Seriously ill refusing sick notes as they can’t afford time off work


People who are very sick are refusing to get sick notes from their GP because they can’t afford not to work, according to the new head of Britain’s family doctors.

Doctors say they suffer from ‘moral distress’ as they feel completely helpless to help some of the UK’s most vulnerable people, said Dr Kamila Hawthorne, president of the Royal College of GPs.

She said people were suffering more asthma attacks or other serious breathing problems because they couldn’t afford to heat their homes amid soaring energy prices.

Many have also reported deterioration in their mental health due to the burden of financial stress.

And rising food prices have also led to an increase in a number of health problems such as mouth ulcers, fatigue and muscle weakness as people have to eat poorer diets.

Patients also experience a complex range of physical and psychological problems due to living in substandard housing and poverty or dealing with domestic violence and childhood abuse.

GPs say they suffer psychologically from their inability to act or anything about these desperate situations.

Dr. Hawthorne said The Guardian“Recently, I’ve had patients who refused sick notes because they couldn’t afford not to work. Very often, when it’s clear that someone needs time off, they don’t take it.

“These are people who ideally, medically, should not be at work. [because] they have a chronic condition like asthma or diabetes, but quite often mental health issues, pretty severe mental health issues, I [see] some cases that really need some peace and quiet to try and help them get better.

She said most people refusing sickness certificates were young or middle-aged adults, but she had also seen people with young families and older people do so.

Dr Hawthorne, who works in a medical practice she runs with her colleagues near Pontypridd, Wales, said people also cannot afford transport to appointments at the general practitioner and even for pre-booked hospital treatment.

It comes as the Prime Minister said the coming months will bring challenges and misery at Tuesday’s weekly meeting.

“Ahead of the winter, the Prime Minister said that this will be a difficult time for the country due to the fallout from the global pandemic and the ongoing conflict in Ukraine,” read a statement from Number 10.

Dr Hawthorne said moral distress for GPs stems from a growing sense of hopelessness among some patients.

She said they can help most people who present with issues such as rashes, menstrual difficulties, anxiety and depression.

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

Doctors are also seeing patient health deteriorate due to very long NHS waiting lists, with the number of GPs declining rapidly while the number of patients continues to rise.

Dr Hawthorne added that being a GP was becoming ‘untenable, unachievable, unfeasible’ and many were retiring as quickly as possible.

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