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Ministers insist on therapy for patients out of work

GPs are set to get the improved access to talking therapies they have been demanding – but under a controversial new scheme that makes therapy compulsory for patients who are off work, writes Cato Pedder.

The Department of Work and Pensions has announced a £360 million rollout across the UK of its Pathways to Work scheme, which compels patients on incapacity benefit to attend 'condition management programmes'.

Access to cognitive behavioural therapy is an integral part of Pathways to Work, and the new announcement is likely to be followed by a specific pledge on therapists, perhaps as early as this autumn.

But while GPs welcomed the prospect of improved access to psychological therapies – a key element of Pulse's Action on Depression campaign – they expressed alarm that they will be expected to police the new welfare scheme.

GPs are to be expected to assess mentally ill patients. Those judged capable of work would then be required to attend CBT courses – with the threat of docked benefits for anyone who did not comply.

Dr Andrew Dearden, GPC negotiator, said: 'GPs are not going to police a benefit agency decision. I am a clinician, not an occupational therapist. And what happens if that counselling fails, or if it is too traumatic or too early for a patient?'

Dr Ian Walton, chair of Primary Care Mental Health and Education and a GPSI in mental health in Tipton, West Midlands, said a compulsory scheme would have to be carefully introduced, but could have real benefits. 'We need to be pressured sometimes,' he said.

The Department of Work and Pensions said as many as 40 per cent of the 2.7 million people who claimed incapacity benefit did so because of mental health problems. It confirmed it was working with the Department of Health on a joint strategy to improve access to CBT.

The Treasury said an application for funding could be considered in autumn's pre-Budget report.

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