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Letter from LMC on refusing benefits requests

The template letter from Lancashire LMC for GPs to ‘just say no’ when faced with benefits requests

Click here to read the letter

Click here to read the news story

Readers' comments (11)

  • From a narrow minded perspective, yes. Although in the wider determinants of health, and the Mental Health impact on patients stugglings to survive financially (perhaps the most marginalised service users!!! heavens forbid a GP may do something for a patient that doesn't have an inordinate amount of £ signs attached!!!! After all, they must be struggling to scrape a living together from the average hundreds of thousands areasonably sized practice gets!!!

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  • As a GP, you are responsible for the welfare of your patient, from birth to inevitable death...

    Surly by assisting our patient to continue to receive benefits particularly will assist with their overall well-being.

    Money is not the reason most become Doctors, this slippery slope must be stopped...

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  • I am horrified to read that today's edition of Pulse, the GP mag, has the following article:

    LMC leaders are considering a ‘just say no’ campaign to support practices who refuse to take-on unfunded work, and have already drafted a letter to help them turn down patient requests for support when appealing against their benefits being withdrawn. The campaign would be designed to back GPs who turn down requests for medical reports from benefit claimants and requests for work from secondary care. The LMC leaders from Lancashire and Cumbria have already come together to create a template letter for all GP practices to use in the area advising patients against personally asking for help from their GP.

    But they are also planning on taking forward a campaign to widen a ‘just say no’ campaign to other areas of unfunded workload at its next meeting, including requests from hospitals and other parts of the NHS and social care.

    The campaign comes after GPs complained of spiraling workload from patients requesting supporting information to protect their benefits, and a rising amount of workload from hospitals being dumped on primary care. Pulse revealed last month that GPs were struggling to cope with 21% rise in requests to provide evidence to verify work capability assessments since January.

    The template letter sent to practices advises patients to contact Jobcentre Plus or the appeals service if they need further medical evidence, and allow them to contact their GP if they think more information is needed.

    Are these people for real, JCP will not provide medical evidence, nor is the likelihood of a successful outcome during appeal/reconsideration good without some form of med evidence!

    I have left the following response and its comment one.

    READERS' COMMENTS (1)

    Fightback 4Justice | 23 August 2013 9:16am

    I am outraged, I am a Disability Benefits Legal Advocate, and founder of a pro bono group on Facebook, Fightback4justice, where we aim to help disabled people fight these often, unfair and unjustified decisions by the DWP. Unfortunately it is a common misconception amongst the medical profession, that DWP contact GPs and Consultants direct in order to obtain their opinion. This is not the case during the appeal process, and often DWP do not contact a GP at all during any stage of the application. Therefore the onus is on the claimant to obtain this medical information ie proof they are disabled, themselves. It is also a sad fact that the likelihood of a successful appeal without medical evidence will most likely fail in the Tribunal or during reassessment.

    We understand the burden this is putting on the medical profession, and note the BMA comments recently calling for surgeries to refuse direct medical evidence requests from patients themselves. However this course of action will, most likely have a detrimental effect on the outcome in a tribunal, and subsequently be detrimental to the health of disabled patients if their Employment and Support Allowance payments ceased completely, as a result of a failed appeal due to lack of medical evidence. Worse still is the prospect that disabled patients will be forced to sign on to Job Seekers Allowance and actively show they are seeking work 35 hours a week, in order to financially support themselves.

    We are ourselves as a group, are seeking to redress the flaws in the Work Capability Assessment, through our campaign work, and there are a number of legal challenges currently in the High Court at present. Sadly as the wheels of justice grind slowly, and the government have appealed a recent decision to finding the mental health test in the work capability assessment unlawful, it is likely to be a significant time before any real changes are made to the way the assessments are carried out. The press releases alone, must be ringing some alarm bells with the medical profession, as genuinely disabled people are taking their own life, or dying after being found fit for work and taken off the mere £71 a week they are given to survive. I have worked for CAB and have seen first hand how this is affecting others, and its heartbreaking, I have clients, with amputated legs, told they can walk 200m without discomfort, one who has one arm also, who has been found fit for work, due to the fact he can press a button with his one and only limb! The decisions by the DWP are sublime and most are overturned in court, with medical evidence. Yes that is the governments failings not the medical profession, but surely the surgeries are going to create more work for themselves when these people come in with suicidal thoughts, or severe malnutrition or hyperthermia due to nil income. From October the government has withdrawn the appeal rate to anyone who is found fit for work and appeals, this can be for months, whilst it decides to look again at the case before passing to tribunal. The DWP will not reconsider in a claimants favour without evidence, and the claimant will be left without even the £71 a week pittance to live on, and have to survive on food banks etc. The knock on effect of a failed assessment overspills into other areas, DLA is often then denied, and Housing Benefit, leaving a patient facing eviction to add to the burden. Many of the propaganda paints a bad picture on this country's disabled, but I see different and challenge anyone who thinks these people are scroungers to take a look at fightback, and the forum and see how people are affected, or better still spend a day with me doing probono house visits, where often a customer has no heating or milk to put in a brew to offer.
    All we respectfully ask that you could try and get a full picture of what is going on, its not your patient's fault they have to prove they have a disability, just because the assessment is not fit for purpose, and full of tricks. There is is a large gap in the regulations that is affecting disabled and vulnerable people in an unfair way and this course of action will push many thousands into an early grave or hospital. The medical profession should be pushing the government to change its policies re the assessments and evidence, not blame the vulnerable who already face enough challenges in life!

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  • >As a GP, you are responsible for the welfare of your patient, from birth to inevitable death...
    --

    Wrong. As GPs we are responsible for delivering services according to the contract we have with the Government (GMS2/PMS). We are not responsible for anything outside of this.

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  • Anonymous | 23 August 2013 10:00am

    "Wrong. As GPs we are responsible for delivering services according to the contract we have with the Government (GMS2/PMS). We are not responsible for anything outside of this."

    Sad that you take the jobsworth's view on this. What about "first do no harm", "be the patient's advocate" etc.?

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  • Can I ask if the letter has been checked by a qualified welfare rights adviser and/or the Tribunal service? It is not usual for a tribunal to request evidence. In a similar way to the procedure in a court of law, the tribunal service is there to weigh the evidence, not to gather it. And DWP is unlikely to seek evidence to undermine their own case!

    I understand the pressures facing GP's, but we have to find a solution to this, as extreme mental, emotional & physical stress, combined with poverty, lack of food & heating and the threat of eviction, are not conducive to good health & well-being. Most moderate campaigners would be more than happy to work with GP's on this, rather than against them, and I have emailed Clare Gerada this morning (as a follow-up to previous contact) to suggest we do so.

    In the meantime, I think this should be up to the consciences of individual doctors, since for many of those most disadvantaged, the best they can do, to promote their well-being and prevent further deterioration in their health, is to support them in their fight for a small amount to live on.

    As I said in a comment on the substantive article, the ONLY safety net now available, for those without family to help, is the 3x food parcels from the foodbank. That's it. No income support, nothing. That's the reality, which I think should be included in the debate.

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  • I have just read the letter re don't ask your GP for medical evidence and I am appalled and shocked at its gross inaccuracy for one, and its total lack of understanding and empathy for those who would request it. I fully understand that GPs are under pressure from ever bulging workloads and can empathise with them on this score, but I also agree that refusing to help the most vulnerable is not the answer. The vulnerable need those with more power than themselves to stick up for them and challenge the governments agenda here which is to strip as many of the poor from claiming benefits and to use their well researched propaganda to marginalise and demonise the group in question in order to push through their archaic and brutal reforms.

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  • I just offer patients a summary print out of their records and any useful hospital letters free of charge. Often I add a short comment of support to the notes and add this to the print out. not a hassle and hopefully helps the patient !!

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  • All this nonsense stops if you leave the UK. Canada, antipodes, Channel Islands, etc., etc..... Why are you still working in the UK? I left and it was the best decision I made for my family. Do yourselves a favour and do the same.

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  • GP's were not considered honest or reliable enough to assess patients fro benefits / ability to work, but when it needs further information, it is the GP's that folk are forced to turn to.
    This government cannot have it both ways, the money they pay ATOS should be paid to GP's who really know their patients.

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