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| TX: 18.01.06 - Incapacity Benefit - GPs PRESENTER: SHEILA MCCLENNON |
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| MCCLENNON Now are doctors to blame for the high number of people claiming incapacity benefit, a number that the government wants to reduce? The suspicion is that GPs have sometimes been too ready to sign off the patients from work, particularly in areas of high employment because incapacity benefit pays more than job seekers allowance. In our reports this week Peter White has been to Barrow-in- Furness in Cumbria, which with the sharp decline of heavy industries has one of the highest levels of incapacity benefit take up in the country. He asked Philip Sharp, a GP in Barrow for almost 35 years, how he reacted to such accusations. SHARP My job as a doctor is personal care. I look at things in terms of the nature of that person, in terms of themselves and their life context and work is part of that life context. And we try and get it right for them. A politician's role is different, they look at it in terms of society, what seems to be best for society as a whole, rather than what's right for this individual who's sat in my consulting room. So they have a job to do and what they do is very valid and I wouldn't change that. But what I do is valid as well. WHITE You've got a standard sick note there, what does it involve, can you talk me through it? SHARP The patient will come in with a sore throat and if it's bad you might give one for a week or maybe a fortnight. But they might come in with cancer, they might come in with Multiple Sclerosis, they might come in with rheumatoid arthritis, so there's a whole range, like mental illness where there might be schizophrenia or long term depression or whatever, you know, so it's a whole range of conditions really from minor to major. WHITE And are these kind of problems on the increase then? SHARP I'd say no, I'd say they've always been there. I think there's more support for them now in medical terms but they're still there just the same. WHITE To qualify for full incapacity benefit you have to fill in a form which contains questions about what you can and can't manage physically. BIGGS The questions are a bit ambiguous - can you lift up a piece of paper from the floor. A lot of people say yeah I can get down there but there's nothing to say after that can you get back up again. WHITE Colin Biggs who has multiple sclerosis has been through this process. BIGGS They're very basic questions but they don't give the full account of what a person's disability is and this form's been going for years and years and years. It is poor because they can probably contact your doctor but they virtually go on what's on that form. You put your medication down, you put what your disability is and if you can rise from the chair, if you can walk upstairs, they just make the assumption that a person's either disabled or not on that. WHITE Some people regarded as borderline to receive the benefit are required to attend a further test in person. These are now known as PCAs or personal capability assessments. You're marked on a clearly defined scoring system on a range of physical and mental tasks. BESSICK It might be helpful if I take you through some of the descriptors. WHITE David Bessick is one of a panel of doctors who carries out these tests in the Barrow area. BESSICK For instance we've got sitting, rising from sitting, bending or kneeling, manual dexterity, reaching, lifting, carrying, vision, speech, hearing, descriptor in relation to consciousness and fits, descriptor in relation to continence and then a number of mental health descriptors. And what basically happens is the doctor looks at the choice that the customer has made and has to decide do they agree with that choice or not. SMITH It's very personal, I found it very personal and it was like how did you get here today, and if you suffer from paranoia and this, that and the other how did you get here today. WHITE Kerry Smith, who's been diagnosed with depression, found this a daunting process. SMITH I said on my push bike because I just concentrate on the road. And they dismissed that totally, he said well if you can get on a push bike you're able bodied enough to work and do ... And I'm like oh and he got me very angry where I was like screaming and crying and he was very insensitive. BESSICK We recognise the situation is potentially emotionally charged, so we advise all the staff - the doctors, the receptionists - to do their best to put the customers at their ease. At that stage the doctor then explains what the examination is all about and this is quite important because our examinations are not there to diagnose conditions, we're not there to treat people, it's not an invasive examination, our job is to give an independent opinion as to that person's function. WHITE Some people argue my GP knows my condition, he knows me, then I go along to this other doc who does this test and says actually you're perfectly okay to go to work, that's how people see it. Do you know how much weight is given to what the local GP says as opposed to the examination that you do? BESSICK GPs on occasions may say this person is or not fit for work but what we have to consider is the scores of the descriptors in relation to the all work test, which is something different to a GP saying this person is or is not fit for work. WHITE Because people know that the government wants to get the numbers on incapacity benefit down they're bound to think, and some that I've talked do, that that's what you're there to do, you're there to get as many people back to work, off incapacity benefit as possible. BESSICK I could understand why people not familiar with the process can think like that but our role is nothing to do with that. Our role is to give independent medical advice to decision makers and that's what we do. WHITE Do you have targets? BESSICK We have no targets no. WHITE So what's your opinion of this method, you have to administer it and you do the interview, is this a fair way to decide whether somebody can or can't work? BESSICK I think this is a very fair way of assessing disability. There are always winners and losers in any benefit system, there are always people who just miss out but it's much improved on the old invalidity benefit system and I think it's a very fair method. MCCLENNON David Bessick ending Peter's report. And tomorrow we look at what happens if your claim for incapacity benefit is turned down. Back to the You and Yours homepage The BBC is not responsible for external websites |
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