On 09/02/07, Margaret <[log in to unmask]> wrote:
> Yes but a benefit's agency employee's idea of an "examination" might not be
> the same as a GP's. Where does one draw the line?

As a fully paid-up barrack room lawyer, I'm interested in the whether
the meaning of words on one document can be affected by those on a
second document, when the first document does not mention the second.

In this case we have a statement on the Med3 "I have examined the
patient today..." and a respectable body of medical opinion (à la
Bolam) which holds that under the circumstances in question, verbal
questioning over the telephone was a sufficient examination. Then we
have the DWP Guide for Doctors which says that we must only use the
form when we have actually seen the patient.

So consider a doctor (let's call him Paul, for the sake of argument)
who has carried out a sufficient examination without physically seeing
the patient. He signs the Med3. He is not signing an untrue statement
because a sufficient examination was carried out. The DWP is not
affected because the certificate will not be presented to them (the
patient has been off work for less than six months). The employer is
not affected because the statement on the certificate is true. The
patient benefits because (s)he does not have to attend surgery.

There has been a technical breach of Paul's contract with the PCT,
which says that he will adhere to the recommendations of the DWP Guide
for Doctors. The PCT may discipline him if it wishes. But I don't
think the GMC would be interested in a minor violation of contract,
carried out in order to benefit the patient, where no deception
occurred and the interests of none of the parties were harmed.

I rest my case, m'lud.

-- 
Michael Leuty
Nottingham, UK