Following this article about DWP interference in the way that GPs treat patients who have been refused ESA, DPAC have initiated a letter to the Royal College of GPs and the BMA GP Section, asking those organisations to get involved in this issue.
The letter to the Royal College of GPs is copied below and the one to the BMA is identical. We will publish on this blog the responses we get from them.
To: Professor Mayur Lakhani, President of the Royal College of General Practice
CC:
Editor Pulse Today
Editor Disability News Service
Second copy to : Chair of the General Practitioners Committee UK Dr Richard Vautrey
Dear Mayur
We write as a group of concerned health professionals and disability campaigners regarding a recent change by the Department of Work and Pensions which we feel will gravely impact on the doctor / patient relationship between GPs and disabled people claiming benefits.
The DWP has issued a new ESA65B, the form used to inform a patient’s GP of their WCA outcome. This form which requests GPs not to send any further fit notes for ESA purposes after a claimant has been found fit for work, unless they appeal had already been at the centre of a controversy.
A claimant, James Harrison died 10 months after being found fit for work and after the jobcentre asked his GP not to issue further fit notes for ESA purposes. James Harrison wanted a fit note because he was too ill to attend the jobcentre appointments, but his GP refused to issue them (Metro), this being just one bleak example of the distress and hardship enacted on people through the current callous benefit regime.
The new ESA65B form which is headed ‘Help us support your patient to return to or start work’ has an added paragraph
In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work. (extract from the DWP’s letter to GPs)
It is all in keeping with DWP’s insistence that not only work is good for health, but also should be a ‘health outcome’. This recurring mantra from the DWP is based on the thinnest veneer of evidence, a single study, which was commissioned by the DWP itself in 2006, which does not even fully support the generalised conclusion that “work is good for you”.
The DWP has also not taken into account other, more in-depth research that concludes that unemployment is less harmful for mental health than a poor quality and insecure job..
There are many reasons, from a clinical point of view, why this action of co-opting doctors by the DWP is wrong and Dr Jay Watts, Consultant Clinical Psychologist, lists some of them:
Health professionals across the country will be horrified at this latest interference from the DWP – a move that undermines clinical expertise and threatens the safety of patients. There are a number of problems. First the letter places the expertise of DWP-funded ESA assessors above that of GPs. This is despite the fact GPs are more qualified to assess mental health, and can do so with the benefits of having known the patient for years, often decades (as opposed to in a one-off assessment).
The DWP letter makes clear that they wish claimants to return to work at any cost, even if that means leaving a current occupation – an attack on the core identity of patients likely to have a damaging effect on mental health.
Second, the letter states that “we know most people are better off in work”. This ignores a considerable literature showing that work can be damaging for mental health, with poor work environments a frequent trigger to mental breakdown. Economic evidence shows that rushing people back into work increases the likelihood of long-term illness.
How then can it be right to encourage GPs to coerce patients back to work, a pressure likely to increase the feelings of shame, despair and anxiety at not working that have been exacerbated by the governments relentless and damaging campaign to associate worklessness with worthlessness?
Third, the pressure the DWP is exerting on GPs to ‘encourage’ patients back to work, and desist from providing fit notes, is an attack on clinical expertise and the sanctity of the clinical space and clinical decision-making.
Without a firm denouncement of this letter from Royal College of General Practitioners, we risk a situation where claimants will feel unwilling to make appointments with their GPs, given the level of fear the DWP and the work agenda elicits, with damaging and potentially life-threatening effects on the physical and mental health of claimants.
It is vital that health professionals speak up for claimants rights, and insist that fit notes and therapeutic conversations are dictated by the needs of patients not the DWP.
We the undersigned, both medical professionals and disability campaigners ask that the Royal College of General Practitioners inform its members of the risks to patients from this measure, ask doctors and allied health professionals to use caution and discretion when following DWP instructions.
We will be publishing this letter to you on the Disabled People Against Cuts website, and look forward to publishing your response
Signed:
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Dr Jay Watts |
Consultant Clinical Psychologist |
Anita Bellows |
Disabled People Against Cuts |
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Dr Philippa Whitford |
MP, FRCS |
Bob Ellard |
Disabled People Against Cuts |
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Dr Louise Irvine |
GP, Lewisham, BMA Council Member |
Roger Lewis |
Disabled People Against Cuts |
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Dr Stephen Carty |
GP Leith Mount Surgery Edinburgh Medical Adviser Black Triangle Campaign |
Denise McKenna |
Mental Health Resistance Network and Disabled People Against Cuts |
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Dr Coral Jones |
GP in Hackney |
Paula Peters |
Mental Health Resistance Network and Disabled People Against Cuts |
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Anna Livingstone FRCGP
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Tower Hamlets GP |
Linda Burnip |
Disabled People Against Cuts |
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Ben Newton |
Community Worker in Glasgow
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Ellen Clifford |
Disabled People Against Cuts and Inclusion London |
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Beatrice Millar
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on behalf of Psychotherapists & Counsellors for Social Responsibility |
Andy Greene |
Disabled People Against Cuts |
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Julia Evans |
Lacanian Psychoanalyst
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Miriam Binder |
Disabled People Against Cuts |
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Dr Laura Winter |
Counselling Psychologist
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John Kelly |
Disabled People Against Cuts |
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Emily Shah |
Trainee Clinical Psychologist, Camden and Islington NHS Trust
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John McArdle |
Black Triangle Campaign |
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Gavin Robinson |
Counsellor |
Brian Hilton |
Greater Manchester Coalition of Disabled People |
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Dr Kara Bagnall
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Clinical Psychologist |
Recovery in the Bin |
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Lauren Canvin, |
Trainee Clinical Psychologist, University of Hertfordshire |
Jennifer Jones |
DPAC Sheffield
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Dr Richard House, |
Chartered Psychologist (BPS), Educational Consultant Alliance for Counselling & Psychotherapy |
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David Cracker |
DPAC Sheffield |
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Andrew Samuels |
Professor of Analytical Psychology, University of Essex: Former Chair, UK Council for Psychotherapy
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Kevin Deegan |
DPAC NORTH Staffordshire East Cheshire |
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Robert Jenkins |
NHS Primary Care Counsellor (Retired) |
Henry Foulds |
Momentum Sheffield Disability officer |
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Debbie Porteous |
Counsellor MBACP |
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Jill Goble |
Brighton DPAC |
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Dr David Porteous |
GP Fishponds Family Practice, Bristol |
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Merry Cross |
Berkshire DPAC |
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Denis Postle |
ARCA |
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Rick Burgess |
Manchester DPAC |
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Paul Atkinson |
Psychotherapist |
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Dr Johann McGavin |
GP Brighton Health and Wellbeing Centre |
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Dr Danielle Gaynor |
Chartered Clinical Psychologist, NHS. |
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Clare Slaney MA |
BACP Accredited |
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Linda Gask |
Emerita Professor of Primary Care Psychiatry University of Manchester and Honorary FRCGP |
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Stuart Morgan-Ayrs |
Clinical psychotherapist |
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Dr Gillian Proctor |
Clinical psychologist and lecturer. |
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Dr Rich Moth |
Registered social worker/SWAN Psychotherapy & Counselling Union |
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Dr Donna Oxley |
Clinical Psychologist, NHS
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Frances Taylor, |
Therapeutic Counsellor and Supervisor, Diversity Worker, Substance Misuse Counsellor Practitioner |
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Dr Jade Weston |
Clinical Psychologist
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Mandy Coghill |
Sensorimotor Psychotherapist |
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Nicola Saunders |
Psychoanalytic Psychotherapist UKCP |
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Ian Parker |
Psychoanalyst, Manchester |
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Sarah Wolfe |
Clinical Psychologist in Children’s Social Care |
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Richard Bagnall-Oakeley |
Integrative Adult & Child Psychotherapist (UKCP Reg. MBACP) |
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Valeska Matziol |
Equalities Research Coordinator |
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Juliet Lyons |
Integrative Child Psychotherapist |
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Annie Mitchell |
Clinical and Community Psychologist; Associate Professor, Plymouth University.
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Dr Sohrab Panday |
GP and Clinical Lead, Mental Health Commissioning Team Hardwick CCG |
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Mark Burton |
Former Head of Disability Service |
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Richard Byng |
GP and academic, Community and Primary Care Research Group and PenCLAHRC, Plymouth University. |
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Kim Jackson-Blott |
Trainee Clinical Psychologist |
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Anna Rose |
MEd MA (Psychotherapist) |
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Dr Lealah Hewitt |
Clinical Psychologist, NHS |
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Dr Safi Afghan |
Consultant Psychiatrist & Primary Care Lead RCPsych |
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Liam Farrell |
Former NHS GP |
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Jen Daffin |
Clinical psychologist in training / psychologists for social change |
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Dr Sheila Cheeroth, FRCGP |
Tower Hamlets CCG, London.
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Libby Kerr |
Psychotherapist UKCP |
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Dr Jackie Applebee GP |
Chair of Tower Hamlets Local Medical Committee. |
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Dr Stephen Weatherhead |
Senior Academic and Clinical Tutor HCPC registered Consultant Clinical Psychologist |
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Dr Kambiz Boomla, |
Senior Lecturer General Practice.
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Dr Rachel Barcroft |
Clinical Psychologist Royal Preston Hospital |
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Rosalind Davy, |
Psychoanalytic Psychotherapist
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Dr Grant Ingrams |
GP, Oakmeadow Surgery, Leicester |
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James Randall-James, |
Clinical Psychologist
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Pauline Miller |
GP St Lawrence road surgery |
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Dr Danny Taggart, |
University of Essex
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Dr Chris Manning |
MRCGP Mental health activist and retired GP with lived experience of major depression(s). |
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Jeyda Hammad, |
Psychotherapist
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Fay Maxted OBE |
CEO, The Survivors Trust |
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Guy Gladstone
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Psychotherapist The Open Centre London |
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Emily Connolly |
Trainee Clinical Psychologist |
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Dr Katherine Macey, |
Clinical psychologist working in physical health.
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Ron Singer |
retired GP and vice president doctors in Unite. |
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Dr Colm Gallagher, |
Clinical Psychologist, Greater Manchester Mental Health NHS Foundation Trust.
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Dr David Shiers |
former Gp (Leek, North Staffordshire) and Carer of a family member with a severe mental disorder. |
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Dr Simon Stuart, |
Clinical Psychologist in Adult Mental Health |
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Dr Carolyn Chew-Graham |
GP Principal, The Chorlton Family Practice, Manchester and Professor of General Practice Research, Keele University. |
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Anne Wagner |
Clinical Psychologist Locality Lead Psychologist |
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Dr Lloyd Baron |
GPST2 Health Education West Midlands |
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Dr Alice Jones |
(FY1 Psychiatry) |
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Sounds like “Arbeit Macht Frei”. Outrageous.
Perhaps it hasn’t but I wouldn’t be surprised if the DWP has now made unemployment as harmful or more harmful than a poor quality and insecure job.