Jeremy Laurance: Our own GPs know us best

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Why would a GP who has a long-term relationship with a patient deny them a sick note? That is the drawback of the current arrangements. There is no incentive. A refusal could cause offence.

On the other hand, there is no one in a better position to assess a patient's state of health than their own GP. This dilemma goes to the heart of Government policy on assessing fitness for work. While in sickness absence there is a move away from involving GPs, in disability the trend is in the opposite direction.

From 2013, a new test will be introduced as two million adults on Disability Living Allowance are moved to a replacement called Personal Indepedence Benefit. An important part of that test will be a medical assessment provided by ... GPs.

On the one hand GPs are being given more responsibility; on the other it is being taken away. The alarming trend is toward easing the burden on bosses by reducing their responsibility to help staff back to work after illness or to stay in work with a disability. How will that help the drive to reduce those living on benefits?

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