Friday, March 28, 2008

working for a healthier tomorow

When I wrote Physiotherapy Blog on 17 March referring to the issuing of "fitness notes" by GPs I did not realise that on the same day a report was being published. Working for a Healthier Tomorrow , published 17 March, reviews occupational health within the UK. The principles it tries to address are correct but as with much political discussion about health it fails in the details because of a fundamental limitation in the understanding of the complexities of healthcare and the contradictory priorities which exist. Unless there is a willingness to intiate reform which crosses over multiple government depertments then there is the risk that this report will initiate a knee-jerk reaction in the formulation of new policies which fail to address the issue of long term sickness and return to work. In particular there needs to be a coordinated approach between the health and social security systems in the same way that the report states the need for cooperation between the different agencies in the healthcare system. If my reading of the executive summary is correct then its proposals seem to excessively focus on the "micro management" of long term sickness and return to work without sufficiently looking at the ways that government agencies also are failing to address the problem. A regular annoyance for me is having to fill out Work and Pensions agencies forms for patients. I am annoyed on two counts. Firstly (and the minor complaint) is that I am not allocated time within my workload to do these forms so the whole system is inefficient because they have to wait for theit turn within my order of priorities, so if there is a conflict between doing an urgent letter to a doctor reporting a patient's progress or one of these Work and Pensions agency forms then the former will always get m time. However my biggest dislike of these forms comes from the fact they ask the wrong questions both in terms of what I can answer about the claimant and in terms of trying to address disability. It is without a doubt that physiotherapists have a huge potential role in helping return to work but their input will be limited unless there is a shift within the national culture regarding long term sickness and claiming benefit. In this there needs to be a central govenment lead not only in terms of telling health agencies that they have to work better together but also in putting their own house in order.

To see the report go to:

http://www.workingforhealth.gov.uk/documents/working-for-a-healthier-tomorrow-tagged.pdf

No comments: