The GPC is seeking talks with the Department of Work and Pensions (DWP) after GPs and LMC leaders raised a series of concerns with the tests and appeals process being used in the Government's drive to get patients off benefits.The GPC said it was alarmed by the high success of appeals against original fitness to work judgements made under the work capability assessment, with private firm Atos charged with carrying out initial assessments. The DWP said that a quarter of people who have received work capability assessments to date have had appeals heard against rulings by Atos assessors. Of this quarter, 38% have had their fitness to work judgements overturned.
The GPC said it was particularly concerned over the length of time patients are having to wait to have their appeals handled – the latest DWP statistics show that an average appeal takes 24.6 weeks to be completed. The committee said it would be flagging up concerns over the levels of pay for doctors who sit on appeals panels, with concerns that the Government is ‘significantly underpaying' GPs. Doctors are currently paid £371 to sit on social security panels.
Dr John Canning, chair of the GPC's professional fees committee and a GP in Cleveland, said:‘A 40% success rate of appeals suggests the appeals process and the first round are inconsistent in their approach. We have concerns about the process with Atos and how their doctors are remunerated and encouraged to work – that is to do with how the contract is managed.
‘The second bit is how long it takes to get an appeal, it can take up to nine months in some cases and that is incredibly unfair on people. I don't believe that the tribunal service is adequately staffed with doctors – certainly not with doctors who are active in clinical practise.
‘The fees that they pay will not backfill a doctor in active clinical practise for a day. The doctors that they are employing do not have to be licensed, they only have to be registered, so they do not have to go through revalidation. They, we believe, are significantly underpaying in order to attract people who are in active practice.'
Dr John Hughes, secretary of Manchester LMC and a GP in the city, said:‘As part of the Govenrment's drive to get people into work, we have more and more patients getting called in for medicals. The quality of the assessment is sometimes in significant doubt, particularly with patients with psychological and psychiatric conditions. It does appear to be very much a tick box exercise.
‘The patients are then taken off benefits - they then appeal and we then get an increased workload from that because they are advised by third parties that if they are appealing then they have to see us for a further sick note.'
Her Majesty's Courts and Appeals Service, which manages the tribunals, refused to say how many doctors used on tribunal panels are clinically active. But a spokesperson said: ‘Medical members undertake regular training and are subject to appraisal on their judicial and medical skills including ‘in-court' observation to ensure they can make fair and robust decisions based on accurate medical information.'
A DWP spokesperson said: ‘If a 'fit for work' decision is overturned at appeal, it does not necessarily mean that the original decision was inaccurate - often, customers produce new evidence in their appeal. The DWP is working closely with the MoJ and the Tribunals Service to reduce the number of appeals.'
An Atos spokesperson said: ‘ [An] appeal tribunal hears all evidence afresh, including any new evidence that was not available to the original Decision Maker, to decide whether the original decision on benefit entitlement was correct. Thus when an appeal panel reaches a different decision this does not necessarily mean that the original decision lacked validity or the original assessment was not correct.'
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