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The waiting game

BMA must condemn work assessments

As frontline doctors, we share the view of many sick and/or disabled people that the BMA leadership has failed to give any effect to the unanimous wishes of its members: that the work capability assessment be scrapped immediately.

It is unsafe, causes avoidable harm, lacks meaningful risk assessment and has no formal reporting mechanism for adverse events such as suicide.

According to the GMC’s Good Medical Practice, a doctor must take prompt action if patient safety is being compromised.

Employment support allowance exceptional circumstances regulations 25 and 31 are a way of highlighting substantial risk of harm to claimants, yet despite this, most GPs are unaware of them.

We call on the BMA to publicise the lawful application of these regulations in order to prevent further avoidable harm. Failure to do so would in our opinion amount to negligence.

From Dr Stephen Carty, Edinburgh, and 17 GP co-signatories

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Readers' comments (1)

  • Here is the full letter which had to be edited for publication:

    On 24th June last year at the BMA's Annual Representative Meeting (ARM) doctors from every discipline voted overwhelmingly to demand that the DWP-Atos Work Capability Assessment end 'with immediate effect'.

    Through their Medical Adviser, the patient-led Black Triangle disability rights campaign originated the motion which became BMA national policy. Part (iii) of the ARM motion called upon the BMA to engage with disability groups to change public policy. To date, the only "official" communication their campaign has received has been a short statement via Facebook.

    As doctors on the front line witnessing daily the enormous avoidable suffering of many of our most vulnerable patients caught up in this Kafkaesque system of 'disability assessment', we find this failure to meaningfully engage unacceptable. More critically, we fully share in
    the dismay with which sick and/or disabled people have greeted the failure of the BMA's leadership to give any meaningful effect to the unanimous wishes of its members: that this dreadful assessment régime should be immediately terminated.

    The GMC’s own publication ‘Good Medical Practice’ states that:

    ‘… a doctor must (overriding duty or principle) take prompt action if he feels that “patient safety is or may be seriously compromised by inadequate… policies or systems.’

    ESA Regulations (2013) 25 & 31 deal with flagging up a substantial risk of harm to patients if they were to be found ‘fit for work’ or to have ‘limited capability for work’ and placed in the Work-Related Activity Group (WRAG) where:

    'the claimant suffers from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work.'

    Regrettably, it remains the case that only DWP and ATOS staff are aware of these regulations whilst GPs remain ignorant of their existence and those performing the WCA and DWP Decision Makers continue to make complex risk assessments based on grossly inadequate patient information.

    Until the current system is entirely revised, there remains no safety protocol for the assessment of risk and the avoidance of harm to patients. There are no formal reporting mechanisms for GPs to report significant adverse events such as self-harm and suicides which many of us have witnessed.

    Black Triangle have led the way in campaigning for the uptake of Regulations 25 and 31 and their legal Counsel has advised that they should be applied in every case where harm would be more likely than not to occur as a result of erroneous DWP decisions regarding patients'
    fitness for work.

    We are also fully aware of the fact that numerous conflicts of interest exist between the ethical versus contractual duties placed upon GPs arising out of the DWP-Atos contract. In balancing a doctor's duty of care to provide supporting information for Tribunal appeals and contractual conflicts with the DWP over the issue of fees and workloads, we submit that the only ethical solution must be the one that causes the least harm to patients.

    Black Triangle's simple campaign for the appropriate application of these regulations utilising one side of A4 has proved highly efficacious in this respect. It has saved General Practitioners a substantial amount of time and expense and has meant that unnecessary,
    costly and stressful tribunal appeal hearings have been rightly avoided.

    We now call upon the BMA leadership to urgently publicise and make known to every GP in the country the existence and lawful application of these regulations without any further delay in order to prevent further avoidable harm to our patients. Any failure to do so would in our opinion amount to negligence.

    Dr Stephen M. Carty, GP and Medical Advisor, Black Triangle Campaign.
    Dr John Budd, GP Edinburgh Access Practice
    Dr Roy Robertson, GP Muirhouse, Honorary Clinical Reader
    Dr Ian McKay, GP Rose Garden Medical Practice, Leith
    Dr Oliver Aldridge, Edinburgh
    Dr Guy Johnson, GP Sighthill Health Centre, Edinburgh
    Dr Helga Rhein GP, Sighthill Health Centre, Edinburgh
    Dr Elizabeth Morton, GP Challenging Behaviour Practice, Edinburgh
    Dr Kate Burton, Public Health Practitioner
    Dr Margaret Craig, GP, Allander Surgery, Possilpark, Glasgow
    Dr Nick Treadgold, GP, Pollok Health Centre, Glasgow
    Dr Christine Grieve, GP Drumchapel Health Centre Glasgow
    Dr Chris Johnstone, GP Paisley
    Dr Donald MacIntyre Consultant Psychiatrist Edinburgh
    Dr Sarah Houston GP
    Dr Ros Wight GP
    Dr Robert Young, Glasgow
    Dr Nora Murray-Cavanagh GP Medical Education Fellow
    Dr David Nicholl, Consultant Neurologist, Birmingham
    Dr Jonathon Tomlinson, GP The Lawson Practice N1 5HZ
    Dr Anita Roy, GP, Yorkshire
    Dr George Farrelly, GP, London
    Dr Peter English, Consultant, London
    Dr Robert Cheeseman, Ophthalmology Registrar, Liverpool
    Dr Ray Noble, Medical Ethicist, UCL Institute for Women’s Health
    Dr Margaret McCartney, GP , Glasgow

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