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Independents' Day

LMCs could face legal action over template letters for GPs to refuse benefit requests from patients

Exclusive LMCs could face legal action over advice to GPs to refuse requests for support from benefit claimants, as campaign groups consult lawyers over communications they claim are ‘staggeringly ignorant’.

Pulse has learnt that two disability activist groups have sought legal advice about taking action against LMCs and they also say there may be grounds for action against individual GPs if they are ‘involved in acts of discrimination’.

But local GP leaders said that the LMCs’ advice was consistent with that provided by the Department of Work and Pensions (DWP) and that the fault lies with the system set up by the Government and not GPs.

The move deepens the row over the support GPs provide for patients who are appealing their benefits being withdrawn.

GPs are facing rising pressure from patients requesting information to protect their benefits, with a 21% rise in requests to verify work capability since January.

As a response, two LMCs have issued template letters for GPs to refuse requests for additional support from benefit claimants, with one considering a ‘just say no’ campaign to support practices who refuse to take on the unfunded work.

But Pulse has learnt that two pressure groups - Black Triangle and Disabled People Against Cuts (DPAC) - are now planning legal action against the LMCs involved.

Dr Stephen Carty, a GP in Edinburgh and the the Black Triangle Campaign’s medical adviser, said they had taken legal advice over the LMC advice and that they felt they had a case.

He added: ‘LMCs are one-trick ponies whose only function is to prevent GPs doing unpaid, or pro bono, work. I think this is a staggeringly ignorant position to take.

‘Any GP working at the coalface will have stacks of examples of patients who have completely fallen to bits over the Work Capability Assessment. There are lots of admirable things LMCs do but this is a disgrace and I have urged doctors to withdraw their LMC subscriptions and stop paying them.’

Dr Carty added that they were also considering action against individual GPs, pending the outcome of the DWP’s appeal against a tribunal ruling from May this year that said the Government’s Work Capability Assessment process discriminates against people with mental health problems.

He added: ‘If the High Court found that the current process was discriminating, then there may be grounds for taking legal action against individual GPs if they were involved in acts of discrimination. If there were legal clarity on this, it would already be happening.’

But LMC leaders said that they had not heard of any legal action yet, and that these requests are outside the normal care provided by GPs.

Wessex LMC chief executive Dr Nigel Watson said: ‘What we have said to patients is that if the appeals people want further clinical information, which only we can give, then we’re more than happy to do that if the appeals people write to us. But what a lot of these people want is not a medical report, just a letter to say that we support the patient.

He added: ‘Some of the disability groups then say that GPs just do things they get paid for and have got quite difficult about it but we’ve just then tried to explain that we provide care for patients, this is what we do, and I think it is not helped sometimes by the fact that there is an inconsistent approach - some practices will do it and others won’t.’

Dr Peter Higgins, chief executive of the LMCs in Lancashire and Cumbria, defended the template letter they drafted to refuse supporting benefit appeals, and stressed the decision on whether to use it or not was still pending.

He told Pulse they had not heard anything yet about legal action, and added: ‘All that we quoted was off the DWP website so I can’t really see where they are going with that.’

The move comes as a group of GPs have supported the Black Triangle Campaign’s work against the DWP and the Work Capability Assessment process by signing an open letter to the BMA.

The letter called on the BMA to endorse an alternative template letter, prepared by Dr Carty, which could reduce the workload of providing supporting information in patients’ benefits appeals. It further said it is GPs’ duty under GMC guidance to take action if they feel that ‘patient safety may be seriously compromised by inadequate policies or systems’.

But a BMA spokesperson said they had already undertaken ‘substantial work’ to point out problems with the WCA.

He said: ‘BMA representatives have met government ministers to put our objections to them directly. We have recently written to the employment minister asking for changes to be made as soon as possible to the way the system is undertaken. We have also met with disability groups including the Disability Benefits Consortium, an umbrella group representing disability charities.’

Readers' comments (82)

  • This is like taking legal action against a plumber who refuses to fix your taps for free...

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  • Perhaps Dr Stephen Carty could move things along by declaring whether he is a paid medical adviser to Black Triangle or whether he does this work pro bono as he is urging the rest of us to do??
    Could we also clarify if Black Triangle's legal advisors are again working pro bono or getting the full solicitor's fee??
    I think these clarifications would remove some of the humbug here!

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  • They would be better off tackling the WCA system itself, rather than the GPs refusal to intervene for free.

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  • If they want us to do the work they should pay us. To say that this is discriminatory smacks of a large chip on the shoulder. There are many examples of work done by GPs for both disabled and non-disabled patients which is not funded by the NHS.

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  • To say that this is discriminatory smacks of a large chip on the shoulder.

    Quite - I'm surprised that any group feels that they should be able to dictate as to what others should do in their spare / family time.

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  • Every time I read an article like this I feel like adding 10% to our charges.

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  • Dr Carty's gratuitous insult to LMCs as "one trick ponies" displays his ignorance of the role of LMCs as statutory bodies that have been in existence for over 100 years.As a GP and Occ Health GPSWI for 30 years, I am well aware of the incontrovertible evidence that being in work is healthy, and conversely that being out of work (independent of cause) carries a significant added morbidity and mortality.As GPs, we should be supporting our patients into whatever employment, paid or voluntary, that meets their capabilities.We can do this within the Equality Act 2010 by recommending commonsense *GP" adjustments on the Fit Note.In this way, we should help and support our patients' needs rather than submitting to their wants.The WCA is far from perfect.Rather than waste time with argy bargy about appeal letters, we should be working to reform the WCA process.In the interim, I strongly support the LMC's attempt to ensure that GPs' time is spent on what we are actually resourced for.

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  • having read all points how can a GP assess the housing needs of the patients without making a visit-this is the remit of the council and the council O/T-money or no money-the letters the GPs give in support are any way weight less-so we need an integrated system where some one from the council should physically go and assess-we are quite happy to give our opinion-actually the law should make it mandatory for the councils to accept our verdict as legal verdicts and then it will work-that's my view

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  • Unfortunately many of the questions regarding mobility, ability to sit at a desk, raise arms, go to the toilet unaided are not the questions that have ever been asked when the patient has been in the surgery and the sick note written. How are GP's supposed to answer this? Bring everyone in and do an assessment? That is what we fear may happen. The letters specifically state" unfortunately we are unable to pay for this."

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  • Yet another reason to quit the NHS or emigrate.

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