Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

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Last year I wrote a critical article about the government’s new Work and Health Programme, I flagged up concerns regarding government plans to enlist GPs in prescribing work coaches for people who are sick and disabled, and in providing advice on job-seeking. The private and confidential patient-doctor relationship ought to be about addressing medical health problems, and supporting people who are ill, not about creating yet another space for an overextension of the coercive arm of the state to “help people into work”, regardless of whether or not they are actually well enough to cope with working.

I also posted my article on the Pulse site for medical professionals last October, raising some of my concerns. I proposed that the government may use the “intervention” as a further opportunity for sanctioning sick and disabled people for “non-compliance”, and I expressed concern that this would conflict with the ethics and role of a doctor. I also stated my concern about the potential this pilot has for damaging the trust between doctors and their patients. I do support the idea of social prescribing in theory, but this scheme is certainly not that. This is plain state harrassment and coercion.

It’s interesting to see that amongst all those listed present at the various pilot-related meetings behind closed doors regarding the government’s new Work and Health programme, there isn’t a single sick and disabled person or relevant representative charity to be found. That’s telling, because it means that the provision is not founded on consultation, is not designed to be inclusive from the start, nor does it have a democratic or representative foundation. It’s another case of government policy that acts upon groups people, prescriptively, as if they were objects, rather than human subjects with identifiable needs and the capacity for democratic dialogue.

I discovered last October, almost by chance, that the Nudge Unit team have been working with the Department for Work and Pensions and the Department of Health to trial social experiments aimed at finding ways of: “preventing people from falling out of the jobs market and going onto Employment and Support Allowance (ESA).”

“These include GPs prescribing a work coach, and a health and work passport to collate employment and health information. These emerged from research with people on ESA, and are now being tested with local teams of Jobcentres, GPs and employers.”  Source: Matthew Hancock’s conference speech: The Future of Public Services.

Now GPs have raised their own concerns about sharing patient data with the Department for Work and Pensions – and quite properly so. Pulse reports that the Department for Work and Pensions (DWP) plans to extract information from GP records, including the number of Med3s or so-called “fit notes” issued by each practice and the number of patients recorded as “unfit” or “maybe fit” for work, in an intrusive move described by GP leaders as amounting to “state snooping.”

Part of the reason for this renewed government attack on sick and disabled people is that the Government’s flagship fit note scheme, which replaced sick notes five years ago in the hope it would see GPs sending thousands more employees back to work to reduce sickness-related absence, despite GPs having expressed doubts since before its launch, has predicably failed.

The key reason for the failure is that employers did not take responsibility for working with employees and GPs seriously, and more than half (59%) of employers said they felt unable to support employees by making all of the legally required workplace adjustments for those who had fit notes signed as “may be fit for work.” Rather than address this issue with employers, the government has decided instead to simply coerce patients back into work without essential support.

Another reason for the failure of this scheme is that most people who need time off from work are ill and genuinely cannot return to work until they have recovered. Regardless of the government’s concern for the business and state costs of sick leave, people cannot be simply ushered out of illness and into work by the state to “contribute to the economy.” When a GP says a person is “unfit for work”, they generally ARE unfit for work, regardless of whether the government likes that or not.

The government plans to merge health and employment services, and are now attempting to redefine work as a clinical outcome. Unemployment has been stigmatised and politically redefined as a psychological disorder, the government claims somewhat incoherently that the “cure” for unemployment due to illness and disability, and sickness absence from work, is work.

This is the kind of mentality that the new Work and Health programme is founded on: Dr Josephine Sauvage, the joint vice chair of NHS Islington CCG and a GP at City Road Medical Practice, where the programme is being trialed currently, said the programme can help patients.

She said: “When we become ill we often stop doing those things that get us out and about and bring fulfilment to our lives.”

Yes, that’s what being chronically ill means: we often become incapacitated and sometimes we can’t do all of the things we did before. But since when is working the only source of fulfilment? And how does forcing people who are ILL to look for ANY job, regardless of pay, security, terms and conditions and appropriateness lead to “fulfilment”? A patient is defined as:

  • A person who requires medical care.
  • A person receiving medical care or medical treatment.
  • A person under a physician’s care for a particular disease or condition.

There is no mention of a person’s employment status or the pressing need for a job prescription in that definition.

As part of the Work and Health programme, beginning next month, the DWP plans to access people’s medical information. Employment coaches will be able to directly “update” a patient’s medical record.

GPs will have to inform patients of the access to information and any extraction of confidential information from their medical files, but cannot withhold information unless their patient explicitly objects.

, a senior journalist at Pulse, says: GPs, as data controllers, will be required to tell patients in person, via notices in the practice and on the practice website of the impending extraction.”

Patients have the right to object to the use and disclosure of confidential information that isn’t used for their medical care.

Patients can explicitly refuse their consent to data sharing. The Data Protection Act 1998 covers personal information including health records. Further provision under Article 8 of the Human Rights Act 1998 establishes a right to respect for private and family life. This underscores the duty to protect the privacy of individuals and preserve the confidentiality of their health records.

There is also additional guidance from the British Medical Association (BMA) here – GPs as Data controllers guidance. (PDF)

You can:

Write your own letter to the GP health centre. Here is a basic letter template in 3 formats that you can download and use:

Opt out letter (PDF)

Opt out letter (MS Word)

Opt out letter (Rich Text)

Make sure you state clearly that don’t wish for any of your data and medical information, including details of your fit notes, to be shared with the DWP and any other third party. You can also:

In addition to sharing information with the DWP, due to changes in legislation, your GP can now be required to upload personal and identifiable information from the medical record of every patient in England to central servers at the Health and Social Care Information Centre (HSCIC).

Once this information leaves your GP practice, your doctor will no longer be in control of what data is passed on or to whom. This information will include diagnoses, investigations, treatments and referrals as well as other things you may have shared with your doctor including your weight, alcohol consumption, smoking and family history. Each piece of information will be identifiable as it will be uploaded with your NHS number, date of birth, post code, gender and ethnicity. NHS England – the body now in charge of commissioning primary care services across England – will manage and use the information extracted by HSCIC for a range of purposes, none of which are to do with your direct medical care.

Whenever I am ill, I don’t ever consider consulting Iain Duncan Smith or the government more generally for advice. There are very good reasons for this. I don’t want to be confronted with pseudoscientific Conservative anti-welfare dogma, I prefer instead to seek the expert, trusted medical opinion of a qualified doctor. I expect professional medical care, not brute state coercion and a punishment regime that is particularly reminiscent of the 1834 Poor Law amendment Act.

And despite assurances from those professionals currently trialing the Work and Health programme that all participation is (currently) voluntary, against the current backdrop of ever-increasing welfare conditionality, the political stigmatisation of people not in work, the frequent punitive deployment of benefit sanctions, the mandatory  welfare-to-work schemes, it’s difficult to imagine a Conservative scheme that will not entail exercising Conservative prejudice and pseudoscientific justifications of Tory economic Darwinist ideology.

It’s hardly the case that the state has an even remotely credible track record of assessing people’s medical conditions, nor is it the case that this government bothers itself with empirical evidence, or deigns to listen to concerns raised by citizens, academics, professionals and charities regarding the harm that their policies are causing. This is a government that can’t even manage to observe basic human rights, let alone care about citizen’s best interests, health and wellbeing.

It’s not possible to make people who are ill better by punishing them, in just the same way as state coercion and using prejudiced language doesn’t “cure” poverty.  I don’t need more quack medicine on top of the current heavy doses of Conservative big state psychopolitics, traditional prejudices and subsequent quacking, slapstick psychobabble. It’s bad enough that Jeremy Hunt thinks he’s the all singing homeopathic Minister for magic and that Iain Duncan Smith thinks he can miraculously cure sick and disabled people by simply forcing them to work. The side-effects of five years of the Conservative’s ontologically insecure rhetoric, that’s been largely ranting, repetitive, incoherent monologue, are nauseating enough. Nobody should need to say any of this in 2016, but tragically, we seem to have a government that hasn’t yet escaped the feudal era. Or playing with their alchemy sets.

I’m in full agreement with Boycott Workfare, the Mental Health Resistance Network, and Disabled People Against the Cuts. I shared my original article with two of those groups and I’m pleased that they have since organised a protest for March 4, 3pm at the City Road Surgery, 190-196 City Road, London EC1V 2QH to raise public awareness of the issues and implications outlined. I just wish I was currently well enough to get to the protest.

They say: GP surgeries are for medical treatment, the job centre is for “employment coaching” and job-hunting.

And governments in first-world liberal democracies are for creating policies that actually meet public needs, rather than imposing totalitarian control, manipulating and micromanaging citizens to meet government needs and political outcomes.

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43 thoughts on “Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

  1. I am so scared. This is appalling. Thank you for your advice on which forms and letters to use. I shall be sharing the advice on fb. I’ve just adopted a little dog as a commitment to staying alive for a few more years, but every time I read about the government’s policies it makes me feel so trapped and unvalued that suicide seems the only way out.

    Liked by 2 people

    1. I know it’s not much consolation, but I am in the same situation. I adopted a cat, though 🙂 I know how awful it is to see yet another political obstacle being placed between you and your future well-being. And yes, it’s so dehumanising and oppressive. But I share as much info as I can, try my best to help as many of us as possible by finding the best solutions I can, and it helps to remember that none of us are alone xx

      Liked by 3 people

  2. Well said Kitty, Great article.

    Wish I could adopt a dog but so afraid the DWP will find a way to force me into their chain gang. Then the dog could end up spending most of its time alone.
    I live alone and a faithful friend would really improve my quality of life. Also afraid I couldn’t afford the vet bills etc.

    A few years ago I would have been nearing retirement so a dog would have been just the ticket. A friend to care for in my old age.

    I have had dogs all my life up till now, the time I could most benefit from one. What a bazaar world this Government is creating.
    Topsy Tervy and insanely disturbing.

    Liked by 4 people

    1. You might find a local dog rescue who can place a dog with you for foster care, where the costs are fully covered. Or you could join the Cinnamon charity, where you can help a person who cannot provide full care for their pet, so you provide walking and companionship for the dog.

      Liked by 2 people

  3. Thank you for this information. I’m like Tracy, every time I see a new government policy it makes me feel sick….almost as bad as seeing the dreaded brown envelope on the mat….I just hope that this doesn’t come to pass.

    Liked by 3 people

  4. I thought I had already opted out of having my medical records shared with anyone. How many times do we have to do this? Already I feel cautious about what I say to my doctor. A little bit of that trust has already gone. The GP was the person who was on your side.
    Perhaps the DWP could sort out employee support in government departments first. My government employer failed to put any of the things in place for me that its own occupational health department had recommended. I was left with no alternative but to stay off sick and eventually resign from my job. What hypocrites they all are.

    Like

  5. Thank you for a brilliant informative but highly disturbing article. I have tucked the links away for future reference as being a disabled lady i’m sure i will need them at some point.

    So, another wonderous “flagship” scheme had failed, seems to be the tory way.. call it flagship and doom it to failure.!! I just wonder who comes up with these utterly stupid ideas and why once again the sick and disabled come under the tory jackboot
    Maybe changing the “sick” note to “fit” note had failed as simply changing the name does not actually change the fact that the person receiving these are not fit for work, and in some cases maybe chronically sick or disabled.
    As the article says “state harassment” … , but then the chronically sick and disabled get this on an almost daily basis from the cruel heartless government. I could go on and on, but many of my dear fiends can fill in the spaces with their own dreadful stories of persecution, bullying and harassment.

    Liked by 1 person

    1. The conservatives clearly can’t accept their ideology isn’t an accurate portrayal of how the world and others actually ARE. They refuse to accept reality, empirical evidence and seem hellbent on re-writing everything from history to people’s every day experiences of being ill. Manipulating the world into conformity to suit their own purposes. We usually call people like that “psychopaths”.

      Liked by 2 people

    1. I don’t know, but last week, people had problems opening links to my blog, they kept getting a notification that said “content not available.” This was after Facebook banned me from posting in groups, without telling me why. My ban is lifted now, so don’t know why there are problems still

      Like

      1. Oh, ok; I don’t do Facebook so it comes to me via an email notification, but today I got it via a comment on twitter (excuse stupid mistake in other message!).

        Going to freak you out now and say it’s Big Brother putting a spoke in the works etc etc 😉

        Liked by 2 people

  6. As if it isn’t bad enough that this government is forcing sick and disabled people into work, now we have this creeping authoritarianism as well. No doubt the DWP will trawl through these medical records for anything that might support further action on their part.
    Might I also suggest that anyone submitting the opt-out letter requests confirmation that this fact has been added to their medical records. Some years ago a friend of mine was disappointed to find that no action had been taken on a similar request.

    Liked by 2 people

  7. Reblogged this on wgrovedotnet and commented:
    Please read this if you value doctor patient privilege, if you don’t the whole world and his uncle will be able to access personal information, one way or another. Kitty Sue advises and offers helpful links to opt-out documents to make things easy.

    Liked by 1 person

  8. Katie, are you aware that the work allowance for universal credit is being scrapped and that payments of child element, the universal credit equivalent of child benefit, is to be limited to the first two children? Effectively this will mean that the UC claimant s will pay 65% tax on earnings as long as they claim, even if they only get 1p in benefits On Feb 3, 2016 7:14 AM, “Politics and Insights” wrote:

    > Kitty S Jones posted: ” Last year I wrote a critical article about the > government’s new Work and Health Programme, I flagged up concerns regarding > government plans to enlist GPs in prescribing work coaches for people who > are sick and disabled, and providing advice on j” >

    Like

  9. Long post – sorry! Please read all the way down.

    Every day since this Government was elected I have been outraged again by yet another infringement of my human rights. My political leanings were very slightly to the left of centre (or what used to be the centre) for many years, but since last year, I have become more and more left wing. (Or “socialist”, in the true meaning of the word) I have been on disability benefits for many years, since the date I was invalided out of the RAF because I was diagnosed with severe bipolar disorder, PTSD, hearing loss and osteoarthritis. The MOD assesses me as 80% disabled. The DWP now says that having to live with a “severe and enduring mental illness” no longer places me in the “vulnerable” category as far as claiming DLA and ESA is concerned. I have enough of a battle with the DWP to claim any money at all, and my psychiatrist and GP have been extremely supportive in writing reports that back up my claims. If I can no longer be sure that my medical professionals will keep my private consultations with them confidential, how can I possibly remain honest when I speak to them?? If all my private medical records are going to be uploaded – by law – to a data base outside the control of my own medical professionals, who will I be able to turn to in order to ensure that anything I say IN CONFIDENCE will remain private? I have been posting about this on Facebook ever since I discovered it; and I have already written to my GP telling her to put the correct flags on my records so that nothing about me goes beyond the surgery’s walls. I have checked, and it has been done.

    There is, however, one VITAL piece of information missing from Kitty’s otherwise excellent article. There is another code you should instruct your GP to put on your medical records – 9Nu4. This explains it well:

    “You can, also, opt-out using the 9Nu4 code – this will ensure that NO CLEARLY IDENTIFIABLE DATA WHATSOEVER IS RELEASED OR SOLD BY HSCIC, FROM ANY INFORMATION THAT IT HOLDS ABOUT YOU.
    The HSCIC cannot then release or sell clearly identifiable data obtained from either your GP or your HES record.
    The 9Nu4 opt-out code would also PROHIBIT RELEASE OF YOUR CLEARLY IDENTIFIABLE DATA, FROM WHATEVER SOURCE, UNDER S251, BY THE HSCIC, TO ANY SUCH ORGANISATION.
    The 9Nu0 opt-out code would ensure that NO DATA WHATSOEVER IS UPLOADED TO THE HSCIC FROM YOUR GP RECORD, AND SO NO INFORMATION FROM YOUR GP RECORD CAN BE RELEASED BY THE HSCIC – TO ANY SUCH ORGANISATION.
    The 9Nu4 opt-out code would also PROHIBIT RELEASE OF YOUR CLEARLY IDENTIFIABLE DATA, FROM WHATEVER SOURCE, UNDER S251, BY THE HSCIC, TO ANY SUCH ORGANISATION.

    ORGANISATIONS, PHARMACEUTICAL COMPANIES OR CHARITIES SUCH AS THOSE THAT PROVIDE ABORTION SERVICES, ARE INVOLVED IN SWEATSHOPS, EXPLOIT CHILD LABOUR, POLLUTE THE ENVIRONMENT, OR CONDUCT RESEARCH OR PHARMACEUTICAL TESTING ON ANIMALS, HAVE AS MUCH RIGHT AS ANY OTHER ORGANISATION TO APPLY TO THE HSCIC FOR YOUR CARE.DATA . THEY JUST HAVE TO KNOW HOW TO ASK FOR THE INFORMATION.

    Liked by 1 person

  10. I recently had an accident and damaged my back , with nerve damage , adding complications ,to the length of recovery, about 3 weeks after the accident , i asked for help with living cost (newly self-employed ) from my local authority , being told I needed to be in receipt of one of a list of benefits , having been employed during the previous eigth years ( last time on benefits ) i had no idea what any of this meant, the lady was nice enough to transfer me direct to a benefit advisor , and after an hour of questions , I was told i should be eligiable for ESA. To cut a long story short ,yes i received ESA, plus 80 per cent of housing cost . then i received a form to fill in and attend a medical a few weeks later , with the threat of ( if it was not completed and returned , i would lose benefits ), I had only just been given an appoitment with a Consultant, only just had a first examination with a Physiotherapist, I was waiting for an MRI scan, I could hardly walk some days , and yet I was being told to attend a medical , when I or any of the professionals treating me at that time, did not know the full extent of my injuries. The form was filled in as best as i could , and sent off, i saw the Consultant , had the first MIR , had further physio, went for walks ( if possible daily) , listened to all the medical advice i was given .The recovery was and still is a slow process, but then i attend the medical , and their a Practitioners Nurse , interviewed me, and examined me by asking me to bend, but stop if I could go no further, he pulled my legs several ways , measured my calves , when any other professional examined me in a similar way they would constantly ask for a scaled measure of pain ( 1 to 10 ) or my ease in the bending , this gentleman did not ask anything of me during this time. Not to my surprise a week or so later i received a phone call to tell me I’ve failed that medical , and I’m to claim JSA. , what takes place after this was a nightmare, I’m told by a nurse that I’m fit for some kind of work , when I’m falling over ,because of leg spasms . in pain , and so much more. I make a claim for JSA, but was asked if i had reasons why i could not actively seek for work when i responded with my problems , the girl told me I should claim ESA. ( the very benefit i had just been suspended from.) and did I want to proceed with my claim for JSA. It gets more complicated by the day , I’m told to ask for a Manditory reveiw of sorts . i make several calls , given run around , misdirected , but i get through to a guy and i ask for this reveiw , then and only then can i call DWP.again to claim JSA.I’m given an interveiw , but it’s the wrong time, new interveiw , then I’m confronted by this guy demanding to know why my wife is not with me, told he’ tried to phone me on my mobile , ( I informed him i do’nt answer unknown number , I’m fed up with PPI. calls ) , but asked why the house number was not called ?, ooops somehow that number was moved further into my files . so yet an other delay,a week later I’m finally interveiwed, were told to aply for exemption for my wife ( in receipt of lower DLA. )an other run around sortting that out , told i was under paid ESA. , more phone calls , more faulse promises more calls , but a week later we receive about £800. Which in many ways has helped us live , because it’s almost a month and still no JSA ( even though I’ve been awarded it ) our housing benefit was also suspended, , and we had to make a payment toward arrears , ( created by bedroom tax. ) and the suspension, my wife and i cannot share the same bed , since she spent 20 days on life support and a further month in I.C.U. ten years ago. We were threatened with notices of eviction for arrears , created by the very agencies i ask to help me through this difficult time , THIS TOPPS it all because as i read my letter of award i discover that again I’m only being awarded a single persons rate JSA., more mistakes on top of an absolute catolouge of mistakes .The only sanity in all of these last few months is that I’ve had a G.P. a Consultant ,several Physiotherapists , and enitionally the A & E doctors and staff , X-Ray technisions , who’s only concern has been my wellbeing , a second MRI. scan showed some compression along my spine , but I’m close to returning to full employment , and have unfortunately gained first hand expierience,of this system of where the medicals are set up to trick you , where my needs for a time of full recovery are ignored , and more frightening than that is the fact that , a nurse can somehow make a determination on someone ability to work in a safe manner , that will not cause further damage , which will cost even more in health needs and put more strain on the NHS. , or such greater damage that it may prevent the paitient from working again ,and be allowed to supercede, all the others looking after my health , ( I asked this very relavent question), if i return to work , and being selfemployed, if I fall off a ladder because of my present problems , WHO WILL COVER ME , WHO WILL BE MADE RESPONCIBLE ???. and each person I asked this of , refused to make a reply. thank you for allowing me this forum to air my expieriences , and i hope that the very people ( doctors ) who care for this counties ill and disabled , are not forced into protraying the very oath that defines who they are. yours stewart voy

    Like

    1. Your expriences are a disgraceful indictment of a system that does not support people who are sick and doing all they can to support their own recovery and survive – meeting basic needs such as for food, fuel and shelter. The DWP put you and your wife’s wellbeing and health in further jeopardy. I wish I could say this was a mistake, a rare experience that is down to human error at their end, but it isn’t. The system is set up to intentionally remove the sick role, recovery time, and as you so importantly point out, if this goes wrong and someone is injured or their health deteriorates as a consequence, or if someone dies as a result – and that may also include other people who are placed at risk because someone has been coerced to work when they are not well enough to do so – noone is willing to take responsibility. The DWP are willing enough to take people’s benefits away on the prextext that they can work, when it becomes clear they cannot, the DWP refuses to accept the responsibility for their own decision and the consequences.

      It needs to change. The system is barbaric and all about saving this government money to handout to the wealthy.

      Like

      1. PLEASE GOD – FORGIVE THEM?

        May I please refer you to the attached letter, from Dr. H. Sharafzadeh, dated the 7th December, 2016, where he states?

        “Digital rectal examination revealed moderately enlarged benign feeling prostate. No nodule or hard area on the prostate but he is having diarrhoea at the moment (30.11.16)

        I see the notes from 27th June, when my colleague Mr. Nissar performed a DRE and he confirmed also that he had diarrhoea at that time.

        I have arranged to see him again in three months time with further PSA reading.”

        This is the same condition I reported to Tony Townsend, the Disability Employment Advisor of Boston Job Centre, with Louise Stocks, Occupational Therapist of Pilgrim Hospital in attendance, during the months of December, 2015 and January, 2016 – before the Medical Assessment of the 27th February, 2016.

        The same condition I reported to Dr. Ranjan Chowdhary, (GMC Licence 3632255), where I confirmed I was “dirty” most days and reported again, whilst I was in the office of Boston’s Citizens Advice Bureau, on the 31st March, 2016, taking the Mandatory Reconsideration. (Witness “Vicki” – I think).

        Further reports were made to the Department for Work and Pensions on the 19th April, 2016, for which I hold an audio CD and statements were made; what do I need to do – take photographs; I can’t help my body; this man, ( Dr. Chowdhary), told lies – I stopped my medication April / May 2015; I have no history of depression. This kind person realised the seriousness of the situation and advised me to appeal and appreciated I needed to be placed within the support group.

        Formal complaints started on the 17th July, 2016, to the Centre for Health and Disability Assessments, with their “final response” issued on the 4th October, 2016. Their conclusions did not resolve anything – I am still mystified why, Dr. Chowdhary gave “evidence” to the Department for Work and Pensions and the appeal court of:

        Extract of letter to Natalie Vickers of the C.H.D.A dated 16th July, 2016.

        Asked about my typical day, I answered “It starts with me waking-up dirty, so first thing I have a shower, dress then come down stairs to do some work, with my lap-top. Whilst sitting at the table I have moments of urgency of needing the toilet, sometimes I make it, sometimes I do not “!! Further into the assessment he asked did the medication work, to which I replied, I still have bowel incontinence. At this stage, I sat back in my chair when he said “DONT MENTION THE INCONTINENCE AGAIN, WE’VE DEALT WITH THAT MATTER”! I then realised he was answering his own questions and he could have written the report without me. He certainly did not take any notice of Dr.Mangions’s remarks, when he said “long standing diarrhoea with episodes of faecal incontinence” nor the statements made within my NHS History explaining I have problems since 2012. I appreciate this is a case of “he said, I said” and maybe I have not quoted word-for-word.

        In short, he glossed-over my bowel problems by saying “investigations indicate I.B.S for which he takes medication regularly”.

        This last declaration is incorrect on both accounts: Investigations for I.B.S. stopped prior to July, 2014 and the “Mebeverine” soon after January, 2015. This can be confirmed within the pages supplied by the Upper Tribunal – Pages 216 and 217 – letter dated 14th October, 2016, to the HM Courts & Tribunals Service, Birmingham from Dr.S.K.Jain – Consultant Physician / Gastroenterologist, Pilgrim Hospital.

        Other areas were completed in the ESA50 Form dated 13th March, 2015 which Dr. Chowhary did not satisfy are :

        Vision Impairment pages 12 & 20 of the Upper Tribunal papers – surrender of driving licence, early 2012 – answered with Certificate of Partially Sighted – Pages 342 to 345.

        Lack of Energy ( page 21) – sleep 10 hours and still need two hours in afternoon; fifteen minutes work and need one hours rest – answered by the letter from Liz Ford of the Stroke Association, dated 14th July, 2016 – Page 200.

        Stress ( Page 26 ) – Dr. Mangion advised me before my stroke of the 8th November, 2011 to avoid stressful situations – answered with pages 1 to 348 !

        I have no history of depression, so no remarks were made within the ESA50 Form, nor at the Medical Assessment of the 27th February, 2016.

        Since taking forced retirement, in December, 2012, my intentions remain the same:

        TO SELL MY HOME AND MOVE NEARER MY SONS.

        2ND E-MAIL :

        Thank you for your correspondence of the 27th April 2017. (Copy attached)

        I am somewhat surprised the Secretary of State requires further findings regarding this case – taking into account those supplied by the Upper Tribunal on Pages 216 & 217.

        I have no objection with another digital rectal examination (DRE) and would suggest this takes place during my appointment with Mr.S.H.Memon on the XXXXXXXXXXXX at XXXXXX. (Copy attached)

        May I also request – Dr.Ranjan Chowdhary is held in attendance, along with any representative from the Department for Work & Pensions and/or the office of Mr.Matt Warman, MP.

        Your prompt reply would be appreciated.

        Like

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