Doctors' sicknotes have long been seen as a weak link in employment law, with many employers believing that harassed and overworked doctors routinely issue unjustified sicknotes to those asking for them.

Perhaps they think doctors do this because they wish to avoid confrontation, do not have the expertise to make a proper diagnosis, are concerned about being sued for negligence or simply do not have time to carry out a detailed examination.

Stress, depression and nervous debility are, by their nature, easier to fake than physical ailments and have long since taken over from back pain as the leadswinger's complaint of choice.

Whether the conclusions in a report published by the Department for Work and Pensions (DWP) in early July will be welcomed by employers is therefore something of a moot point.

The report presented the conclusions of the DWP's research into the possibility of allowing non-medical healthcare professionals - or NMHPs in DWP jargon - to issue sicknotes as well as GPs.

Broadly speaking, the conclusion was that NMHPs may be in a better position than GPs to assess their patients, provide accurate diagnoses and detect those not telling the truth. NMHPs concerned with physical conditions - osteopaths, chiropodists and the like - were most keen to be allowed to issue sicknotes, whereas those dealing with mental health issues, such as psychologists, were less keen, although still in favour of the idea overall.

Whether these conclusions would, if given effect, lead to an increase in "fake" sicknotes remains to be seen.

It is possible that an employee, refused a sicknote by his GP, would trawl round his treating NMHPs until one could be persuaded to deliver the goods.

There is no reason why an NMHP would be any less concerned than GPs about the legal implications of negligently refusing to certify a patient as unfit for work, and it might be that GPs will see the extension of NMHPs' powers as a reason to abrogate their own responsibility.

That in turn may slow down the process of sicknote production, leading to ever more uncertainty for employers.

- Stephen Elliott is a solicitor in the employment team of North-East law firm Ward Hadaway. He can be contacted on 0191-204 4000 or by email at stephen.elliott@wardhadaway.com

Published: ??/??/2004