Job Coaches Could Soon Be Doctoring Your Medical Records
ON FRIDAY, members of Disabled People Against Cuts (DPAC), Mental Health Resistance Network (MHRN) and Boycott Workfare will be protesting together with medical professionals against the placement of job coaches in seven Islington doctors’ surgeries.
In a move that is potentially both unethical and unsafe, NHS Islington Clinical Commissioning Group (CCG) has accepted funding from the Department for Work and Pensions (DWP) to “drive employment outcomes through strategic health commissioning,” with health professionals tasked to deliver benefit cuts for DWP.
This is supported by Richard Watts, leader of Islington council, who is quoted as saying: “We think there is much more that health services can do to promote the idea of employment for people with health conditions.”
Dr Josephine Sauvage from the CCG said: “Prescribing free and confidential employment coaching could be really beneficial to a patient’s confidence and self-esteem, as well as their long-term recovery.”
But campaigners don’t have a positive view of this pilot. We think merging healthcare and employment services in this way can go badly wrong.
The arrival of job coaches in 7 Islington GP surgeries is part of a raft of measures to support the imposition of “work cures,” including setting “employment” as a clinical outcome and allowing employment coaches to directly update patients’ previously confidential medical records.
The Islington pilot comes at a time when unemployment is being branded as a psychological disorder, for which work is the cure. There are further plans to locate Camden and Islington Psychological Therapies Service (iCOPE) staff in Islington jobcentres, compromising their clinical judgment by embedding them in a coercive “back to work” environment.
Dr Lynne Friedli says: “These ‘work cure’ programmes are not only coercive, they peddle a damaging myth that work benefits everyone and that good-quality jobs are available to all.
“In fact, stark inequalities in the UK labour market mean that for many, jobs are insecure, exploitative and don’t provide either emotional satisfaction or a living wage.”
For many disabled people who do have the capacity to work, gaining a decent-quality, fairly paid, stable job may improve their independence and quality of life. However adopting a stance that the individual is to blame in some way if they do not work ignores the barriers disabled people face both gaining and keeping employment and the attitude of employers towards employing them.
Research carried out last year for DPAC by the Public Institute Research Unit, entitled Workplace Hell for Disabled People, indicates that in the last four years there has been a deterioration in the workplace experiences and long-term job prospects of disabled workers — including increasing levels of unlawful discrimination, problems with zero-hours contracts, fewer legal rights and disintegrating long-term job prospects.
Cuts to government support through Access to Work funding and loss of Disability Living Allowance which enable disabled people to work are further compounding the difficulties faced in gaining employment.
A spokesperson for the campaign Boycott Workfare said: “We’re always receiving complaints from people who are trying to continue with courses that would give them real skills and qualifications, who face pressure from the DWP to abandon them for workfare or farcical ‘training’ from DWP contractors.”
Employment coaches for the pilot are provided by Remploy, now owned by Maximus, the private company contracted to carry out work capability assessments. This process is independently associated with increased suicide, self-reported mental health problems and prescription of antidepressants, and found by a judicial review to “disadvantage people with mental health problems, learning disabilities and autism.” It is difficult to imagine any organisation less suited to working in partnership with primary care or with a worse record in relation to mental health and disabled people.
In a recent parliamentary debate which highlighted the atrocious performance of Maximus, MP Louise Haigh stated: “We have failing contractors acting with impunity while it is the sick and disabled paying the price for the government’s flawed agenda.”
Benefit claimants with mental health issues fear that the scheme could become compulsory and that GPs will “prescribe” job coaching in place of actual treatments. They also fear that those who do not fully comply with the scheme could risk losing their benefits.
A spokesperson from Mental Health Resistance Network said: “Our concern is that this scheme will not be voluntary. Over time it will become mandatory and lead to sanctions and loss of benefits.”
Patients could be deterred from seeking urgently needed medical treatment and trust between patients and their GPs could be undermined. The pilot is due to run until September 2016, after which it likely to be rolled out in other areas, despite there being no plans for a formal evaluation of the pilot.
And these takeover plans do not end with health. The DWP aspires to “join up” all public services (including transport and housing) to “get local people back to work.”
A DPAC spokesperson warns that “many disabled people already feel they have to watch every word they say when seeing their GP, in case it is used against them to stop their benefits. Many will feel that the GP surgery is not a safe space to discuss their health concerns if a GP can prescribe job coaching.”
Medical professionals will be supporting the protest in opposition to a welfare reform agenda that is undermining ethical practice in health.
- The protest will take place at 3pm on Friday outside Islington’s City Road Medical Centre, 190-196 City Road, EC1V 2QH.