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Posted: 1/22/2006 10:13:39 PM EDT
www.timesonline.co.uk/article/0,,2087-2004163,00.html

Doctors set to get bonuses if they cut sicknotes

Robert Winnett, Whitehall Correspondent

DOCTORS are to be offered financial incentives to curb “sicknote Britain” by forcing people on benefits back to work. Under plans to be unveiled by ministers this week, employment advisers are to be stationed in GPs’ surgeries and medical assessments will be revised to make it more difficult for doctors to sign people off as long-term sick.

A “national education programme” for GPs will also be launched. Ministers then hope to introduce targets and financial incentives — after consultation with medical bodies — to ensure that GPs abide by the new rules and cut the burgeoning cost of incapacity benefit.

The crackdown will be unveiled in a green paper on welfare reform to be delivered this week by John Hutton, the work and pensions minister. The proposal is expected to pass into law by the autumn.

More than 2.7m people claim incapacity benefit at a cost of £12.5 billion a year. The claimant count outstrips the combined number of single parents and unemployed people on benefits. Incapacity benefit starts at £57.65 a week and rises to £76.45 after a year.

Tony Blair wants to cut the cost of incapacity benefit and reduce the number of claimants by 1m in 10 years. But many of his most radical proposals — including means-testing payouts — are understood to have been abandoned over fears of a backbench rebellion.

A Whitehall source said yesterday: “We are looking at how GPs can get more people back to work rather than signing them off sick. We are also looking at the role incentives can play.

“We want to get the process right first so doctors can direct people back to the workforce before the system of incentives for GPs is put in place.”

This week Hutton will announce a pilot scheme to place advisers in GP surgeries. Those claiming long-term sickness will be assessed to see what work they are capable of doing before being allowed to claim incapacity benefit.

At present doctors simply have to assess how claimants perform in basic tests. For example, the physically disabled are tested to see if they can walk, bend or kneel; those with mental disorders for their ability to relate to others and to “cope with pressure”.

This system is now regarded as too crude — for example, it automatically entitles all blind people to benefits — and a more sophisticated medical assessment is proposed.

Under current rules, payments also increase after six months and again after a year, discouraging people from returning to work. Blair is understood to favour reducing incapacity benefit by up to 25%, to match the £56.20 weekly jobseekers’ allowance “The process will be transformed,” said the source. “The focus will be on people’s ability to work rather than what tasks they can’t perform.”

The government also wants to give employers incentives to encourage them to be more flexible in dealing with sick staff and to promote good health within the workforce. Ministers have held talks with the insurance industry to cut premiums for firms with low levels of long-term absence.

The British Medical Association said that GPs’ integrity could be compromised by the proposals. Hamish Meldrum, chairman of the BMA’s GP committee, said: “Our first duty is to the patient. Doctors are advocates for the patients, not policemen for the Department for Work and Pensions.”

Since the 1980s the number of incapacity benefit claimants has soared five-fold. Hutton admitted this month that benefit had been used to hide the true level of unemployment. oMore than 1,100 local hospital beds face closure as National Health Service trusts have to make cuts to reduce their £620m deficit, according to a poll of members of the Community Hospitals Association.

Additional reporting: Sarah-Kate Templeton
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