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March 28, 2010 7:48 pm
Go to the doctor for a sick note on the Tuesday after the Easter bank holiday and you may find yourself issued instead with a “fit note”.
For the first time in almost 90 years doctors will no longer simply certify whether a patient is fit for work or not, but will have a form allowing them to state whether the patient “may be fit for work” if certain conditions were met.
These include an employer offering a phased return to work, altered hours, changed duties or adaptations to the workplace.
There is considerable scepticism about the initiative as the employer does not have to take any notice of the “fit note”. But Dame Carol Black, the government’s health and work tsar whose 2008 recommendation led to the change, says she hopes the scheme will be the start “of a quiet revolution”.
The government, she notes, has spent billions of pounds on welfare-to-work programmes to get people off incapacity benefits and back to work. “But until now it has done almost nothing at the very start of the process that can lead people to dependence on long-term sickness benefits in the first place. The logical thing is to staunch the flow.”
Many people with back pain, neck pain, anxiety and stress are able to work with only limited adaptations needed from their employer, she argues.
Recent research by the insurer Aviva, however, shows two-thirds of employers have little or no knowledge of the change and how it will work for them. Just 5 per cent thought it would reduce absence rates that are estimated to cost the UK more than £100bn a year. The research also shows 57 per cent of employees do not believe their doctor is qualified to judge them fit for work.
The British Medical Association has supported the change in principle, but some GPs fear it could change their relationship with patients, turning them from patient advocates into judges of someone’s ability to work.
Dame Carol says she does not consider it “good advocacy” just to give people repeated sick notes when it is established that the longer people are off sick the less likely they are to return to work.
“What this is really about is a change of culture, and the way people think about work and what they can do,” she says. “It will be a slow revolution. I don’t expect rapid change. But it is the start of better early intervention.”
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