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Welfare reform conflicts with our duty to do what’s best for patients

‘GPs need more guidance on their role in supporting patients as well as their ethical responsibilities’ says Dr Graham Kramer

As a GP, I’m emotionally struggling to witness what some of my patients are experiencing with welfare reform.

This is not specifically a deprivation issue, although GPs working in deprived areas will face greater fallout arising from welfare reform.

The duty of GPs is to promote the health of their patients as a prime concern. It is well-recognised that employment for many people can be therapeutic and so we try to actively promote work as a means to achieving health.

However, for some people – many of whom are struggling to overcome daily disability and complex mental and socio-emotional issues – work is
a far-away prospect, particularly where adapted flexible employment is unavailable. Forcing people off benefits and into work can seriously destabilise their health.

Some patients on benefits find they can devote some of their capacity to helping others and try to give to their community through volunteering. But this valuable peer support is being eroded by the reforms and risks undermining networks of support for self-management. 

In my experience there is little meaningful communication between GPs and the Benefits Agency, making
it impossible to develop collaborative approaches that best meet the needs
of patients.

ATOS assessments seem one-dimensional and assessors’ decisions necessarily involve a conflict of interest with the principle to ‘first do no harm’.

There is a need to evaluate how these reforms are affecting people’s physical and mental health. There also needs to be an evaluation of how the reforms are affecting GP workload. GPs need more guidance on their role in supporting patients as well as their ethical responsibilities.

Dr Graham Kramer is a GP from Montrose

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