A recent investigation by a problem in the UK healthcare system: the “fit note.” The sent a questionnaire to over 5,000 doctors in England. Out of the 752 doctors who replied 540 said they have never refused a request for a note when a patient said they had mental health concerns.
This is happening at a time when the UK is dealing with a lot of people being sick and not working. Many people are struggling with health issues.. The system is putting doctors in a difficult position. They have to be a doctor and a judge at the time.
The Difficult Job of Doctors: Helping Patients vs. Making Decisions
Many doctors feel that they should not have to decide whether a patient is sick or not. The investigation found that many doctors think they should just focus on helping patients. One doctor said, “It is hard to be a patients friend and a judge.” When someone has a health issue there is no easy way to prove it. There is no test for stress or anxiety.
Doctors have to trust what the patient says. One doctor asked, “Who am I to say I do not believe that someone is struggling?” Doctors feel like they are in charge of deciding who gets benefits and sick pay. This is not what they wanted to do.
The Rise of Mental Health Fit Notes
The problem is getting bigger. According to NHS data:
- There were 850,000 more fit notes given out last year compared to six years ago.
- Over 956,000 notes said the reason was health issues.
- 72% of fit notes do not say why the person is sick but mental health is the main reason people are not working.
Fit notes are given out by doctors. Nurses, pharmacists and physiotherapists can also give them out. Doctors do most of the work.
Safety. The Easy Way Out
A report found that some doctors give out notes because they are afraid. Some patients get angry. Refuse to leave the doctors office until they get the note they want. One doctor said, “They argue and fight we end up having to give in for our safety.” Other doctors said it is just easier to give out the note of dealing with a lot of paperwork or a long argument.
This is not good for the doctors or the system. Some doctors think that younger people are taking advantage of the system. They think that some people are saying they are sick when they are not.
The Problem with Being Off Work for a Long Time
When people are off work for a time it is hard for them to go back. A government report found that:
- People who are off work for 4-6 weeks have a 96% chance of going to work.
- People who are off work for a year have a 50% chance of going back.
The Royal College of GPs thinks that doctors should handle short-term notes. Other professionals should handle long-term assessments.
Changing the System: What Happens Next?
The government says that the fit note system is not working well. They are looking for ways to help people stay at work or go back to work. Some big companies are already doing things to help their employees. For example Jaguar Land Rover has centers where employees can exercise, get counseling and physiotherapy.
However it is hard for small businesses to do the thing. They are worried that new rules will cost them much money and create too much paperwork.The Human Side
A mental health charity called Mind says that any new system must be kind and understanding. They are worried that if the system is too strict people who are really struggling will be forced back, to work soon. The current system is not. Doctors want it to change. The government is trying to find a way to fix the problem without hurting peoples health.Read More
