Sicknotes stay a matter of trust

THE sicknote system will continue to rely on patients' honesty. A better signing-off scheme has yet to be found.

The system of doctors having to write notes for patients taking time off work was branded a 'sham' after some UK doctors admitted giving the certificates on demand.

They signed off patients who were well enough to return to work, suggesting that the notes could not always be believed.

But British Medical Association local branch vice-president Dr Brian Parkin said that taking advantage of the system was not a problem here.

'I don't think abuse of the system is great, although I'm sure it exists as with anything.'

He said that it depended on people's honesty.

'The doctor has to rely on the patient's account of their symptoms rather than specific objectives.

'If the patient says they feel dreadful, the doctor will believe them, unless there is clear evidence to the contrary.'

He said that it was not as straightforward as it might seem and that people had different thresholds of discomfort.

Employers in Guernsey normally required a certificate after three days.

But in the UK workers who become ill can self-certify for up to seven days.

Some 70 GPs in Scotland were interviewed by university researchers whose findings were reported in the British Medical Journal.

The doctors said that they had neither the time nor the desire to challenge patients.

Many were disillusioned with the system and wanted it changed.

Dr Parkin said that doctors were not keen on their certification role, although it had not been discussed recently.

'I don't think we have a good alternative to it available. Generally sick notes are only issued when people are genuinely unwell.'

Minor illnesses such as viral infections were most common at this time of year, he said.

Doctors preferred to concentrate on their primary job of helping people to get well rather than writing sicknotes, he said.

'If someone came up with a good alternative I think they would be pleased about it.'

The researchers said that the Government should consider an alternative system, possibly including self-certification with spot checks, similar to tax self-assessment.