Doctors urged to refuse medical certificates for time off work

Photo / Greg Bowker

Doctors are prescribing work as a key part of recovery plans for most ill or disabled New Zealanders.

The Royal Australasian College of Physicians, in a position statement issued in Auckland yesterday, urged doctors to stop giving patients medical certificates for conditions where time off work is "discretionary".

Social Development Minister Paula Bennett hailed the statement as backing her push for welfare reform.

"We must raise aspirations for New Zealanders, particularly those on benefits or who are unwell or injured but are capable of working," she said.

But Auckland disability advocate Helen Capel said the doctors' statement would only increase stress on sick and disabled people.

"People will use this lecture and say it's the best thing for you, take anything [any job], so it puts more pressure on to people," she said.

The statement comes as a select committee considers submissions on a bill requiring sole parents to seek work when their youngest child turns 6. Sickness beneficiaries who can work part-time would have to seek part-time work or have their benefit reduced.

The statement accepts that people need time off work for some conditions, such as crushing injuries, debilitating pain and recovery from surgery.

"However, with many medical conditions there is a substantial discretionary element to work absence," it says.

"By 'discretionary element' we mean that, while the person has a health condition, they are able to attend work if the right accommodations are made."

It says many general practitioners "do not believe they have responsibility for the management of long-term work absence, work disability and unemployment, despite these being a major determinant of health, equivalent to that of smoking and obesity".

"Although GPs, medical specialists and other allied health professionals may feel that they are advocating on behalf of their patients by issuing discretionary certificates, in fact long-term disability may be the end result," the statement says.

It says "a paradigm shift" is required to recognise the health benefits of work, including physical activity, financial security, giving structure to the day and helping people to feel that they contribute to and are part of society.

"In the majority of instances, the model of getting better first and then returning to work is demonstrably unsuccessful and unhealthy," the statement says.

Ms Capel, who has cerebral palsy and has been on an invalid's benefit for 30 years, agreed that keeping physically active and mentally stimulated was good for you.

But she said there were not enough well-paid jobs available to give sick and disabled people decent living standards.