Select Committee on Work and Pensions Written Evidence

Memorandum submitted by the British Medical Association after the publication of the Welfare Reform Green Paper

  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

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