Thanks Russell-very valid point and can you define what you mean by risk?
Because that is what I am trying to assess
----- Original Message -----
Sent: Monday, November 12, 2007 9:37
AM
Subject: Re: An interesting point
Don't get involved unless you want to, ensure you charge what
you consider to be a reasonable fee for the level of work and level of risk
involved.
Personally, I tend to include advice to seek an assessment by
an Occupational Health service after making it clear that I am the patient's
GP and have no Occ. health experience or qualifications. IANAL, not sure
if that would be deemed sufficient by our learner friends if it cam down to
it...
Russell
On Nov 10, 2007 11:18 AM, Adrian Midgley <
[log in to unmask]> wrote:
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Dr Harry Brown wrote:
> Often I am written to by
people's employers, asking for medical
> details, specifically asking
opinions on fitness to work-often a
> job description is provided. I
now adopt the view that I either
> don't get involved and reply to
that effect or provide medical
> facts (assuming consent is provided
of course). I understand (is
> this correct) that GPs should not get
involved in providing such
> Occupational Health work (apart from sick
notes which is a
> statutory duty) and really should state employers
should obtain
> occupational health advice.
There is no
prohibition.
It is neither part of GMS, nor funded by the NHS, nor does
the NHS
_intend_ to fund it and therefore one might expect the secretary
of
state and other commentators to object to GPs using their NHS "pay" to
perform such extra jobs.
(Actually, one finds
the SoS regarding occ health and insurance
medical income as being
something the NHS has paid GPs for performing
their NHS contracted
activities, and quite likely if we diversify
more, so as to have 50% of
our income from other and arguably more
honest contracts and contractors,
the SOS will tell the Daily Mail
that we have now doubled our pay for the
NHS. But I digress)
No doctor should take on work which
they are not capable of doing
adequately well, or if there are
limitations on our opinions, we
should ensure anyone buying them is aware
of those limitations.
However many GPs have always done occupational
health work for local
employers, and these arrangements are sensible and
appreciated by all
three sides.
> I remember the BMA saying that we should not
do Hep B vaccinations
> for high risk groups on behalf of employers
and it should be an
> occupational health issue and employer's
responsibility not the
> GPs.
I don't think the BMA has said
one should not do it.
I am completely sure that the BMA's view is that
whoever does Hep B
immunisations for occupational reasons, allowing the
employer to
discharge their responsibility satisfactorily by providing
them,
should charge and be paid for them, since it remains the
NHS/DoH's
view that this is not part of GMS, is not funded under the NHS,
and is
part of a cost of business to employers who send their workers
into
such hazards.
And I don't disagree with that.
We do
immunisations for various employers, on regular and ad hoc
bases, enjoy
it and are happy to continue doing so. The profit is
modest and
welcome.
One might employ an occupational health nurse if there was
a lot of
it, or even an occupational health physician, and depending on
the pay
and conditions they might be very happy about that... One
might even
make a partnership arrangement.
-
--
Midgley
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