Protesters criticise scheme that puts job advisors in GP practices

Disability rights and mental health campaigners have slammed a pilot scheme to put employment advisors inside GP practices.

Over a hundred activists, supported by doctors, held a protest outside a practice in Islington, north London on Friday.

The voluntary scheme allows clinicians to refer patients with long-term health conditions, for employment advice. The move fits with government plans set out in the 2014 autumn statement, in which health secretary Jeremy Hunt said GP practices could be encouraged to link up with Jobcentres and other social security services.

Groups including Disabled People Against Cuts (DPAC) and the Mental Health Resistance Network fear the plans could be expanded under a government drive to reduce the numbers of people receiving social security support.

GP-patient relationship

Campaigners fear the plan puts GPs at risk of breaking their ethical duty to ‘do no harm’, that it could undermine patients’ trust and exacerbate mental health problems.

Islington Borough Council defended the 12-month Working Better pilot programme it co-funds with the Department for Work and Pensions’ Jobcentre Plus. Council leader Richard Watts said the programme was not linked in any way to welfare-to-work conditionality or the benefits sanctions regime.

Protest organiser and DPAC member Paula Peters told GPonline campaigners feared the scheme could become mandatory.

‘We are concerned about GPs prescribing job coaching,' said Ms Peters. ‘This this is compromising GPs’ hippocratic oath to do no harm, and blurs the lines between health and work.

‘We are concerned the GP [practice] will become a place of coercion, bullying and conditionality. That if you don't see the jobs coach [they] will report it to the DWP.’

GP workload

Kent GP and National Health Action party activist Dr Bob Gill sent a letter of support to the campaigners. Practices trialling the programme may have ‘unwittingly crossed another boundary which plays into the wider agenda of blurring functions and roles of public servants’, warned Dr Gill.

‘The Jobs on Prescription schemes will damage the doctor-patient relationship particularly for people with mental distress and physical disabilities. The GP will be seen as an agent for the DWP with a potential conflict of interest in advising patients into job focused interviews,' said Dr Gill.

Ms Peters said there were ‘many GPs who are absolutely horrified that this is being done’. She added: 'They have said this isn't a role they should be involved in. GPs don't have the time, they are already overworked.’

Disabled people are concerned about the potential for breach of medical confidentiality from allowing jobs coaches access to medical records, said Ms Peters, although Islington Council has said no personal data will be shared with the DWP or JCP.

‘We already have to watch what we say to a GP anyway in case it’s used against us in a [fitness to work] assessment,' Ms Peters said. Under the new scheme GPs could be seen as ‘collaborating with the DWP’.

Patient confidentiality

Cllr Watts said: ‘Islington Council has long since been on the side of our most vulnerable residents as we continue to fight against the government’s benefit cuts, which threaten disabled people’s ability to exercise independence in their lives.

‘To be clear: the Working Better scheme is entirely voluntary and not linked, in any way, to any welfare-to-work conditionality or sanctions regime.

‘This is not about work being a ‘cure’ for people’s health conditions. It’s about doing more to break down barriers and make employment support services more accessible and inclusive to those who want to benefit from them.

‘I’d very much like to invite anyone who might have concerns about the scheme to come and meet us so we can discuss them in detail.’

A statement from Islington CCG said: ‘The Working Better pilot is a voluntary programme run by Islington Council offering advice and guidance to patients who have expressed an interest in returning to work.

‘This local pilot which is entirely voluntary was developed following work to understand the experiences of local people. Patients (including those who may have experienced mental health problems) are offered the opportunity to be referred for employment advice and guidance if they feel that a return to work would be beneficial.

‘Employment coaches are provided by Remploy, and involvement in this local pilot will have no impact whatsoever on receipt of benefits. This is made clear by the healthcare practitioners making referrals and trained employment coaches delivering the support. If at any time, a patient decides they no longer wish to be involved in the pilot, they are able to leave.’

A DWP spokesman said: 'This small local project in Islington is testing whether it works to offer services to people with long-term health conditions or disabilities at doctors surgeries – potentially making it easier for people to look for work if they are able. 

'Exploring new ways to deliver services is an important part of our efforts to provide the best possible support to claimants.'

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