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Feature Austerity Investigation

GPs increasingly have to tackle patients’ debt and housing problems

BMJ 2014; 349 doi: (Published 02 July 2014) Cite this as: BMJ 2014;349:g4301
  1. Gareth Iacobucci, news reporter, The BMJ
  1. giacobucci{at}

In the second part of his investigation into the effects of changes to the welfare system, Gareth Iacobucci hears how referrals to employment and welfare advisers are becoming as much a part of general practice as referrals to orthopaedic surgeons

GPs have reported a rise in numbers of patients presenting to them with housing problems in the past year, many of whom have been affected by the introduction of the new under-occupancy penalty, dubbed the “bedroom tax” by its critics.

The new penalty was introduced as part of the Welfare Reform Act 2012, which has led to some claimants having their housing benefits cut because they have a spare room in their property.

What The BMJ’s survey found

Some 68% of 1056 respondents to The BMJ’s survey said that the under-occupancy penalty had increased their workload to some degree. (See the first part of the investigation for the survey details and methods.1)

As with the employment support allowance (ESA) (covered in the first part of the investigation), the under-occupancy penalty seems to have had most impact on doctors working in inner city areas. Three quarters (77%) of these respondents said that the policy had increased their workload, comprising 22% who said it had “significantly increased,” 29% who said it had “increased,” and 26% who said it had “slightly increased” their workload (fig 1).

As a result of this and other measures such as the £26 000 (€32 000; $43 000) a year cap on benefits, many doctors said that they were seeing an increase in patients presenting to them with problems connected to unemployment and debt. Nearly all the GPs (92%) said that debt among patients had increased their workload (fig 2)

Almost nine in 10 GPs (89%) said that unemployment among their patients had increased their workload to some degree …

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