Memorandum submitted by the British Medical
Association after the publication of the Welfare Reform Green
1. The BMA supports measures which will
assist a speedy and appropriate return to work following injury,
ill-health or other health-related problems. However, we have
significant concerns about the present proposals for welfare reform.
These will be covered in greater detail in our response to the
Green Paper but, meanwhile, we would highlight the following that
we believe demonstrate flaws in the present proposals:
The Green Paper fundamentally misrepresents
the role of GPs by referring to their key role "in helping
people back to work". The central purpose of the primary
health care team in managing the sick is restoration of health,
or where this is unrealistic ensuring the best possible strategies
for the patient to manage the chronic illness.
Expecting family doctors to certify
whether their patients are fit enough to work will have a detrimental
effect on doctor-patient relationships.
2. The BMA believes the role of certification
should be removed from GPs in order that they can act as independent
advisers to patients to enable them to achieve their greatest
potential for employment, without the concern that the GP is either
acting as an agent of the DWP or has performance targets to achieve.
3. We suggest that the role of short-term
assessment of sickness for the purpose of absence from work is
best undertaken by employees and employers with advice from occupational
health professionals and perhaps brief factual information from
GPs. Employers should therefore have greater responsibility for
their own occupational health services and managing the short-term
sickness interests of their employees. Absence management is a
human resource issue not a medical issue, and thus it should not
fall under the remit of GPs or even the NHS.
4. The provision of GPs with special interests
in occupational health is an interesting suggestion and may be
welcomed by some GPs. What are not addressed are the workforce
and resource implications of moving skilled diagnosticians from
primary care into assessment roles. Much of the work could be
achieved by carrying out detailed workplace assessments.
5. As employers, GPs will welcome the changes
to bureaucracy associated with Statutory Sick Pay. In the short
term we suggest that the need for signing-off notes is removed
and the employer is encouraged to accept an employee back to work
according to a joint assessment of the situation together with
a workplace assessment when required.
6. Any voluntary and/or private sector providers
must meet strict minimum standards for advisers and others working
in the system. GPs are willing to work with appropriately trained
and skilled personnel. Unfortunately we have experience of some
voluntary sector organisations misunderstanding the role and purpose
of GPs' current role in the benefits system which can lead to
conflict and misunderstanding.
The BMA is a voluntary, professional association
representing doctors of all branches of medicine across the UK.
Our current membership of over 134,000 includes over 16,500 medical
students and nearly 4,000 overseas members. We are also an independent
trade union and have represented doctors in negotiations since
the beginning of the NHS in 1948.
1 March 2006