Government crackdown on sickness

Physiotherapy Blog has touched on some of the following issues before. An item on the BBC website says that the UK Government wants to crack down on the growing numbers of people on long tern sickness benefit. There are proposals for the NHS to promote return to work in people who are claiming sickness benefit and the suggestion that GPs give "fit notes" to say what people can and can not do when they are going back to work. Physiotherapists are ideally placed to facilitate return to work and could also support any scheme to assess fitness but there are some huge problems which i have touched on before. Probably the biggest problem is that assessment within a hospital or consulting room is not the same as performance in the workplace. It is impossible to determine the specifics of a work activity within the short period of time in a physiotherapy appointment. The other big issue is the subjective perception of the claimant, especially if it is a pain problem. We probably all know the now old saying "pain is what the patient says it is" but that become a barrier to return to work. Now the NHS exists almost like a machine which tries to move atients through as fast a possible it is no longer well placed to address long term issues such as return to work. The idea that all interventions can be provided as short interventions just does not fit with this model. An approach to physiotherapy based on average episode of care in Britain of 6 physiotherapy sessions breaks down when faced with return to work problems. At present no one is really addressing the contradiction of a Health Service which in the last 10 years has placed waiting time above all other priorities yet isunable to sort out the sickness which is costing the country dear.