It is the idea that the contracts of General Practitioners should somehow be adjusted so that they have some kind of incentive not to sign patients off as sick.

One can see why the government would have this idea. It is concerned tht GPs sign people off as sick too readily. That is surely right. But this is the wrong way to deal with it. It will corrupt the relationship between doctor and patient, which should be supportive. This will make the doctor into a kind of policeman of benefits, suspicious of symptoms which a patient claims. The patient will sense this suspicion. What should be a friendly relationship will become something different.

A better way to deal with this is what they did in New York. Those people who seek to be on incapacity benefit should be seen by doctors who are not their usual General Practitioners. These doctors should be looking for what work these claimants can do. Their role should clearly be that of acting for the government helping the individuals get benefit, if entitled, and/or identifying what kind of work they could do.

More generally, the Green Paper plan seems to be that people will be required to come in to talk about getting a job in the 'Pathways to work' programme. If they do not come in to talk about it, they might have their benefits reduced. This is nothing like as radical as in New York, for example, where claimants were:

1. Assessed for what they could do.
2. Required absolutely to seek work of the sort they could do. Aided by private companies which got paid more if they succeeded in getting claimants into work.
3. If no work could be obtained, they would be required to work for the state for three days a week (sweeping the park, helping in a hospital, clerical work and so on) and required to seek work the other two days.

The difference between the New York and that of the British government is that between chalk and cheese.