Seriously ill refusing sick notes because they can’t afford time off work, heath chief says

Very ill people are refusing to get sick notes from their GPs because they cannot afford to skip work, according to the new leader of Britain’s family doctors.

Doctors say they are suffering “moral distress” as they feel completely powerless to help some of the UK’s most vulnerable people, Dr Kamila Hawthorne, chair of the Royal College of GPs said.

She said people were suffering from more asthma attacks or other severe breathing problems as they can’t afford to heat their homes amid soaring energy prices.

Many have also reported deteriorating mental health because of the burden of financial stress.

And rising food costs have also led to an increase in a number of health issues such as mouth ulcers, fatigue and weak muscles as people are having to eat a poorer diet.

Patients are also experiencing a complex range of physical and psychological problems as a result of living in poor housing and poverty or facing domestic violence and childhood abuse.

GPs say they’re suffering psychologically from their inability to take action or anything about these desperate situations.

Dr Hawthorne told The Guardian: “Recently I’ve had patients refusing sicknotes because they can’t afford not to work. Quite often, when it’s clear that somebody needs some time off, they won’t take it.

“These are people who ideally, medically, should not be at work [because] they have a chronic condition such as asthma or diabetes, but quite often mental health problems, quite severe mental health problems, I [see] some cases that really do require a bit of sicknote peace and quiet to try and help them get better.”

She said most people refusing sick notes were young to middle-aged adults, but she had also seen people with young families and older people do it.

Dr Hawthorne, who works at a GP surgery she runs with her colleagues near Pontypridd, Wales, said people have also been unable to afford transport to get them to GP appointments and even to pre-booked hospital treatment.

It comes as the prime minister said the months ahead will bring challenges and misery during the weekly meeting on Tuesday.

“Looking ahead to winter, the prime minister said this would be a challenging period for the country caused by the aftershocks of the global pandemic and the ongoing conflict in Ukraine,” a statement from No. 10 read.

Dr Hawthorne said that GPs’ moral distress comes from an increasing sense of hopelessness with certain patients.

She said they can help most people who come in with problems such as skin rashes, period difficulties and anxiety and depression.

But she added that more people were coming to GPs with “intractable social and psychological problems that are very difficult to solve”.

Doctors are also watching patients’ health worsen because of very long NHS waiting lists as the number of GPs is rapidly declining while the number of patients continues to increase.

Dr Hawthorne added that being a GP was becoming “untenable, unworkable, undoable” and many are retiring as quickly as possible.