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The move deepens the row over the support GPs provide for patients who are appealing their benefits being withdrawn.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

  • Of course it's ridiculous to expect anyone in health to work for free
    -----


    The problem is that some of the non-facetious posts are suggesting exactly that!

    :)

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  • @7.43 the problem is that a lot of costs/ work is based at practice level. CQC registration is per practice. A single hander will have to do all the work (or pay for it) whereas a 10 partner practice will be able to share out the work between a group. The cost of inspection will be less, but the work involved in preparing those pointless policies is the same.

    I have no real idea why anyone would go single handed, it would drive me crazy. But in some parts of the country it is needed and they have my sympathy that things are being made harder for them.

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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?

    _____________

    I'm not Ian but there was another avoidable suicide in the news just today where the coroner explicitly implicated financial difficulty due to ESA benefit being stopped for someone struggling with depression......

    http://www.theargus.co.uk/news/10649155.Crawley_man_killed_himself_after_losing_benefits/?ref=twtrec

    Why would the mention of avoidable suicides be "trolling"?

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  • The whole issue is degenerating into an unedifying 'bun fight'.
    It will end badly for all concerned.
    Sick patients need benefits, the DWP's processes require them to justify themselves via medical evidence, it is what it is. This is a burden on GP's, for some it is obviously also beyond what they consider to be their role, nevertheless it is what patients consider their role includes.

    It would be far better if the profession and in particular those LMC's concerned were to work out a mutually acceptable compromise with the so-called 'claimant lobby' to ensure that the issue can be managed.

    If the profession does not do this then the courts will end up deciding....maybe after a long, expensive and bitter battle.

    The government has created a system, like it or not, which requires the need for medical evidence at both the initial assessment and appeal stages. Engage with the system and try to find ways of making it less onerous for all concerned.

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  • The DWP only request an ESA 113 from the claimants GP in 7% of cases.

    The decision maker is then relying solely on the information provided by the patient in the ESA 50.
    Bear in mind the claimant may be illiterate, learning disabled or mentally ill and lacking insight

    So just to restate that - in 93 percent of cases the DWP decision maker has no idea how ill the claimant might be. - no wonder the appeal success rate is so high!

    Yet some LMCs think the best thing to suggest is to deny patient access to supportive medical information for the purposes of appeals.

    There may be a case to answer that this represents unlawful indirect discrimination and breach of equality duties

    My time given to the Black Triangle Campaign is entirely pro bono. The legal counsel sought is also pro bono. The campaign is staffed entirely by volunteers many of whom are disabled.

    My views do not necessarily reflect the views of Leith Mount Surgery Partnership.

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  • Add 10% to what charges? (anon 3rd sept)

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  • Robin knows best!! ........

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  • I will advise all my work-shy lot to go and register with Dr Carty at Leith Mount Surgery.

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  • Stephen Carty 11.05pm

    "My views do not necessarily reflect the views of Leith Mount Surgery Partnership."

    Yet you still benefit financially from their views and conveniently added the modify of 'necessarily' in your sentence.

    No credibility I'm afraid. Its easy to have the courage of your convictions when they cost you nothing.

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  • Anonymous | 04 September 2013 0:27am

    I will advise all my work-shy lot to go and register with Dr Carty at Leith Mount Surgery.

    Perhaps you should either reveal your identity or remove yourself from this discussion. These claimants could only be in receipt of ESA if you or one of your colleagues provided them with a fit note in the first place. The use of language such as "work shy" to describe long term sick and or disabled persons is Daily Mail rhetoric. Perhaps you also think them to be scroungers or unsustainable. - reveal yourself - anonymous posting is for cowards and trolls

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