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Return to Our
Comments
4th. May 2004
We understand that there has been concern
over the quality of Medicals and Medical Reports issued by
some doctors employed by Medical Services. These Medical Reports
are used by Benefit Agencies, now absorbed into the local
branch of the Department of Work and Pensions (DWP), to decide whether
ill patients are entitled to disability payments. One must
remember that these patients are some of the most vulnerable in our society.
If the medical reports are inaccurate then, on the written statement of
a doctor, a patient can be barred form receiving the benefits to which
they have a right.
If the patient happens to be an iatrogenic patient having suffered serious damage through the NHS system, which has then been 'covered up', then the problems can become compounded. In 1998 SchlumbergerSEMA UK became involved, under contract from the DWP, to improve Medical Services. SEMA was to be responsible for carrying out medical examinations and medical reports to assist BA decision makers to award entitlement to Benefits it was accepted that the system for handling complaints was not performing as well as it should. We believe that problems still persist. According to one website " Making a mess of Medicals" was still very common. The Work & Pensions Committee, we understand, issued a recent report when the Committee found that ..." there is still a problem with unsatisfactory medicals and with the process itself......the decicison maker had ...misused or misinterpreted evidence. Poor medicals were another factor". We understand that SchlumbergerSema has handed over the organisation of Medical Services to a company called " ATOS ORIGIN", which is now under contract to the D.o.H., and is therefore still paid with tax-payer's money. The following case shows how disgracefully low the standards of some doctors can be. This case we believe is likely to be one of many and it is time action is taken against the "bad apples" that infect the system. CASE STUDY SUBMITTED BY A MEMBER
Background[ Complete with copies of 'Medical Reports'] The patient was diagnosed in March 1993
with a very serious heart condition classified as unstable angina,
The patient was then given *6 months Statutory
Sick Pay,
was retired on health grounds with a *Civilian Infirmity Pension
on 1st. October 1993. A stress ECG was evidence that
her heart could only achieve a very low work load of 3 METS showing
that she had *"severe exercise intolerance" Even at this low level of exercise her
heart beat was grossly abnormal and showed marked ischaemic changes
- all proof of a badly diseased heart. She was *prescribed
numerous cardiac drugs. [ The patient
was not aware - that the items marked with an asterisk were the criteria
needed to give her SDA]
Misdirection or Misinformation given by the local DSS Office On retirement she rang the local DSS Office and inquired as to whether she would be entitled to any State Benefit. The Office informed her that because she had not paid her full NI stamp (she had opted for a married woman's exempt rate) - she was not entitled to anything. She accepted this. Applied for Severe Disablement Allowance (SDA)in Oct. 1998: granted The patient discovered that the Benefit SDA existed and that she was entitled to it. This is a benefit that can be given to anyone who is classified as 80% disabled for work and has not paid full NI stamps, indeed those who have never paid any NI stamps or have never worked could qualify for this award. The patient claimed the Award backdated to October 1st. 1993. SDA Granted - backdated for only 3 months The patient was informed that she would receive SDA backdated to 3 months to 14th July 1998. In a letter stating that an adjudicator had found her to be "at least 80% disabled..." The Benefits Office confirmed in writing that the regulations forbade any further backdating of the the award. No medical was required. A patient is exempt from a medical if the condition is " severe and persistent cardio-respiratory progressive exercise intolerance" October 2002 asked for a Review of decision A friend, familiar with the Benefits system, suggested that the patient should have been given the backdated SDA because the medical evidence submitted all dated from 1993 and advised that she should ask for a Review of the decision. Conflict of interest The patient did this and, four months later, in January 2003 the 'Complex Decision Manager' wrote to say that she had reviewed all the papers and agreed with the Adjudicator who had vetoed any backdating in 1998. The patient later discovered that this 'Complex Decision Manager' was none other than the original Adjudicator - surely a blatant conflict of interest? Referred matter to Benefit Agency Manager: 'Misdirection Ruling' & 'Good Cause' The Benefit Agency Manager was sympathetic and informed the patient that she could apply for the backdating on the grounds of 'Misdirection Ruling' and "Good Cause' . This ruling should have been applied in October 1998. He even agreed with the patient that she had been 'diddled' out of her SDA and invited her to make a claim. Application for copies of File documents under the 1998 Data Protection Act When the patient studied her documents she discovered not only a conflict of interest but serious mismanagement of her claim: virtually nothing of her medical condition was recorded; no mention was made of 6 months SSP; no mention was made of receiving Infirmity Pension; no mention was made of any of her GP's statements. Most importantly, her repeated written assertions that she had been misinformed by the Local Benefit Agency ( she had then moved area) were ignored and therefore the 'misdirection ruling' was not applied although from the evidence it should have been applied. An internal memo admitted that this had been overlooked. June 2003 - submission of two sets of documents One set of documents included a statement with several pages showing evidence of mismanagement. The second set consisted of a 3 page statement and 16 pages of medical evidence dating from 1993 proving conclusively that the patient would have been awarded SDA in 1993 if she had applied for it. Fun and games with the Medical Services & DWP Nottingham? The patient received Three requests for irrelevant and unnecessary medical examination. How can a medical ten years after the date in question determine the state of health of the patient in 1993?
Four General Points relating to both doctors: 1. Neither doctor LISTED the medical evidence as required in part 3 of the Regulation SDA15 Form which clearly specifies: " Other Evidence before the
medical adviser: Please list chronologically any additional evidence
considered, giving type, source and date of each document or X-ray"
NONE of the hospital test results,
consultant letters or GP's statements etc. were listed, surely a breach of professional
practice? Furthermore, since the Medical Adviser's Reporting Form represents
a legal document, and since both doctors failed to comply with instructions,
then this must surely mean the 'Medical Reports'
are null and void i.e. they are INVALID.
The 'opinions' of
the doctors should be based on medical evidence.
2. NEITHER doctor responded to the 14 points raised by the patient. Here are just a few:
3. NEITHER doctor noted that the patient had the STATUTORY requirements for SDA in October 1993:
It states quite clearly in the 'Medical Services' Incapacity Benefit Handbook for Approved Doctors ( April 2000 print) that doctors must provide advice : "in accordance with the relevant legislation' 4. NEITHER doctor gives the correct dates for backdating. Both state it is from 19th March 1993 although the patient was starting her SSP from this date for six months. Is this to exclude the period of Statutory Sick Pay, to give the impression the patient did not have a Qualifying Period? Both reports were disgracefully indequate, or as one health professional put it when shown them: 'They are RUBBISH! ' Dr G's 'report' dated 29th September 2003 must be in a category all of its own.
This apology
for a 'medical report' was signed by Dr. G and unbelievably he
signs himself 'Medical Manager' for Nottingham. This man has
shown utter contempt for the procedures and appears to be dangerously ignorant
of even the most rudimentary knowledge of cardiac disease. and yet he is
in overall charge? What kind of standards must exist at this Office? He appears to have been a very unwise choice, as
he demonstrates such poor professional standards.
On the basis of this scrap paper
'medical report' the patient was called in for two more irrelevant
and, we believe , unlawful medical examinations to establish her medical
condition of 10 years ago!!!
We believe
this patient has been subjected to both medical and bureaucratic abuse!
She must now go to all the trouble to get her Data records corrected!!
The 'Medical Reports' of Drs P & G can be read by clicking here The complaint has gone to
ATOS ORIGIN
ATOS ORIGIN has the power
to reprimand or to dismiss substandard doctors. Surely, there can be no question
that these are seriously substandard doctors?
The patient asked for copies of the doctors' responses to her complaint through the Data Protection Act.
The Whereabouts of Dr G?
Dr G wrote
his response to the patient's complaint from an address in Edinburgh.
It was discovered that Dr G. has, at least since September 2003 to 8th
April 2004, been working part of the week in Edinburgh and part of the
week, 400 miles away in Nottingham, some of this time as ' Medical
Manager'. This does not appear to be a very economic use of a doctor's time.
Furthermore, the cost in travelling expenses and subsistence allowance alone
must be a great drain on the public purse. His official residential address
according to the GMC has been in Edinburgh since 2001. Surely, some other
doctor could have been found to work as Medical Manager in Nottingham? ATOS
ORIGIN claim there is no shortage of doctors. We now understand that he
has moved permanently up to Scotland. Should we pity the patients in Edinburgh?
What is the patient asking for? 1 An apology from ATOS ORIGIN 2. The dudd 'Medical Reports' removed from her File because they are misleading and untrue and put her at risk and are doing her harm. 3. The acknowledgement that she had the statutory requirements for SDA on 1st. Ocotober 1993 and would have received it if had she known of its existence and applied for it. 4. The dimissal of the Drs P & G Would anyone disagree with these requests? The patient is concerned that:
1. We think that most people will be appalled to read the low standards of these doctors. The patient had requested that they be dismissed after she had read their contemptuous responses to the complaints made against them by ATOS ORIGIN and the patient. 2. Surely doctors who refuse to list the medical evidence and and produce invalid reports putting patients at risk should be sacked? 3. Doctors who do not know the statutory regulations should surely have their contracts terminated? 4. Doctors who do not appear to have the least understanding of basic cardiac ECG tests, and pay no attention to consultants' letters should not be working for ATOS ORIGIN? 5. According the 'Handbook for Disability Doctors' - no opinion should be given without it being based on medical fact - these doctors made no mention of the medical evidence. 6. Will ATOS ORIGIN take sanctions against these doctors and exercise QUALITY CONTROL. Vulnerable ill patients should surely get protection from rogue doctors. ATOS ORIGIN have confirmed that these doctors are still working and there is no intention to sack them!!! 7. What confidence can we have now in the standards of the Medical Services doctors? 8. Anyone who has had unsatisfactory reports should get in touch immediately with ATOS ORIGIN or SIN. The patient has asked that all other so called 'Medical Reports' written by Drs P & G should be investigated. She has also asked for 'Complaint Histories' of the two doctors, on the grounds that such information has a bearing and is important in relation to her complaint. This information has been refused. Recommendations: Every piece of medical evidence submitted by a patient or health professional to support a claim for Benefits should be stamped by Medical Services when received, and each Medical Service doctor who reads a piece of medical evidence should be obliged to stamp the paper with his/her name + GMC number with a signature and date to show it has been read. At the moment it is astounding to note that only the OUTSIDE of the patient's File is stamped when it goes to Medical Services, at least in Nottingham. Are the Managers of Medical
Services & DWP Benefits Office Nottingham Managing?
Doctor G wrote his 'Medical Report' dated 29th September 2003 on scrap paper and addressed it to 'Jane' who is a Manager at the Medical Services, Nottingham. On the basis of this disgracefully unprofessional and indeed, in our opinion, unlawful 'report', the Manager orders the patent to attend ( twice) for an irrelevant and indeed unnecessary medical. Why did she not return the report to Dr G and insist that he write one on the statutory regulation paper? She was fully aware of the 19 pages that the patient had submitted, for they were in her File. She was also aware that the doctor had not complied with the law because he had not listed any medical evidence. What on earth did this Manager think she was doing? It states quite clearly in the previously mentioned ' Medical Services Handbook that : " The Decision Maker has a legal duty to ensure that their decisions are based on facts which are clearly established by evidence " page 9. We believe that this 'Manager' and others were in breach of their legal duty Dr P's report was also sub-standard and, indeed, in our opinion unlawful, as was Dr G's second report, too. But these were also accepted by managers at Medical Service and DWP Nottingham. These managers should surely be exercising QUALITY CONTROL. They must also have been aware that the patient has the Statutory requirements for SDA. A Deputy Higher Executive Office, from the DWP Blackpool Office ( this Office deals with Disablement Living Allowances ( DLA) confirmed that they, the managers, must accept any statement that a doctor from Medical Service makes, even though it is nonsense. She gave permission to be quoted. What on earth is the public paying vast sums of money for if management absolves itself from all responsibility? This also means that such doctors must believe they are unaccountable. Furthermore, the managers at the various DWP Offices around the country are all aware of the statutory requirements for SDA. What were the managers, of Nottingham DWP doing ignoring these statutes? The patient should not be expected to know the intricacies of the Benefit Law. Here are some of the QUOTES from a Handbook on PROFESSIONAL STANDARDS OF MEDICAL SERVICE DOCTORS page 71
Judge for yourselves. Click on to see the so called' Medical
Reports' of Drs. P & G
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