See today's news item.

This statement appears at paragraph 35 of the consultation document:

It is recognised that most of the medical professionals who issue (sick notes) on a regular basis are not experts in occupational health.

I thought this was interesting since that it is exactly what GP's and consultants are asked to be when completing a factual report for DLA/AA claims, in which they are given less than 1/4 of a page of A4 to describe care/mob needs and the patients awareness.

In complaints about DM standards and in appeal submissions I frequently refer to these reports:

Ogden J, Bavalia K, Bull M et al. "I want more time with my doctor": a quantitative study of time and the consultation. Fam Pract. 2004; and Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. British Journal of General Practice, 2002.

in support of this argument:

"GP’s do not usually know about their patient’s day-to-day life and how they cope with disabilities. Most people tend to see their GP relatively infrequently and only for short periods at time (research has shown the average consultation time is less than 10 minutes ) and consultations tend not to involve details required by the entitlement conditions: how someone can plan, prepare and cook a main meal; the nature of ‘severe discomfort’; whether the patient needs help dressing, or prompting to get out of bed, dress, eat and go out."


Now, I can quote the DWP itself in support of the argument. Good news - short live the factual report!!

It sounds really bizarre, what is a Doctor going to put on a fit note for a patient with full blown flu for example.

I so glad the freedom of information campaigner Heather thingy started the process that exposed the many venal self serving Grrrr's, in a way that the most blinkered apolitical individual couldn't miss by a mile.

What's more if the masses didn't know it before, they know now that some of these individuals are 'not fit for purpose'. Which is even better than Torquay United being back in the promised land, which is pretty good.

Back to 'fit notes' , if they want to get e.g. disabled people into work, they could go about changing employment law and employment rights errrrrrrrr in a good way for employees, as well as looking issues like 'positive discrimination' and so on so forth. But that requires going against the vested interests that they've vested so much interest in.

Back in the Bad Old Days, " fit for light work" was the verdict delivered by the department's medic. The verdict has returned, but now it is to be delivered by the claimant's GP.

The evidence at the back of the consultation document is interesting from the GPs who test-drove the draft. Under the present scheme they can only choose between "fit" and "not fit". In the new one they will still get these but also will get "may be fit for some work" as well. There was a big switch from "not fit" to "maybe fit for some work" for people with back pain, but very little change in choice for people with depression.

You do hear a lot of people say "my doctor says I'll never work again" when the doctor is clearly thinking of the old job. Maybe this will help - and put pressure on employers to help people to stay in work - which I think is the idea. Doing nothing is absolutely the worst thing you can do for back pain.

I don't think the flu one is a problem. The doctor will simply say not fit for two weeks (if it keeps you off work for less than two weeks it isn't flu) and that will be that.