Is R V not aware of the push to include social and economic issues as part of a GP's job? What else would he like people to pay for? Opinions like these in no way support the continua ation of the UK Welfare State but encourage a pay me for everything thing i can squeeze out of you culture towards vulnerable people. for everything

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  • As a GP I'm able to see the LMCs point of view
    This work isn't resourced. However as a holistic practitioner this isn't morally right
    I once wrote a letter of support for a patient with COPD who was getting nocturnal exacerbations because his council turned the heating off overnight and he couldn't adjust it. This ended up costing more in terms of 999 calls and non elective admissions. Did I charge him for the letter? No I didn't. Did it make a difference? Yes it did. The housing association let him turn his thermostat up overnight, he stopped going into hospital and he enjoys good health with an excellent community respiratory team support. What I did as a doctor was part of my job. I went into medicine to make the odd small difference and not to play the "jobs worth" card.
    The system in wrong and the poor patients are caught in the middle

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  • "The system in wrong and the poor patients are caught in the middle"
    Quite right.
    As are the GPs and the staff advising them to get a letter.
    We are to write letters schools, examination boards, councils, workplaces, golf courses, health club, gymnasiums, acting schools, performance art groups etc. And many many more. These are not part of the contract and are underfunded. Refusal or an invoice often upsets the patients because we are seen as a 'free' service. We are not trying to be moneygrabbing or evil, we are trying to keep staff employed, a building in condition that will satisfy regulators, pay for locums so we can be educated or go on holiday,to try to not work the 12 to 14 hour days all the time and still provide a decent medical service which we cannot do when yet another job is foisted on the the GP without the funds to complete the job. Of course we can see the benefit for patientss but so would all of us being availble at 3am benefit some to the detriment of others. Just wait till it is fully privatised, the caricature of greedy GPs will seem like [insert famous really nice person depending on Lady Di or Mother Teresa type leanings]- a distant memory of soemthing that should have been treasured

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  • Ann Marie Houlder you are a breath of fresh air and an inspiration. What a shame all GPs are not like you.

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