As the NHS descends into chaos, a US healthcare insurance firm is quietly being installed to take over key front line services from GPs including providing certification to bosses for staff absences due to sicknesss. In addition employers are to be given tax breaks to fund medical treatment for staff when it has been recommended by these private sector healthcare professionals.
The new ‘Fit for Work’ service is to be run by Maximus in England and Wales, the same company brought in to replace Atos to carry out the despised assessments for out of work sickness and disability benefits. In a major embarrassment for DWP Ministers, Fit To Work was expected to launch late last year but so far all Maximus have managed is a website and a phoneline.
When the service is finally implemented employers will be able to refer staff to Fit for Work if they have been absent due to sickness for four weeks. GPs will have additional powers to make a referral from the first day of sickness provided the period of absence is expected to last over four weeks. The patient cannot refer themselves, although they can, at present, refuse to be referred. What employers will make of that refusal is anybody’s guess.
Once an employee starts on Fit for Work they will be handed over to Health Management Limited, a subsidiary of the private US healthcare firm Maximus. This will mean their GP will no longer have a responsibility for issuing Fit Notes and a Maximus ‘Health Professional’ – not a doctor – will certificate their sickness and liaise with their employer. The DWP are encouraging Maximus and employers to share sensitive healthcare information on patients, however the employee can refuse consent for this to happen.
Maximus will develop a Return To Work plan, based on what in most cases will be a short telephone assessment with the patient. Ominously this plan will be based on a ‘biopsychosocial’ approach – the same quackery that has caused such heart-breaking chaos in the assessment system for sickness benefits and suggests that someone’s attitude or psychological state may be the driving factor of their illness.
Not only will Maximus now be responsible for certificating sickness, but they will also be able to recommend treatment to try and force the patient back to work as quickly as possible. Of course because this treatment will not have been proscribed by an NHS doctor then that will mean referral to a private sector healthcare company, such as, well, Maximus. To smooth the road, the government have decided to offer a tax break of up to £500 for employers who agree to pay for this treatment. This really is privatisation of front line health services by the back door.
Throughout all the guidance notes for Fit For Work it is emphasised that the employee’s consent must be sought at every stage of the process. If the employee refuses to provide that consent then all the government are prepared to say is that they will not then be referred to Fit For Work. Whether this refusal is used by employers to attempt to initiate disciplinery action is yet to be seen. Whether this is successful is likely to end up being a matter for employment tribunals and trade unions reps should be getting clued up on this new scheme now.
All the currently published guidance is available at: https://www.gov.uk/government/collections/fit-for-work-guidance
In Scotland the scheme will be run by the Scottish Government and with more details on the Fit for Work Scotland website.
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