Disabled people and benefit claimants are to protest in London against a scheme to embed job coaches with family doctors, which they say will contaminate healthcare with the punitive culture of the government’s work programme.
Critics warn that the scheme jeopardises doctor-patient confidentiality, risks alienating patients from their doctors and perverts the primary role and ethical mission of the healthcare system, which is to help people to recover from illnesses.
Paula Peters, an activist with Disabled People Against Cuts (DPAC), said: “There is a blurring of the lines between healthcare and the [Department for Work and Pensions] and it’s wrong. We are already having to watch everything we say to doctors, we treat every appointment as a work capability assessment in case it’s used against us.
“We need that money to live. We became unwell through no fault of our own. We need the healthcare support.”
Activists will march on an Islington GP surgery on Friday, one of six that is part of the pilot scheme that officials see as “an opportunity to embed employment into the ‘wiring’ of the healthcare system” by making it part of the clinical outcomes doctors seek for patients.
Funded in part by the local clinical commissioning group (CCG), but with the bulk of the money coming from the DWP, Islington’s Working Better scheme is as yet the only one of its kind in the country.
It offers patients at the six participating practices who are unemployed and have a long-term health condition access to one-to-one employment support with Remploy job coaches.
According to council documents, the coaches are based in surgeries for up to one day a week “to work with patients to establish their previous work experience, knowledge and skills, to build confidence, set goals and identify job or educational opportunities”.
One aim is for these advisers to have the power to write directly into patients’ medical records, a suggestion that has alarmed campaigners. Doctors will also be encouraged to raise the subject of employment with their patients, recommend the benefits of being in work and even refer them to employment services.
The rationale for the scheme is that there is a large body of evidence linking employment with good health. While it is currently voluntary, critics fear that it is part of a strategy by work and pensions secretary Iain Duncan Smith to bring jobcentres, and their culture of welfare sanctions, into the heart of the NHS.
Islington’s pilot is focused on patients who suffer from mental health problems, since mental ill-health is the major reason for people claiming employment and support allowance.
However, critics have accused the scheme of picking on the most vulnerable patients. Peters said: “You put a mental health patient who is distressed, who is not well, and pile the pressure on them, they are going to relapse. They might harm themselves.
“We have lost so many disabled people already to these schemes, how many more are we going to lose before doctors say ‘I didn’t become a doctor to get involved in schemes like this’?”
Robert Stearn, a PhD candidate at Birkbeck who is supporting the campaign, added: “It’s part of a move to put jobcentres and jobcentre staff into different areas of civil society. The jobcentre already goes into schools, it already goes into libraries.
“The justification for this is they want the jobcentre to reach as many people as possible, but the flipside to this is it makes all these places inaccessible, it makes them areas of pressure and coercion.”
The Guardian contacted Islington CCG for comment, but had not received any reply by the time of writing.
