Prime Minister Rishi Sunak’s suggestion to shift responsibility for issuing fit notes from GPs to specialist work and health professionals has sparked controversy. Retired GP Dr. Brian Fisher argues that this move not only implies a harsher regime that forces people back to work unnecessarily but also undermines the comprehensive care provided by GPs. Fisher highlights the role of GPs in balancing illness, personality, and work demands in their fit note decisions, emphasizing that the vast majority of people on fit notes are genuinely unable to work. He also raises concerns about the potential impact of privatizing this process, citing the case of Stephen Carré, who died by suicide after being denied a ‘fit to work’ appeal by private company ATOS. Fisher calls for a focus on properly funding the NHS, transforming social care, and addressing poverty and deprivation as more effective ways to improve health outcomes.