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Want the long term sick bill down? Add the money into the overall budget for the NHS, minus a cut for paying off the deficit. It will look good on the NHS figures as extra spending on Hospitals (Propaganda I know but hey, at least it will now actually show up on the national accounts). And then let Doogie Hauser MD make a choice, he can either spend the extra money on people with Leukaemia, or spend it on the long term “sick” who find work interferes with their squash game. Instead of passing the buck onto somebody else by signing Mr Workshy off sick, Gregory House M.D. will want, nay have, to pick the people who are in genuine need. The people who have nothing wrong with them but are limping around like they’ve been shot with an Elephant Gun can go bug the Ambulance Chasers at the National Accident Helpline.