Welfare policies increase physician workload in UK

1. The United Kingdom’s Welfare Reform Act 2012 was passed as part of austerity measures to reduce welfare spending. 

2.  General practitioners report having increased workloads as a result of increased patient debt and unemployment problems following the passage of the Act. 

Evidence Rating Level: 4 (Below Average) 

Study Rundown: The United Kingdom’s Welfare Reform Act 2012 introduced new policies to reduce the national deficit, but some of these policies may have significant ramifications on healthcare. A recent BMJ survey had already shown that over half of general practitioners (GP) in the UK find their current workloads to be “unmanageable” or “unsustainable,” and new austerity measures were likely to further strain providers. In particular, the under-occupancy penalty, or “bedroom tax”, cuts welfare benefits for spare bedrooms. Among the approximately one thousand GPs surveyed, 68% noted increased workloads due to the under-occupancy penalty, with GPs in inner city areas being the most affected. In addition, 92% of GPs said patient debt had increased their workload over the past year, and 89% reported that patient unemployment had a similar effect.

Though these survey results support anecdotal evidence describing an increasing number of appointments being devoted to non-medical problems, the study design is weak, being based on physician self-reporting and a relatively small sample size. Further, the survey questions may bias responses towards answers reflecting increased workloads, as four answer choices described degrees of increased workload while only one was worded “no increase.” Answer choices for decreased workloads were conspicuously absent. Still, while the evidence is less than conclusive, these results further support a significant decrease in healthcare quality and physicians’ ability to keep up with demand in the face of increasing austerity.

Click to read the study in the British Medical Journal

Relevant Reading: Has austerity brought Europe to the brink of a health disaster?

In-Depth [survey]: This survey by the BMJ sought to qualitatively define the impact of the United Kingdom’s welfare austerity measures of GP workload. Of the 28602 GPs received an email with a link to the survey, 7151 opened the email, and 1056 responded. The survey consisted of questions relating to increases in workload caused by the under-occupancy penalty, debt, and unemployment. GPs were also asked to report the location of their practice in one of four regions: inner city (24% of responders), suburban (27%), town (35%), or rural (18%). 68% of respondents mentioned an increase in workload due to the under-occupancy tax, with the most affected group being GPs in the inner city (77%). Most GPs (92%) said that debt had increased their workloads over the last 12 months while 89% said that unemployment had also contributed to a workload increase. GPs in the inner city saw the largest increase in workload, with 36% and 38% reporting “significantly increased” workloads due to debt or unemployment, respectively. 

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