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GPs buried under trusts' workload dump

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The move deepens the row over the support GPs provide for patients who are appealing their benefits being withdrawn.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

  • If you look at his own practice website and his private fees charged and "we do not issue letters for housing matters"- he's not quite practicing what he's preaching!!

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  • Many of these responses typify the mercenary mentality of doctors today. They are happy to line their pockets wasting public money doing unevidenced QOF work on a healthy population while ignoring the desperate plight of the most sick, disabled and vulnerable people in society.

    It's moolah before morality. Profit before protecting the sick, disabled and vulnerable.

    Good on those doctors (most of whom are in Scotland) who signed the letter to the BMA.

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  • All of the health professionals reading this site should note that requests for this kind of work (the same kind of work that keeps you from seeing your family and children before they get to bed) sadly too often come from people with the above attitude who think that they have a right to everything for free. Of course, there's no shortage of abuse when they don't get what they want and sadly they drown out the deserving people who genuinely need consideration.

    It's worth considering this before spending time on work we are not contracted to do (and often in no position to undertake).

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  • Anonymous @ 10.49 - well spotted

    Assuming that this is the same Dr Carty, as appears likely - These are fees that far eclipse the charges we make in a similarly deprived area and indeed Dr Carty's Practice seems to charge for many services we provide for free.

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  • This comment has been moderated

  • "They are happy to line their pockets wasting public money doing unevidenced QOF work on a healthy population while ignoring the desperate plight of the most sick, disabled and vulnerable people in society."

    This is such a stupid comment. This is one of the mechanisms by which surgeries get paid, and whilst some of the QOF targets are indeed stupid, most surgeries would not be viable without undertaking this.

    This poster would have us drop the work that keeps the surgery running and replace it with work that we're not meant to be doing that won't pay for staff and business costs. We would, in effect, be paying out of our own pockets to complete reports for other people!

    Genius!

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  • I remember reading the original post which was deluged by the vehement pro-benefit lobby group.That is what happens when you have a freely open discussion forum.Pulse needs to get its act together and tighten up its access policies.Secondly the issue about policing benefits or immigrant access to the NHS should be decided at the national level between our GP representatives and the government.The GPC/RCGP/BMA need to take a tougher stance ensuring the DWP is not shirking its responsibility by passing the buck to us.This is a constant source of friction and stress for jobbing GPs on a daily basis and goes against the doctor patient relationship which is based upon trust and not suspicion

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  • I would suggest that HCPs put their own house in order first. Meaning that many work for Atos Healthcare, the prime contractor to the DWP for the WCA "assessments" that caused this problem of mounting numbers of appeals against decisions to withdraw benefits from seriously ill patients. The problem is further compounded by the insistence of the DWP to send claimants back for another assessment even when they win their appeals in court. Iain Duncan Smith, the Work and Pensions Secretary, has resolutely refused so far to reveal the numbers of claimants that have actually died soon after the cessation of benefit payments. This is the reality of the situation now, people are dying because of benefit cuts and the government won't even admit how many. Is it any wonder that many will seek help from their GPs? For many it will be the last port of call before they depart forever.

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  • I think the NHS should be free. By that I mean rather than paying tax and national insurance to fund the wages of doctors, nurses and staff, and buildings, and equipment, all labour should free of charge and if clinicians want buildings and equipment they should fund it all out of their own pockets. This is supposed to be a caring profession and it seems to me that it's hardly caring to want to be paid to do the job. If you want to get paid, why not consider retraining as a lawyer - I'm sure Dr Carty's lawyer will charge a fee, and rightly so as lawyers don't seem to be a caring profession.

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  • @Ian Sanderman who wrote "people are dying because of benefit cuts"

    Should we take you seriously or are you just trolling?

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  • Does anyone know Dr Carty's website address so we can all have a look?

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