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GPs asked to refer patients to food banks

GPs are being placed in an ‘impossible position’ by charities who require them to refer patients to food banks before they give them support, GP leaders say.

Pulse has learnt that practices are being asked to write recommendations for patients or assess their suitability to be referred to food banks, organisations that provided emergency food supplies for 346,992 people nationwide in 2012/13.

The issue was recently raised in a parliamentary debate, where one Conservative MP claimed that GPs were responsible for ensuring there was not a ‘culture of dependency’ on food banks.

But GPs have said that the additional responsibility puts them in a difficult situation with patients and that they are ill-equipped to know the social situation of their patients.

Dr Paul Moore, a GP in Newhaven, East Sussex, said he had been asked to write recommendations for patients seeking support from the ‘Food 4 Seahaven’ charity in his region.

He told Pulse: ‘My problem with it is, people ought to be able to get food in other ways than going to their doctor, it ought not to be an issue that you have to refer people for food. I expect people to be able to access their basic human rights in a civilised society through social support, rather than charitable giving.’

He added: ‘It’s not a job I resent for the sake of the patient, but I resent it for the sake of society, that we have that role, and that role is necessary.’

Dr Peter Swinyard, Chair of the Family Doctors association and a GP in Swindon told Pulse these protocols were putting doctors in an ‘impossible position’.

He said: ‘Who do you say “feed me” too, and who do you not? I don’t know what the food bank’s criteria are. I don’t know the social background of quite a few patients - I know most of my patients, because I’ve worked here for a long time – but there are people who are working in practices where they haven’t worked for a very long time.

‘How are they supposed to know whether someone is – what in Dickensian terms, you might call the “deserving poor” - and who’s basically a scrounger who’s just trying to a get a meal out of the system. I think that’s putting GPs in an impossible position.’

Alun Cairns, Conservative MP for the Vale of Glamorgan, raised the matter in a House of Commons debate on Wednesday, where said GP recommendations were essential to ensure that food banks ‘rightly limit the provision they make available’.

He said: ‘First, people must have a voucher that comes from recognised body such as the social services, a GP, or a women’s aid or drug support group. They rightly limit provision because they do not want to create that culture of dependency. They are about bringing those people back into the state support system and the charitable groups that need to address those problems.’

A spokesperson for the food bank charity Trussell Trust told Pulse that they system had been put in place to ensure people were ‘plugged in’ to official support networks to address the cause of their immediate crisis.

They added that individuals who presented at a food bank without a referral, may still receive a meal, but would have to consult with a suitable authority before they could collect food to take home.

Readers' comments (28)

  • what a totally ridiculous expectation. Does living on benefits but a 46" television with Sky make you more deserving more than someone with a better income but no carpets. I havent got a clue, I am about doctoring not social decision making.

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  • Just write a proforma letter that states 'My patient tells me that he is hungry, and I have no reason to disbelieve him'

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  • Just write a proforma letter that states 'My patient tells me that he is hungry, and I have no reason to disbelieve him'
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    This will encourage the practice to continue. We don't do such letters as 1) we have no way of verifying the patient's circumstances 2) it's not a medical problem 3) because it's not GMS work and 4) because it hinders the care we provide to patients with genuine medical problems.

    We explain the situation to the person concerned and then follow with a stern letter to the organisation in question asking them to sort this out themselves.

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  • Alun Cairns, Conservative MP for the Vale of Glamorgan

    This guy needs to start living in the real world. I already work 12+ hours/day seeing patients. Is he recommending I stop part of my GMS service I currently provide to make time for this assessment? And which part of undergraduate or post graduate training puts GPs in a position to aseess this?

    Please, please, GPs in this ignorant MP's constituency (or Pulse) write to him to clarify!

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  • The first rule of any charity is to promote itself!! People don't need food banks in fact the reverse as the vast majority are fat and that DOES cost money! I work inner city London and I do not see poverty or starvation! It's a travesty.

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  • Trussell Trust my arse!!

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  • For the past 3 Christmases, I have used my Nectar & Clubcard points to buy stuffs to donate to foodbanks. I have never been an official volunteer, but have occasionally spoken to people queuing for a parcel. Many of them work 2-3 jobs, I can see how hard it was for them to have to ask for vouchers. I'm appalled at the 'scrounger' label mentality of some GPs.

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  • Vinci Ho

    So according to these politicians- these three hundred odd thousands people actually had no dignity and took these food banks for granted,huh??
    So now these people need to be punished and must go to 'beg' their GPs to give them permissions to have food . What kind of government is this?😡

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  • This govement hopefully should be one that will be in opposition from 2015(both sides).

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  • How much food is in a package from a food bank?
    Is it more than the cost of a GP appointment?

    Just because it is free at the point of delivery, does not make it free. It is one thing for people to not appreciate the cost of the service, but other organisations should.

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  • anon 0.32am - you seem to be suggesting that patients who asked to be referred to food banks out of desperation are wasting your time. Would you not want to know if a patient was malnourished and their health (physical and mental) was suffering as a result? The average food parcel has enough dried foods to provide nutritionally balanced meals for 3 days. The average value of each individual item is approx £1 - but its not just food, also loo rolls, toothpaste . .

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  • I think you've misunderstood anon 0:32.

    Each GP appointment costs the nation money. You may not be paying for it when you are making an appointment but it still costs, never the less. So, if an appointment costs (let's say) £4, and the cost of the food parcel is £9, you're better off having 50% more parcels and accept not all of the parcels are taken by those who really need rather then using that money to make an assessment.

    Please remember GPs have only finite number of appointments. If you ask GPs to taken on an extra job without funding for it, you'll have to ask yourself what job you'd like the GPs to drop first.

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  • "Would you not want to know if a patient was malnourished and their health"
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    Whilst this may sound harsh, having issues with finance and not being able to afford food is not a medical problem. That is to say, what can we, as medical professional do about this? This is a social issue and people in this position would be better off speaking to their MP. This isn't something I can fix with a prescription and I have no special skills to make an assessment about someone's social situation.

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  • Please remember the people who ask for help put food on all of our tables

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  • "Please remember the people who ask for help put food on all of our tables"
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    Sure, there are lots of people who are in unfortunate positions that deserve better and should be remembered at Christmas if not all of the time.

    I'm still yet to see anyone post a good reason at to why this group of people need to be seen by an already heavily overstretched GP service for no apparent medical reason before being given food by an external body.

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  • I'm still yet to see anyone post a good reason at to why this group of people need to be seen by an already heavily overstretched GP service for no apparent medical reason before being given food by an external body.

    Uh . . because they're starving and probably don't know who else to turn to. We can't just dish out food boxes to everyone, or we'd be besieged with freeloaders with nothing left for the genuine cases. We try not to turn genuine cases away but we need some kind of referral - food banks are run through donations, not the state. It could be your son or daughter, brother or sister or heck, even yourself, one day.

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  • "We can't just dish out food boxes to everyone"

    Why on earth do you think it is the job of a medical professional, who is trained to diagnose and treat medical problems to see them in this regard? Which part of medical school training or the years of training afterwards do you think is required here?

    "you have to do it because we need someone to do it" is a pretty damn poor reason. Remember, this STOPS us from managing the chronically sick, from seeing our depressed patients, and makes it harder for us to get to cancers etc early.

    Yes, food banks are important but I am appalled that you think it is our job to sort out the 'freeloaders'. Again, WHY ON EARTH DOES THIS NEED A DOCTOR?

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  • So can war, poverty, poor working condition, and high criminal rates.

    Do you expect the doctors to replace the army, install economic stratergy, change employment law and joint the police? Just because something has relation to the health, it is not alway's "doctor's responsibility".

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  • The person who hopes that the present government will be in opposition next time should be careful what he wishes for. If the last lot had stayed in for another term we would all be asking for food parcels.

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  • Interesting. I went to medical school to diagnose and treat patients and to do appropriate referrals.
    There are other agencies that are closer to people and can actually decide if people need food bank referral not by the GP who sees the patient for 10mins.
    Food banks referral should be done through another agency instead of stretching already stretched GPs. So if the patient needing food bank referral is unable to get appointment for one week, is he going to starve or does such a patient need to be seen urgently at par with chest pain, worsening asthma, COPD etc
    Food banks are very good( personally I contribute to food banks through my church) but the administrative aspects of it ought to be done properly and not saddled on GPs

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  • My wife in conjunction with the Trussell trust has set up a foodbank. IT is the Dn's / social work woman's aid etc who usually refer people. They refer people who they think need the foodbank. A Gp is not usually the person who refers a patient though I think a GP should be able to refer a patient if he thinks the patient is starving. I would agree that the Gp should not be required to see a patient to tick some silly box to declare a patient worthy. That is a waste of our service. Remember a conservative Mp mentioned this- the same party who walked out of a parliamentary debate on foodbanks. A foodbank would not turn a patient away so I'm sorry to say it is better to refuse the request and send the patient to the foodbank anyway.

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  • "How sick and starving would they need to yet, before being worthy of your time, skills and years of training?"
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    I think we're all getting a very good idea about the kind of person that is posting here. Apparently there are so many "freeloaders" (what a charming term he/she has used) that they want us to waste our time sorting these out (regardless of whether or not it's our job or whether we have a million other things to do), and yet they are incapable of spotting someone who is so 'sick and starving' that they need food provided to them. Wow.

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  • Yet another raise of expectation. Started as a useful resource, now cannot delivewr so wants someone to take the blame.
    I have a medical degree- I will carry out my work in a professional manner.
    Tell social services to assess and decide who needs what. It is likley that the needy are already on Social service radar.
    I have no problem writing a proforma letter of referral for appropriate assessment by the specialist professionals .
    Not sure how they will take it.

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  • This is a very poorly written and misinformed article. Some clarification:

    1. Every Foodbank who joins The Trussell Trust is named after the town or community: Hammersmith & Fulham Foodbank, Central Liverpool Foodbank, Coventry Foodbank etc. Food 4 Seahaven, therefore, is not part of The Trussell Trust and they should not be blamed for a national situation that is thoroughly unquantifiable and based on a "food bank" that is not part of their network.
    2. The Trussell Trust position allows GP's who wish to refer to Foodbanks to sign up as referring agents but they are not forced to do so and if they did, they would be referring on health grounds and not on the basis of a full awareness of the financial circumstances of the individual.
    3. There is no quantifiable evidence of Foodbanks run in partnership with The Trussell Trust signposting, as has been implied, droves of hungry people to GP's only to subsequently be referred straight back to the Foodbank. There would be several very high profile human rights cases currently taking place and media article to boot if that were the case.
    4. One of the major reasons GP's have started to sign up is simply because over the last three years the numbers of people presenting as starved or malnourished is increasing at a significant rate. The ability to refer to a Foodbank on the basis of poor physical health offers another option for a GP to ensure the individual is receiving an ongoing source of support.

    It would serve us all well if the author of this article educated themselves before criticising an organisation who are not responsible for what is alluded to.

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  • Sam Spruce

    The very fact of this discussion indicates the appalling state of British society. There is no 'austerity' other than that created by the government in collusion with the banks and other major corporations. This situation should not be allowed to exist in Britain so the question is why are we having a discussion about who should authorise the use of food banks? They shouldn't be needed in the first place. The medical profession should take a much stronger stand against this government than they have done so far.

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  • Should it not be the work and actions of a MP to ensutre that people in their constituency are not suffering lack of food? As a group they are responsible for the nation's nutritional state. Social problems are a a partional responsibility to the GP if it involves neglect or lack of primary needs. I do not think that we are responsible for the bad choices that our patients sometimes make.

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  • The root problem, as the Government rightly emphases, is the culture of dependency. People must be helped to become less dependent on food. Evidence-based dependency reduction programmes should be developed, available on referral from a GP.

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  • Well I think that this article is a bit inflammatory. Foodbanks are voluntary organisations - they are ASKING not REQUIRING GPs to refer people to Foodbanks. We did a review of Foodbanks in Sheffield which is available here. (http://localdemocracyandhealth.files.wordpress.com/2013/12/dp14366-food-report-new.pdf) Foodbank volunteers are generally quite clear - it is not for them to make judgements about who should or should not get short term support from food banks. They need professional agencies who are involved in the caring profession (I thought that GPs would include themselves in this) to help them. Most food banks are very clear that their existence and growth are a deeply regrettable by product of current government policy.

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