GPs ‘under pressure’ to diagnose autism and ADHD for benefit entitlement, report finds

GPs are ‘coming under pressure’ to diagnose conditions such as autism and ADHD that lead to benefit entitlement, despite disbelieving that these diagnoses ‘fairly reflect or will solve children’s difficulties’, a new report has argued.

Three quarters of GPs believe clinical diagnoses for autism or ADHD are ‘given out too easily’ where behavioural interventions ‘would be more appropriate’, according to a poll of 1,000 GPs carried out by the Centre for Social Justice.

And 57% believe ‘financial entitlements linked to autism or ADHD diagnoses strongly influence parental requests for assessment’.

The report said: ‘GPs are, again, coming under pressure to diagnose conditions that lead both to benefit entitlement and education, health and care (EHCP) and special educational needs (SEN) plans, despite disbelieving themselves that these diagnoses fairly reflect or will solve children’s difficulties.’

Three quarters of GPs also believe diagnostic boundaries for conditions like autism and ADHD ‘have expanded to include behaviours previously considered within the normal range’, the poll found.

The report said: ‘Two thirds believe “most” of the children referred for these conditions are primarily presenting with behavioural or environmental difficulties, rather than a neurodevelopmental condition.

‘Well over half believe the financial rewards of a diagnosis are the primary influence for parents to seek one. These are the frontline clinical judgments of the doctors who see these children every day.

‘Our GP polling suggests that in the years of the cost of living crisis and stagnant real wage growth, many parents – and particularly struggling lone parents – are making rational decisions to pursue additional income through the welfare system by seeking diagnostic labels for behaviour previously considered within the normal range.’

The report said that where diagnostic boundaries are ‘wide’ and clinical judgement plays a large role the financial incentives created by the Child Disability Living Allowance (CDLA) and its associated passports into Universal Credit can ‘influence decisions to seek a diagnostic label for difficulties that might otherwise be addressed through earlier, practical interventions’.

It added: ‘This is not a moral failing on the part of parents navigating a system that offers few alternatives; rather, it is a rational response to financial pressure and a system design that has made diagnosis the primary route to support.’

Among other recommendations, the report argued that the Government should better target child benefits to reinvest £0.5bn in front-line support for children with behavioural needs.

It added: ‘Based on GP clinical evidence that the majority of behavioural and neurodevelopmental diagnoses are given where functional impairment does not warrant them, and that 54% of PIP claims with autism or ADHD as the primary condition are unsuccessful under functional assessment criteria, we estimate conservatively that between 50 and 75% of new claims in this category would not meet a properly administered functional needs threshold.

‘This would see around 151,000 to 227,000 fewer cases by 2030, while children with severe or complex needs would be fully protected at their current award rate.’

Pulse has contacted the Department of Health and Social Care for comment.

An independent committee commissioned by the DHSC recently found sharply rising diagnoses and referrals for ADHD and autism that do not appear to be explained by changes in population prevalence.

In an interim report, the committee said services are under ‘significant and sustained pressure’, and that the status quo is ‘unlikely to be sustainable or fair’.