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Save me from the unworking well

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Normally when I’m on my summer holiday the phone is off, the TV is never on, newspapers remain in the rack, and the outside world and I amicably break all contact for a few weeks. We can do without each other, for a short period at least. 

However, in the car on my current jaunt, while changing one Goon Show CD for another, I accidentally turned on the radio and heard two pieces of vital information.

First, we have a new heir to the throne; a baby boy, who at that point remained unnamed. I took the opportunity to dash down to the bookies in Shetland and get five quid each way on ‘Keith’, while the odds were still long. By the time you read this we’ll probably know for sure; I confidently expect to clean up on that one.

The second item that accidentally got through my firewall was that Atos, that paragon of common sense and private enterprise, will as of next year lose its monopoly on quizzing unemployed disabled people to assess their suitability for work.

The Government’s audit found as many as 41% of Atos’s written reports on disability claims were flawed. But in my experience – although it is unfashionable to say so – Atos nearly always gets it right.

These fitness-to-work assessments – under Atos, and under anyone who takes the role for that matter – generate a massive amount of work in general practice. Entire surgeries could be filled with the disgruntled unworking well, full of indignation at being considered reasonably healthy.

An irresistible force is meeting an unmovable object here, and we are caught in the middle. We are, as a profession, dedicated to making our patients as healthy as possible, and yet a proportion of punters are hell bent on trying to prove they’re really ill, and need us to confirm it. This is a paradox we face daily. The fact is, nearly everyone is capable of some kind of work. I had considered, at one point, putting up a portrait of Professor Stephen Hawking in my consulting room with a caption that said ‘This bloke is not on the sick’.

Being found fit for some kind of employment by Atos does not mean you’re necessarily capable of being an FBI agent or a lumberjack. However, you might be able to work at a desk on a telephone, or hold a lollipop on a zebra crossing. And we all know, without any shadow of a doubt, that any form of regular employment is not only financially beneficial but also leads to less depression, greater social contact, increased well being, a decreasing tendency to addiction and social deprivation, and an increased likelihood of being in a stable relationship. 

So it may be bye-bye to Atos, and if so good luck to whatever new organisation takes over. I have only one request; try to keep general practice out of it. The dilemma of constantly dealing with requests to confirm illnesses that I have already sorted out is wasting far too much time and muddying the doctor/patient relationship. Take sickness certification away from us. We are too close.

 

 

Readers' comments (76)

  • I suspect the unintended consequence of us losing the responsibility of medical certificates would be a huge increase in requests for letters of support. At least there's a clear structure by which we can avoid them currently.

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  • Spot on.....ATOS gets it right nearly 100% of the time, personally I would like to shake them by the hand and say job well done. The fact is everyone can work no matter what their illness is... unless of course....they are clearly dying and sick leave should only be temporary, for a maximum 3 months for the majority of the patients that I see, ATOS should be congratulated not phased out

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  • Such a waste of tax payers money that so many appeals are upheld - if Atos were any good there wouldn't be so many successful appeals.

    Atos have found people fit for work who have susequently died only a few weeks later.

    I personally know of a young man with autistic spectrum disorder who Atos was found fit for work yet he is incapable of doing most ordinary, everyday things and his mum has to go everywhere with him - on his appeal Atos's decision was overturned.

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  • As a business owner, when employing staff and taking up references, do you ask about sick leave taken in the last number of years?

    If your staff need repeated lengthy spells of absence or admissions to hospital would you be an understanding employer and constantly pay out for sick leave year after year as it ate into your profits?

    Would you take on a partner to share your workload who is off sick 6 months out of 12 due to a debilitating combination of chronic diseases?

    If one of your nurses was able to work 2 days out of 5 but couldn't tell you (from one day to the next) which 2 days he can work due to the unpredictable nature of his diseases, how would you go about planning nursing provision at your surgery?

    As an employer, how would you feel if your reception staff ("work at a desk on a telephone") needed round the clock assistance with medication, feeding and toileting in such a way that it impacted on their ability to work?

    What kind of job would you have this patient work in? She has epilepsy, heart problems, severe autism and curvature of the spine, needs constant one-to-one care, has no concept of danger and has the mental age of a 10-year-old and was assessed by ATOS as "fit for work"

    http://www.guardian.co.uk/society/video/2012/oct/04/welfare-assessors-disabled-work-video.

    Seriously, I'm beginning to wonder if ATOS has taken over the contract for GP revalidation - as some official body seems to be wrongly declaring a lot of intellectually challenged GPs like Peverley as "fit for work".

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  • I agree with Dr P.

    My cousin, who lives in Japan with Dawn's is in his early 20s and he works. It's a government subsidised project for the disabled - and I've got a nice hand crafted basket to prove his work (which he gave us for our Wedding gift). Ok, he gets min wage and it doesn't make his benefit entitlement anyless so it's not costing the nation any less but never the less, he is happy for leading a "normal" life within the society.

    It also proves a point, just because you have diagnosis of illness or disability, it does not mean you cannot work. But the threashold for "unable to work" is very low in UK compared to other countries.

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  • This whole business is nonsense. Some patients seem to think that as their GP we are here to fight every and any battle on their side. I often don't agree with the patient but feel intimidated by them into doing what they want "or else" they will make a complaint. Unless there is immunity from complaints, we cannot act objectively.

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  • Well said Dr Peverley. And Im going to get a photo of Prof Hawking up on the wall as you suggest. I think its a pertinent point.

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  • Atos doctors are 100% right, and the judges who overturned up to 43% of decisions going to appeal are 100% wrong. Obvious.

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  • Anon 4.12pm..........is an example of my point earlier.....I personally tend to grovel to patients for fear of complaints....as you can see if you dare to challenge some, they go berzerk.

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