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The Friday Surgery

The new Department of Work and Health?

In light of the recent consultation on the future of Jobcentre plus, and the decision to trial job coaches in GP surgeries, this week The Friday Surgery thinks through the implications of such a move.

Dear Messrs Cameron, Hunt and Crabb,

I hope you don't mind me writing to you after reading about the recent consultation on the future of Jobcentre plus. This comes fast on the heels of the recent move to pilot psychotherapists in job centres and Remploy job coaches in GP surgeries. I read that six GP surgeries in Islington will embed DWP-funded Remploy job coaches in its practice. The pilot scheme allows GPs to refer patients who are unemployed and have long-term health problems to job coaches based within the surgery who will have the power to write entries in patients’ medical records. Doctors will also be encouraged to raise the subject of employment with their patients, recommend the benefits of being in work and even refer them to employment services.

This development confirms my intuition that for far too long the potential of doctors have been wasted on saving people's lives and helping people live without pain when all the time they were in a perfect position to really contribute to society by pushing vulnerable people into low paid and insecure work that they are probably not ready for.

I remember once getting hit by a car and, believe it or not, the paramedics seemed more interested in my displaced tibia than they were in helping me to develop a career vision statement. I was so angry that I actually made a complaint. Similarly last year when I rushed my son to A&E due to his severe asthma attack the consultant actually had the temerity to focus on stabilising his breathing rather than helping me to think through how to dress for success. They didn't once mention sharpening my interview technique either. With these wasted opportunities in mind I thought I'd help you think through some natural extensions of your philosophy.

Maternity suites- unemployed people have babies too and the time between contractions strikes me as the perfect chance to support people back into work and regain control of their lives. It's great that people have babies during birth but surely this time would be better spent sending off CVs? Many labours can last 24-36 hours or more. Imagine what a key role midwives could play in pushing people toward the labour market. Once the babies have popped out they too could be given some CV support. Granted there wouldn't be much to put on it other than 'was born' but you can never be pushed towards work too early.

Chemotherapy - chemotherapy often requires prolonged stays in hospitals and so represents the perfect opportunity for the cancerous unemployed to start to take responsibility and become strivers rather than just sitting around with tubes in their arms. The Remploy oncology coach could become a key force in getting these people off their backsides and into a McJob.

Dialysis- this strikes me as another obvious opportunity for Remploy. Don't get me wrong, it's great that we have technology for removing waste and excess water from the blood as an artificial replacement for lost kidney function, but is that really more valuable than a generic course in highlighting your personal brand?

A&E- accident emergency is of course a high pressure medical environment where doctors have to make life or death decisions on a daily basis. Such an arena has been crying out for Remploy motivational job coaches to find unemployed people in A&E and badger them into work. How many times have people died in A&E because there wasn't a job coach there to threaten them with sanctions during CPR? This madness simply has to stop.

And these ideas may also be applied to other public services such as the fire service. A good job coach won't just tell you how to do something; they will explain why you have to do it. Surely there can be few better places to do this than when rescuing an unemployed person from a burning building?

To conclude, we have to weigh the benefits against the gains. Yes, the idea of locating job coaches in job centres distorts beyond recognition the Hippocratic oath. Yes, we know that it will put vulnerable people off getting the care they need and perverts the ethical purpose of healthcare. And yes, we know that there is a huge academic literature showing that those in the powerless position of trying to make sure they keep the benefits that provide basic food and life resources will feel compelled to go along with anything suggested, even if they are explicitly told they have the right to say no.

But are these really more important than being able to highlight transferrable skills on your CV?

Best wishes

Carl Walker

The National Health Action Party are cosignatories of a recent consultation response document that argues against the co-location of NHS services in JWP and the presence of JCP in GP surgeries.

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