In perspective - austerity alert

The ‘Deep End’ group of GPs works in the most socio-economically deprived areas of Scotland.

Last October, we published our report on the impact of welfare reform on our most vulnerable patients and the wider community see the Deep End Report

We described how patients with ongoing physical and psychological problems were left struggling with the Employment Support Allowance (ESA) application and appeals processes.

We described the trauma of the impersonal and inflexible Work Capability Assessment.

The report also examined how the ‘bedroom tax’ forces families to pay more for their ‘under-occupied’ homes or even leave their communities in order to find smaller, cheaper accommodation.

If they, or the extended family, have to move away, the children will lose out on baby-sitting, or someone to pick them up from school when their parents are working.

For these vulnerable children this extended family support is essential.

The recent austerity reforms are detrimental to our patients, their children and the wider community.

The reforms mean that 600,000 more children will be living in poverty by 2016 see the Child Poverty Action report.

Given the breadth and scope of physiotherapy, it is likely many of you have come across patients requesting letters of support in one form or other.

An example might be the 60-year-old woman in the orthopaedic clinic with severe osteoarthritis who tells you that she has been assessed as being able to walk 50 metres and is therefore ‘fit for work’.  

It might be the patient with heart failure in the rehab class who has been taken off ESA and is now receiving Job Seekers Allowance with its lower payments and requirement to prove availability for work.

Another example could be the little girl with cerebral palsy who relies just as much on her grandmother next door as she does on her mother, but, because of the new ‘under-occupancy rules’ or ‘bedroom tax’, finds her grandmother being forced to move.

So how does one respond when faced with a request for support from a patient struggling with our new welfare system?  

You could emphasise your obligation to treat the ‘illness’ while refusing to play a part in the broader context.

You could assume that a system has been designed to deal with these problems and that it is not your responsibility to intervene.

Alternatively, a quick note on headed paper, emphasising the nature of the illness and the extent of the resulting disability, will be received well and looked upon favourably by an appeals tribunal.

Recognising the damage that the loss of social capital would inflict, you could provide that letter of support to the mother of the child with cerebral palsy and possibly avert a disaster caused by the ‘bedroom tax’.

You will not be rewarded either financially or professionally by choosing the latter.

You may, however, just sleep a little better at night when thinking of the other 599,999 children.
Raymond Orr is a GP in Glasgow

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