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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