Quote from policywonk:
"I also see the point about independent assessors having more time to be up to date with the legal aspects. But will they be properly medically trained? Will they be fully up to date with the clinical aspects?"
I can respond to this point, Policywonk, because I spoke to DH about this last night and he told me he bumped into one of the assessors themselves at a primary care conference some months ago.
The assessor has been a GP for 12 years. He works 2 days doing assessments (not for a private company, for the department of health) and three/four days a week at his usual surgery so he's up to date on clinical work. I think it's imperative to have good, impartial, experienced generalist doctors involved who are set no targets at all - this chap certainly wasn't working to targets (in my opinion nurse practitioners simply wouldn't have had the years of diagnostic training you need to do this system justice).
He is a very sympathetic chap and tries to take account of the fact that this is the first time he has met each patient. The good thing is, the GP can still have acted as an advocate for the patient before turning up, so most patients with a strong claim have been well prepared and assisted by their existing doctors and simply sail through the process.
The assessor says that one of the things that he likes about the process is that he feels like he is often helping people who WANT to get back into work, get back into work by giving them the confidence in their own capabilities to apply for different kinds of jobs. He also says he feels like he is helping people who need benefits receive them with the minimum of extra fuss - they get an expert assessment they can trust and use, if necessary, in court. In short, the money ends up going where it is most needed. I struggle to see how this system is 'unfair' if simply applied knowledgably and impartially to individuals.
One thing the assessor mentioned to DH was that he often looks out of his first floor window to watch individuals approach and leave the building in which the assessments have taken place. He has, on a couple of occasions, noted limps appear and disappear using this method. He also recalls one young woman who had seemed to him desparately depressed and unable even to form sentences through her tears suddenly whip out a mobile phone upon leaving, shout (loudly enough for it to come through the window), "I got him good - sucka!!" and laugh uproariously for a good two minutes. These individuals ARE the minority but their cases do highlight the fact that fraud within this system should - for moral reasons - cease. It simply is not fair to let it continue. And frankly I don't care whether this saves us money or not - what I care about is money reaching those who truly need it.
Just to finish this incredibly long post with an anecdote that highlights why the current system needs changing. DH met with a young woman keen to discuss her IB claim. She had just turned 18. She walked in, and without saying a word plonked the form on his desk. DH began to try to get her to discuss her symptoms (she had not been near a doctor, or a hospital, during the last two and a half years so he was not immediately sure what she had come to discuss) but she cut him off, explaining that she had a hairdressers appointment. He asked, even more confused, what she felt was preventing her from being able to engage in work. She explained, rolling her eyes, that there were no jobs, "and I'm depressed, you know?". DH tried to explore these feelings in more detail, tried to administer the Beck depression scale and tried to suggest a range of solutions such as an urgent referral to a counsellor or a CPN. The woman became increasingly impatient, refused to complete the scale - even verbally - because of aforementioned hair appointment and refused DH's offer of an urgent double appointment later in the day to talk about this when she had more time. At the end of the consultation, she asked him if he was going to sign the form or not. DH said no, not now, not without having had more of a chance to talk to you. The woman immediately left, submitted a formal complaint and returned the next day - to see a different doctor - with three of her older brothers in tow. Again, the form was refused and another complaint issued. The week after, the woman successfully had her form signed by a locum.
As for why doctors surgeries do not complain about harrassment etc. very often, there are several reasons. Notably, the PCT rarely supports them in such claims unless someone has actually ended up in hospital. They feel it generates negative publicity and is against the 'customer service' ethos towards which today's NHS is striving. In addition, most GPs do not like assuming an adverserial attitude towards their patients, and would rather conduct informal mediation / try to move the patient to a different practice before involving the police. Lastly, a GP who has been alone with a threatening patient often faces a serious counterclaim from said patient if he/she dares complain - and whilst the PCT is not obligated to care about patients threatening doctors (there is a real 'it's all part of the job' attitude) it is obligated to care about doctors allegedly threatening / doing anything else to patients.
Phew. If anyone read all that, well done. I was just delighted that DH had actually met one of these fabled assessors in the flesh and was able to share his experiences. I hope that any future assessment system employs people with as much genuine empathy and clinical knowledge but as much backbone as this guy seems to possess.