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The move deepens the row over the support GPs provide for patients who are appealing their benefits being withdrawn.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

  • Anonymous | 03 September 2013 11:49am
    Star Trek fan?
    A utopic world where money has no meaning and life's needs are covered by the genorosity of others. Whilst I care for the sick (or believe themselves to be sick) Ford give me a car or if I'm very lucky Bugatti will provide for me. Waitrose to allow me to shop free as I can't earn any money being in the caring profession. Clakes send me 2 pairs of shoes and Durex a big box of condoms so I do not have children that the state will have to look after. Forget the Durex as I'll be sleeping in the park and practising from a bench because I cannot buy premesis as I can't earn. Not sure the wife wants sex in a laurel.
    I was all for this forum being open so we could see the trolls and idiots as well as the well meaning majority of non-medics feeding in views, after your comment I feel different.

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  • Why does people believe GPs should work for free just because we are in medical profession? Other then the minority who are in charitable trusts, do they know of any profession as a group work for free?

    This isn't discrimination, it's as simple as refusing to do unpaid work. Why don't Dr Carty & Co. give up all their worldly possessions and work for free if that's what he believes.

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  • I already provide good quality typed/ not handwritten/ scribbled reports when asked to provide information for ATOS/ DWP etc.
    I also sit in front of a computer sometimes until 8-8.30 PM completing the rest of my work. So not much blood left in the stone to suck.
    I am also a member of the public who can be sympathetic to those patients who are genuinely in need who sometimes go against my advice by attempting to return to work against medical advice, sometimes losing benefits which they would have been better continuing to claim.
    On the other hand I am less sympathetic when I receive a letter from DWP about a patient who is receiving ESA who I haven't seen for 2 years, who isn't on any medication, who I wasn't even aware was on the sick. Or the patient who claims not to be able to bend/ walk etc. who I then see shopping normally in the same Aldi as me.
    At the end of the day we all do occasional supporting letters, but in general terms I feel it is generally best to answer the questions on these forms using the information contained in the medical records (or my own knowledge of the patient's case) instead of being spoon fed the "right answers" to questions by third parties such as Citizen's Advice when I am really in no position to be able to verify what I am being asked to say.
    I don't think a blanket refusal to provide further information is likely to be appropriate. However also agree with other contributors who correctly point out that these reports aren't a statutory part of our contracted work.
    So at the end of the day I will continue to use my common sense in these matters.

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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."

    _________

    But... the disability campaigners showed themselves to be far better acquainted with the facts than the GPs who were commenting.

    It's telling that you would rather debate the issues with uninformed GPs who confirm your false, right-wing biased understanding of the situation than with people who actually know the facts.

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  • Dr Carty's practice website is Leith Mount surgery in Edinburgh, where he seems to be raking it in quite nicely with his inflated private fees! Maybe thats why he feels everyone else should just be working for free! Our private fees for a similar deprived practice are not even a quarter of that!

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  • Snapshot of my morning surgery
    9am- Abusive call from bloke who's pissed off he can no longer get his branded viagra on NHS, and thinks the generic stuff is s**t, "he pays his taxes you know"- even though he's never worked a day in his life cause he's got a "bad back". Next patient- wanted letter there and then for his appeal for "depression", he's not been to the surgery for the last 5 years, on no meds and failed to attend his counselling we had ref him to 6 years ago. Next patient shouting dogs abuse because he got taken off his ESA at appeal- again not worked for 20+ years due to drug abuse, but not attending drug services for years and not attended GP for years so we had no medical evidence to give him! So for all the disability rights activists out there- do you get the picture!!! We all know those patients that are genuine and I am sure most of us will go out of our way in our own time to help them, but the rest of this stuff is just making our lives miserable! I am fed up being abused every day. I am a caring GP of 20 years experience, but I've had enough, not young enough to retire but I'm out of here and going abroad!

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  • http://www.leithmountsurgery.co.uk/privatefees.pdf

    I cant comment on his charges under competition rules but if I were his patient , I would call Dr.Carty the biggest hypocrite in the world. Given his practice leaflet clearly states they do NOT issues letters for housing matters and then goes on to criticize the LMC and thereby fall afoul on GMC best medical practice and also will have to some bits to fill in the probity section during his appraisal. Of course its possible he may be working for free but he is in a partnership which has these as standard written rules hence should have walked out or amended it before jumping onto the LMC.

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  • Interesting he does not provide letters on housing matters. Could the same arguments not be used for this as well!

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  • But... the disability campaigners showed themselves to be far better acquainted with the facts than the GPs who were commenting.
    ---

    Not really. What the GPs on the other continued to point out was that 1) they are not contractually obliged to provide this information and that 2) undertaking this works takes them away from their families or other NHS work that they are contracted to do.

    Are you disputing either of these facts?

    It's telling that you continue to gloss over these issues and continue your abuse and name calling.

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  • Ildiko Spelt

    I totally agree with Augustus Bennett's comment, I am in the same situation. It is very hard to write a medical certificate to a young person who never worked and hasn't been in the surgery since very long, is not on any medications, but is on benefits. Unfortunately these cases are very frequent. I am happy to support the genuinely ill patients.

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