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Tag Archives: biopsychosocial

Jobs for the boys – and a possible conflict of interest – in new government contract

25 Friday Jul 2014

Posted by Mike Sivier in Uncategorized

≈ 13 Comments

Tags

benefit, biopsychosocial, cash, Coalition, conflict, Conservative, contract, government, health, Health and Work Service, Incapacity Benefit, Interest, Maximus, Mike Sivier, mikesivier, money, paid, pay, people, politics, profit, provider, result, sick, social security, taxpayer, Tories, Tory, Vox Political, WCA, welfare, work, work capability assessment, Work Programme


[Image: Ktemoc Konsiders - http://ktemoc.blogspot.co.uk/]

[Image: Ktemoc Konsiders – http://ktemoc.blogspot.co.uk/%5D

The Coalition government has named the company that is to carry out its new programme to discourage people from claiming incapacity benefits – and, like all Coalition decisions, it is a disaster.

The contract for the new Health and Work Service in England and Wales will be delivered by Health Management Ltd – a MAXIMUS company.

This is triply bad for the United Kingdom.

Firstly, MAXIMUS is an American company so yet again, British taxpayers’ money will be winging its way abroad to boost a foreign economy, to the detriment of our own.

Next, MAXIMUS is already a Work Programme provider company in the UK. The Work Programme attempts to shoehorn jobseekers – including people on incapacity benefits – into any employment that is available, with the companies involved paid according to the results they achieve (on the face of it. In fact, it has been proved that the whole system is a scam to funnel taxpayers’ money into the hands of private firms as profit, whether they’ve done the work or not). Health and Work, on the other hand, is a strategy to slow the number of people claiming incapacity benefits with an assessment system – think ‘Work Capability Assessment’ designed to fast-track sicknote users back to their jobs.

We know from the government’s original press release that it has failed to reach its target for clearing people off incapacity benefit, so it seems that Health and Work has been devised to make more profit for MAXIMUS by ensuring that it can claim fees, not only for the number of incapacity benefit claimants it handles on the Work Programme, but also for the number of employees it ensures will NOT claim incapacity benefits.

It’s a win-win situation for the company and a clear conflict of interest – logically the firm will concentrate on whichever activity brings it the most UK government money. MAXIMUS may claim there are ‘Chinese walls’ to prevent any corruption, such as one activity being carried out by a subsidiary, but this must be nonsense. MAXIMUS will do what is best for MAXIMUS.

Thirdly, we have a new layer of bureacracy to torture sick people who only want peace and quiet in order to get better. Look at what Vox Political had to say about the scheme when it was announced in February:

“‘The work-focused occupational health assessment will identify the issues preventing an employee from returning to work and draw up a plan for them, their employer and GP, recommending how the employee can be helped back to work more quickly.’

“Health doesn’t get a look-in.

“No, what we’re most probably seeing is an expansion of the “biopsychosocial” method employed in work capability assessments, in an attempt to convince sick people that their illnesses are all in their minds. Don’t expect this approach to be used for people with broken limbs or easily-medicated diseases; this is for the new kinds of ‘subjective illness’, for which medical science has not been prepared – ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia and the like.

“People with these conditions will probably be sent back to work – with speed. Their conditions may worsen, their lives may become an unending hell of pain and threats – I write from experience, as Mrs Mike spent around two years trying to soldier on in her job before finally giving up and claiming her own incapacity benefits – but that won’t matter to the DWP as long as they’re not claiming benefits.”

That previous article was wrong, in fact. There is a health angle to this.

It is a plan to stitch us all up.

Follow me on Twitter: @MidWalesMike

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Will Question Time’s panel do what Parliament can’t – and hold Iain Duncan Smith to account?

07 Saturday Jun 2014

Posted by Mike Sivier in Benefits, Conservative Party, Disability, Employment and Support Allowance, Media, Politics, UK, Universal Credit

≈ 39 Comments

Tags

'ad hoc', allowance, Atos, BBC, benefit, biopsychosocial, Coalition, Conservative, corporate manslaughter, Democrat, Department, Disability Living Allowance, DLA, DWP, employment, ESA, fit for work, FOI, Freedom of Information, government, human rights, Iain Duncan Smith, Ian Hislop, IB, IDS, Incapacity Benefit, incapacity benefits: deaths of claimants, Lib Dem, Liberal, Michael Meacher, Mike Sivier, mikesivier, Owen Jones, Parliament, Pensions, people, Personal Independence Payment, Peter Lilley, PIP, politics, Private Eye, Question Time, Reform, returned to unit, RTU, sick, social security, support, theory, Tories, Tory, Universal Credit, unum, vexatious, welfare, work, work capability assessment


140428IDSshrug

Picture the scene if you can: It’s shortly after 11.35pm on Thursday (June 5) and all my inboxes are suddenly overflowing – with the same message: Iain Duncan Smith will be on Question Time next week.

The implication was that there is an opportunity here – to show the public the homicidal – if not genocidal – nature of the changes to the benefit system this man mockingly describes as “welfare reforms”.

We were given the name of only one other panellist who will be appearing in the June 12 show, broadcast from King’s Lynn: Private Eye editor Ian Hislop. He is certainly the kind of man who should relish a chance to take the politician we call RTU (Returned To Unit) down a peg or two – in fact the Eye has run articles on DWP insanity fairly regularly over the past two decades at least.

Personally I’d like to see him joined by Michael Meacher and Owen Jones, at the very least. A rematch between Smith and Jones would be terrific television (but it is unlikely that the coward IDS would ever agree to it).

All such a panel would need to get started is a question about “welfare reform”. Then they could start at the beginning with the involvement of the criminal US insurance corporation Unum, which has been advising the British government since Peter Lilley was Secretary of State for Social Security. There appears to be a moratorium on even the mention of Unum in the British press so, if this is the first you’ve heard of it, now you know why.

Unum’s version of an unproven strand of psychology known as biopsychosocial theory informs the current work capability assessment, used by the coalition government to evaluate whether a claimant of sickness benefits (Incapacity Benefit/Employment Support Allowance or Disability Living Allowance/Personal Independence Payment) should receive any money. The assessment leans heavily on the psycho part of the theory – seeking to find ways of telling claimants their illnesses are all in the mind and they are fit for work. This is how Unum wormed its way out of paying customers when their health insurance policies matured – and it is also how Unum received its criminal conviction in the States.

Here in the UK, the work capability assessment appears to have led to the deaths of 3,500 ESA claimants between January and November 2011 – 73 per week or one every two hours or so. These are the only statistics available to us as the Department for Work and Pensions stopped publicising the figures in response to a public outcry against the deaths.

Members of the public have tried to use the Freedom of Information Act to pry updated figures from the DWP. I know of one man who was told that the 2011 figures were provided in an ‘ad hoc’ release and there was no plan for a follow-up; the figures are not collected and processed routinely. The last part of this was a lie, meaning the DWP had illegally failed to respond to a legitimate FoI request.

Having seen that individual attempts to use the FoI Act to get the information had failed, I put in a request of my own and suggested others do the same, resulting in (I am told) 23 identical requests to the DWP in June last year. Apparently this is vexatious behaviour and when I took the DWP to a tribunal earlier this year, it won.

But the case brought out useful information, such as a DWP employee’s admission that “the Department does hold, and could provide within the cost limit, some of the information requested”.

Now, why would the Department, and Iain Duncan Smith himself, want to withhold these figures – and lie to the public about having them? It seems to me that the death toll must have increased, year on year. That is the only explanation that makes sense.

The DWP, and its Secretary-in-a-State, have had their attention drawn to the deaths many times, if not in interviews then in Parliament. DWP representatives (if not Mr Duncan Smith himself) have taken pains to say they have been improving the system – but still they won’t say how many deaths have taken place since November 2011.

If it can be proved that DWP ministers were aware of the problem (and we know they are) but did not change the situation enough to slow the death rate (as seems to be the case), then it seems clear that there has been an intention to ignore the fact that people have been dying unnecessarily. This runs against Human Rights legislation, and a strong case could be made for the corporate manslaughter of thousands of people.

And that’s just ESA!

When we come to PIP, there’s the issue of the thousands of claimants who have been parked – without assessment – for months at a time, waiting to find out if they’ll receive any money.

Universal Credit currently has no budget, it seems, but the DWP is clearly still wasting millions of pounds on a project that will never work as it is currently conceived.

It would be nice to think that at least one member of Thursday’s panel might read this article and consider standing up for the people, but it’s a long shot.

Possibly a million-to-one chance, in fact.

According to Terry Pratchett, that makes it an absolute certainty!

Here’s hoping…

Follow me on Twitter: @MidWalesMike

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The fakery and failure behind the DWP’s new ‘health’ scheme

11 Tuesday Feb 2014

Posted by Mike Sivier in Benefits, Business, Conservative Party, Employment, Employment and Support Allowance, Liberal Democrats, Media, People, Politics, UK

≈ 27 Comments

Tags

absence, Adolf Hitler, appeal, BBC, benefit, benefits, big lie, biopsychosocial, Chronic Fatigue Syndrome, Chronic Pain, cumulative, Department, DWP, economic plan, employee, employer, employment, Employment and Support Allowance, ESA, fail, fake, fibromyalgia, fit for work, health, Health and Work Service, Iain Duncan Smith, ill, Incapacity Benefit, job, Labour Force Survey, leave, long term, Media, Mike Sivier, mikesivier, nudge, occupational health, Pensions, people, politics, public relations, sick, social security, subjective, Telegraph & Argus, unit, Vox Political, welfare, work, work capability assessment


131109doublespeak

It seems that the Department for Work and Pensions is sticking to the ‘Adolf Hitler’ model of public relations: If you tell a big lie and repeat it often enough, people will believe it. The press release announcing the new ‘Health and Work Service’ is riddled with long-debunked old lies – and one new statement that deserves our scrutiny.

This is the press release used by the BBC in its article on Saturday, telling us that the new, privately-run service is needed to combat the high cost of long-term absence from work.

It seems to be the DWP’s new practice to pass announcements to – let’s call them “trusted” – media outlets before putting them up on the government’s own press website, as a kind of test-run, allowing any credibility problems to be fixed before the government commits itself in an official way.

That’s why the announcement appeared on the government website yesterday (Monday) – two days after the BBC broke the story. Now – in just half the time it took to appear – let’s look at why it’s a load of rubbish.

“As many as 960,000 employees were on sick leave for a month or more each year on average between October 2010 and September 2013, the government has revealed,” the document begins.

Oh really? The DWP reached this figure by applying the findings of a survey, showing the ratio of long-term absences to total days of sickness absence, to findings by the Labour Force Survey showing the total number of days of sickness absence in the UK. That’s 9,000 sick days and 70 absences, applied to an average of 120 million sick days per year. This is based on 2,019 interviews with employees. There’s just one problem.

At the time covered by these surveys, there were around 4.9 million private sector employers.

Considering the huge size difference between the sample surveyed and the body it represents, it seems unlikely in the extreme that the figure is accurate. If it is right, it would be by luck; it’s probably wrong. The figure might as well have been made up – and you should treat it as though it was.

“The government has already taken big steps in getting people on long-term sick benefits back into work as part of the government’s long-term economic plan, with almost a quarter of a million coming off incapacity benefits since 2010-” Let’s stop there and examine the information content of this sentence so far.

The “government’s long-term economic plan” is a phrase that is being shoe-horned into every press release possible and means nothing. There never was a “long-term economic plan”, and there isn’t one now. Have you seen it? Of course not – it doesn’t exist. This is just a comforting nonsense inserted to lull people into false security that somebody knows what they are doing; I suspect the newly-privatised “nudge” unit may have had something to do with this.

As for “almost a quarter of a million coming off incapacity benefits since 2010”, check out this interview with Iain Duncan Smith, published in the Telegraph & Argus in 2010. He said: “I intend to move 1.5 million off incapacity benefit by 2014.”

It’s now 2014. We don’t have up-to-the-minute figures but on November 13 last year, the DWP press office helpfully tweeted us its then-current figure for people moving off incapacity benefits in a handy chart: 156,000.

140211fakes

That is a long way from a quarter of a million, and only around one-tenth of the Secretary-in-a-State’s 2010 target.

“- and almost a million who put in a claim actually have been found fit for work.” This is a bare-faced lie. It relates to a statement that 980,400 people were judged capable of work between 2008 and March 2013, but there are two problems with this. Firstly, it does not take into account the number of successful appeals against the ‘fit for work’ judgement (125,700); when adjusted to account for these, the total drops to 854,700. Secondly, this refers to the cumulative number of ‘fit for work’ outcomes of initial functional assessments since October 2008, and it seems likely that many people will have made repeat claims after being knocked off-benefit by an adverse decision. We do not know how many people have done this. Therefore the figure is meaningless.

So far, the DWP has told us that working people get sick (no surprises there), that it has failed to reach its target for clearing people off incapacity benefit and that its work capability assessment system is failing to push as many off-benefit as it should, because it is riddled with errors.

How does this connect with the creation of a new ‘Health and Work Service’, dedicated to ensuring that people who spend more than four weeks at a time off work with an illness get back into their job with a minimum of difficulty?

It’s obvious, isn’t it?

This is a scheme to ensure that people are discouraged from claiming incapacity benefits; the idea is that a drop in new claims, coupled with the number of uncontested ‘fit for work’ decisions, might lead to a larger drop in the number of active claims – which means the amount of money being paid out in benefits would also drop.

Inclusion of the word ‘health’ in the title of the new service is misleading, as it seems unlikely that consideration of an employee’s physical condition will have anything to do with the aim of the exercise.

Look at what the release has to say: “The Health and Work Service will offer a work-focused occupational health assessment and case management to employees in the early stages of sickness absence.”

It continues: “The work-focused occupational health assessment will identify the issues preventing an employee from returning to work and draw up a plan for them, their employer and GP, recommending how the employee can be helped back to work more quickly.”

Health doesn’t get a look-in.

No, what we’re most probably seeing is an expansion of the “biopsychosocial” method employed in work capability assessments, in an attempt to convince sick people that their illnesses are all in their minds. Don’t expect this approach to be used for people with broken limbs or easily-medicated diseases; this is for the new kinds of ‘subjective illness’, for which medical science has not been prepared – ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia and the like.

People with these conditions will probably be sent back to work – with speed. Their conditions may worsen, their lives may become an unending hell of pain and threats – I write from experience, as Mrs Mike spent around two years trying to soldier on in her job before finally giving up and claiming her own incapacity benefits – but that won’t matter to the DWP as long as they’re not claiming benefits.

That is what we can all expect from the new ‘service’.

It will be a fake, necessitated by failure.

Follow me on Twitter: @MidWalesMike

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Here’s why Labour needs to go a lot further to win back our trust

22 Sunday Sep 2013

Posted by Mike Sivier in Benefits, Corruption, Disability, Employment, Health, Labour Party, People, Politics, Poverty, Public services, UK, unemployment

≈ 54 Comments

Tags

Anne McGuire, Association of British insurers, Atos, back-up plan, benefit, benefits, biopsychosocial, capita, Chronic Fatigue Syndrome, Chronic Pain, condition, Conservative, dead, death, degenerative, Democrat, Department for Work and Pensions, die, disability, Disability Living Allowance, disabled, DLA, doctor, DWP, Ed Miliband, Employment and Support Allowance, ESA, fibromyalgia, George Engel, government, health, illness, Incapacity Benefit, income protection, insurance, Labour, Liam Byrne, Lib Dem, Liberal, Lord Freud, Lyme disease, Mike Sivier, mikesivier, Mo Stewart, Multiple Sclerosis, New thinking on the welfare state, people, Peter Lilley, policies, policy, politics, Reform, sick, social security, Star Wars, Steve Webb, subjective, Tories, Tory, unemployment, unum, Vox Political, WCA, welfare, work, work capability assessment, workplace


130922unumlabour

Only days after Ed Miliband announced a Labour government would sack Atos, the party’s conference is hosting an event part-funded by the architects of the ‘work capability assessment’ administered by that company – the criminal American insurance giant Unum.

‘New thinking on the welfare state’ is a fringe event taking place at the Labour conference on Monday, September 23, organised by the right-wing thinktank Reform (which has Unum as one of its funders) and sponsored by the Association of British Insurers (which includes Unum among its members). Does anybody doubt that it has been arranged in order to give Unum a chance to influence high-ranking party members? No?

Then consider: This is a private round-table policy seminar, staged by Anne McGuire MP. Rank and file Labour members aren’t invited – attendance is by invitation only. Can you smell a rat? Still no?

The event has already been staged at the Liberal Democrat conference (by Steve Webb MP, whoever he is), and will also be a feature of the Conservative Party conference, courtesy of that turncoat floor-crossing slime Lord Freud. It shouldn’t take a genius to work out that Unum wants to ensure that all three parties have the same social security/welfare policy, going into the next election – and that Unum continues to figure prominently in the formulation of that policy.

If you didn’t smell a rat infestation before, by now you’re probably wondering why pest control hasn’t been called.

Ed Miliband knows that any change of the organisation administering work capability assessments is purely cosmetic; the Conservative-led Coalition itself is bringing in other companies to carry out the work, and Capita has already been taken on to carry it out in some areas.

It is the policy itself that must change.

Unum knows all about that policy. The company came up with it in the 1990s as a way to combat claims on its health insurance policies for ‘subjective’ illnesses such as ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia, multiple sclerosis, Lyme disease and others – by aggressively disputing whether a claimant was ill.

It based its new test on the Biopsychosocial Model of illness developed by the psychiatrist George Engel, which is itself an unproved theory. Unum removed the bio- and -social aspects in order to concentrate on the ‘psycho’ – the claim that a person’s illness is all in their mind; that they are imagining it.

This worked very well for the company until the American people realised that they were being diddled out of their insurance money and very large lawsuits were launched that ended with the company having a criminal record in several US states.

Undaunted by this, Unum branched into the UK and cosied up with then-social security minister Peter Lilley, who wanted to cut the number of people claiming disability benefits. Unum saw an opportunity here, with a long-term goal of making state disability benefits useless to the British citizen and forcing them to pay out for the companies duff health insurance policies – which had already fallen foul of the law in America.

That’s why the work capability assessment takes precedence over any evidence your doctor might provide to support your claim, and it’s also why doctors are being actively discouraged from providing any evidence at all; that’s why UK law currently sees a glowing future for people who may be paralysed, but for one finger, as a button pusher; that’s why people with Parkinson’s Disease or other degenerative conditions are being told they will be able to work again in the future; and that’s why thousands upon thousands of people have died as a result of the current policy – especially since the Conservative-led Coalition came into office in 2010.

Meanwhile, Unum has begun a mass-marketing campaign to encourage able-bodied British citizens to invest in ‘Income Protection Insurance’ and a scheme known as the ‘Back-up Plan’. These are only available via the workplace, and it is understood that it has been designed to ensure that the company can resist paying out if anybody should be unlucky enough to have to make a claim.

So you see, the plan is to leave the sick and disabled of this country with no support whatsoever; they can either take out Unum’s insurance policies, pay the company a fortune in premiums and get nothing in return – or they can throw themselves at the mercy of a state which has no mercy and be refused the benefits for which their taxes have been paying ever since they were old enough to pay taxes in the first place.

Either way, Unum wins. For younger readers, it’s like the plot of the prequel trilogy in the Star Wars saga, where the character who becomes the Emperor engineers a war in which he controls both sides. So you see? Those films weren’t as bad as we all thought.

But of course, any person or organisation that intentionally creates a parallel between itself and the most evil character in recent fiction should absolutely not be anywhere near the real-life political decision-makers of this or any other country.

That’s why Mo Stewart, the retired healthcare professional and disability researcher who has spent four years examining the relationship between Unum and the UK government, has contacted Ms McGuire, demanding to know why she is having anything to do with the firm.

She wrote: “Given the amount of evidence against the practice of the dangerous corporate giant, Unum Insurance, and the fact that Labour MPs have exposed their influence with government during debate, the British disabled community are wondering why you would chose to host a fringe meeting by Unum at the conference on Monday?

“‘New Thinking on the Welfare State’ it seems is the title of the meeting, and they should know since Unum have been helping to systematically destroy the welfare state, as welcomed by various governments, since 1994.

“If you were planning to cause offence, you couldn’t have done a better job.

“Keep betraying the British disabled people and you’ll be waiting in the wings for a lot longer before Labour ever return to Government.

“I have spent the past 4 years exposing the links between the DWP, Atos Healthcare & UNUM Insurance. Some of your colleagues are very familiar with my work, which is to be considered by the UN within weeks, and I suggest that if you wish to be taken seriously as the Shadow Minister for Disabled People then you need to be familiar with this evidence.”

This blog wholeheartedly supports Mo Stewart’s position.

If you want to add your support, you can contact Anne McGuire by emailing anne.mcguire.mp@parliament.uk – and you might wish to include Ed Miliband and Liam Byrne (while he’s still there): ed.miliband.mp@parliament.uk and byrnel@parliament.uk

If you’d like to do more, feel free to broadcast that facts about Unum as widely as you can. There seems to be a media blackout on mention of this criminal organisation’s involvement with the state, so you cannot rely on the national news media. This means word of mouth – viral networking – is the only alternative.

Spread the word.

Oh, and Ed? Mr Miliband? We’ll all be waiting for you to make a slightly more solid commitment to the British people. You know what it is because we’ve made it perfectly clear already:

New policies on sickness, disability and incapacity benefits that are humane to claimants and rely on real medical evidence – not the opinions of an unqualified ‘decision-maker’ at the DWP.

Expel Unum from any position in which it may influence the government – including fringe events at party conferences. This may mean dismantling the DWP altogether as that organisation appears to have been terminally compromised.

End the work capability assessments. Find a different way to assess people’s ability to work – perhaps one that involves knowledge of what jobs are available and whether employers have any intention to take on people with limited abilities… Something practical, rather than the dribble that masquerades as current government policy.

And, for goodness’ sake, get rid of Byrne (and McGuire… and let’s not forget Stephen Timms) and replace them with backbenchers who actually understand and sympathise with the plight of benefit claimants who have been made to suffer under a needlessly brutal system.

You don’t dare betray the British people again.

If you do, you’ll have more than eggs to dodge, whenever you dare show your face in public.

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Catch-22 for PIP-claiming taxpayers, while giant corporations pay no taxes at all

11 Tuesday Jun 2013

Posted by Mike Sivier in Benefits, Business, Conservative Party, council tax, Disability, Health, Housing, Liberal Democrats, People, Politics, Public services, Tax, UK, USA

≈ 8 Comments

Tags

allowance, Atos, bedroom tax, benefit, benefits, biopsychosocial, Catch-22, Chancellor, Coalition, Conservative, corporation, council tax reduction scheme, David Cameron, Democrat, Department for Work and Pensions, descriptor, disability, Disability Living Allowance, disabled, DLA, DWP, employment, ESA, fit, George Osborne, government, health, Liberal, Mike Sivier, mikesivier, Mo Stewart, Personal Independence Payment, Pickles Poll Tax, PIP, politics, sick, social security, support, tax, Thames Water, Tories, Tory, unum, Vox Political, WCA, welfare, work, work capability assessment, work-related activity


A drop in the ocean:  That's what your taxes are, in comparison to the £30,450,000 owed by Thames Water in corporation tax this year. But Thames Water is paying nothing and, if you have to claim PIP or ESA in the future, that's what you're likely to get, in spite of paying up on time and in full.

A drop in the ocean: That’s what your taxes are, in comparison to the £30,450,000 owed by Thames Water in corporation tax this year. But Thames Water is paying nothing and, even though you’ve paid up on time and in full, if you have to claim PIP or ESA in the future, nothing is what you’re likely to get.

“Unum Provident is an outlaw company. It is a company that has operated in an illegal fashion for years.” – California Department of Insurance Commissioner, John Garamendi, 2005.

Is there really a connection between the roll-out of the government’s new Personal Independence Payment scam, outlawed (in the US) insurance company Unum, and the fact that Thames Water didn’t pay any taxes for the last financial year, despite profits totalling around £145 million?

Would any of you be surprised to read that the answer is yes?

PIP, the replacement for Disability Living Allowance, entered the second stage of its roll-out yesterday, when new claimants of working age, applying for disability benefit, were told they would be asking for it rather than DLA. New claimants in northern England have been applying for PIP since April.

The new system follows very closely the pattern established by the claim system for Employment and Support Allowance. ESA claim forms ask sick or disabled people to relate their symptoms to a series of ‘descriptors’, using ‘yes’ or ‘no’ answers (there is space to describe the individual issues but we have no proof that this receives any consideration at all).

The descriptors are based on a perversion of the so-called ‘biopsychosocial model’, created by American company Unum Provident to provide a defensible excuse for refusing to pay out on disability claims, at a time when the company was finding it hard to come up with the cash. Unfortunately (for Unum) the US legal system decided the excuse was not defensible after all and ordered Unum to reconsider 200,000 claims, back in 2006. Unfortunately (for British disability claimants) by then Unum already had its claws in the UK’s Department for Work and Pensions. For more on Unum, see Mo Stewart’s excellent series of reports, written over a three-year investigative period, here and here.

At least one major newspaper reported last year that the Atos-run work capability assessments were finding 70 per cent of ESA claimants fit for work. Of the remaining 30 per cent, 17 were put in the work-related activity group, meaning they were being asked to recover within one calendar year of the benefit being awarded, no matter what their condition. The remaining 13 per cent were put in the support group, which allows indefinite continuation of their claims.

Official government figures put entitlement for the benefit at 99.6 per cent. Less than half of one per cent of claims have been found to be fraudulent.

So there’s a bit of a credibility gap in the government’s system, isn’t there? A gap spanning 69.6 per cent of claimants at best, and 86.6 per cent at worst.

That is the Unum influence. The government has taken this company’s criminal (in America) scheme to deprive insurance policyholders of their payouts and applied it to the national insurance scheme that is the British benefits system, in order to deprive UK citizens of their benefits and rob them of the rewards due to them for paying their taxes.

Let’s all remember, please, that the majority of people claiming ESA have paid their taxes, on time and in full. How many big businesses operating in this country can say the same?

Not Thames Water, that’s for sure. The BBC reported yesterday that the UK’s biggest water firm, which is privately-owned, paid no corporation tax in the last financial year, despite making £145 million in (it says here) pre-tax profit.

The company says this is because it has offset the interest payments on its debts against its tax liability, and claimed allowances on capital project spending. It has been seeking government support for a £4.1bn project to build a new “super sewer” under the Thames, as reported in Vox Political last year.

The total amount of tax owed but offset in this manner is around £1 billion – but let’s not forget that this amount may drop. Part-time Chancellor George Osborne has already cut corporation tax by a quarter (from 28 per cent in 2010 to 21 per cent now) and there is no evidence that he won’t carry on slashing it, to help out his big business buddies and royally screw up the public finances.

Thames Water increased its bills by 6.7 per cent last year. It has reported an increase in revenues of six per cent. Doesn’t that mean that it only needed to raise its bills by 0.7 per cent in order to maintain profits? Doesn’t that mean that the remainder of that increase is down to the greed of its private shareholders, amounting to nothing less than robbery of the 14 million customers who – in this great era of consumer choice, ushered in by David Cameron – have absolutely no alternative water suppliers at all?

I wouldn’t want to be living in the Thames Water catchment area and applying for PIP right now. Also, what if you’re in that position, but living on social housing that the government decides is too big for you, triggering Bedroom Tax payments? How are you going to pay what you’ll owe on the Council Tax Reduction Scheme (the Pickles Poll Tax)?

If you’re in that position, just remember it’s a Conservative-led government that put you there, in Coalition with the Liberal Democrats. Did you vote for either of them in 2010?

If so, will you do it again in 2015?

If you say yes, you’ll be entitled to PIP on grounds of insanity – but then the government will lose voters, so that won’t be allowed.

Catch-22.

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Are British workers being lured into health insurance that will never pay out?

22 Monday Apr 2013

Posted by Mike Sivier in Benefits, Business, Corruption, Crime, Disability, Health, People, Politics, UK

≈ 8 Comments

Tags

Atos, back, biopsychosocial, British, chronic, Coalition, Department of Social Security, Disability Living Allowance, DLA, Employment and Support Allowance, ESA, fatigue, fibromyalgia, George Engel, government, health, healthcare, IB, illness, Incapacity Benefit, income, insurance, Lyme disease, mental, model, Multiple Sclerosis, nervous, pain, Personal Independence Payment, Peter Lilley, PIP, plan, protection, self-reported, subjective, syndrome, UK, unum, up, WCA, work, work capability assessment


unum

Working people in the UK could be facing a huge drain on their income, if they join an insurance scheme being offered by a discredited American firm.

It seems that the company behind the hated Work Capability Assessment that has denied disability benefits to thousands of genuinely sick and disabled people, has begun a mass-marketing campaign to encourage able-bodied members of the British public to invest in ‘Income Protection Insurance’, and another scheme known as the ‘Back-up Plan’.

This insurance scheme is only available via the workplace, and it is understood that it has been designed to ensure that the company can resist paying out whenever a claim is made.

In other words, if you join the scheme, you will be giving away your money to a criminal firm. If you become ill or suffer disability in the future, you will not receive a single penny of the insurance money that is due to you.

That is the allegation against Unum Insurance, the American giant that has spent more than two decades advising successive British governments on how to avoid paying sickness and disability benefits to the most deserving claimants in our society.

If you have been contacted in the workplace and offered a chance to take out this insurance, please get in touch. Your experience of this system and insights into its operating procedures could be invaluable.

For those who don’t know the Unum story, you can read some of it here. Unum’s bosses devised their current system to combat the rise of ‘subjective’ illnesses such as ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia, multiple sclerosis, Lyme disease.

The solution devised by the bosses was to reduce the number of successful claims it paid out, by aggressively disputing whether the claimant was ill. So the company skewed its medical examinations to its own favour by questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims.

The acknowledged basis for this attitude is the Biopsychosocial Model of illness, developed by the psychiatrist George Engel – but it’s a bastardised version, removing the bio- and -social aspects and concentrating on the ‘psycho’. This version of the theory, as used by Unum, has been utterly discredited. It is nonsense, totally disregarding such inconvenient medical procedures as diagnosis and prognosis, or limited life expectancy.

But it proved a great success for Unum – so much so that the UK government sought advice from the company in the early 1990s, when Peter Lilley was running the Department of Social Security. He wanted to reduce the number of disability claimants on his books, and Unum was only too happy to help out. It has been at the heart of disability benefit policy ever since.

We have Unum to thank for the Work Capability Assessment (administered by another private firm, Atos – an IT firm that has no expertise in healthcare, even though that word occasionally appears on its company logo). The recommendations made by Atos representatives, following these assessments, have led to the deaths of at least 73 genuinely ill people every week (according to government figures that are now almost a year old), who have claimed Employment and Support Allowance (formerly Incapacity Benefit). The real figure may be much higher.

The Coalition government considers this to be a great achievement and has now begun expanding the Work Capability Assessment regime to cover claims for Disability Living Allowance, now branded the Personal Independence Payment, with criteria that are much more difficult to achieve.

We can all expect many more deaths to arise from this.

Now, it seems, Unum believes the UK is ripe for bleeding – and that is why it is trying to sell its bogus insurance to working people here.

If you have been contacted, please get in touch.

For further information (with annotations pointing to the really damning evidence) see ‘The Hidden Agenda’ by disability researcher Mo Stewart.

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Welfare benefits: ‘The Lords regret…’

13 Wednesday Feb 2013

Posted by Mike Sivier in Benefits, Conservative Party, Disability, People, Politics, UK, unemployment

≈ 18 Comments

Tags

appeal, Atos, benefit, benefits, biopsychosocial, building regulations, Chris Grayling, Coalition, Conservative, David Freud, Department for Work and Pensions, disability, Disability Living Allowance, disabled, DLA, DWP, electrical safety, Employment and Support Allowance, ESA, government, Iain Duncan Smith, Jobseeker's Allowance, JSA, Labour, Lord, Maria Miller, mark hoban, Mike Sivier, mikesivier, Parliament, people, Personal Independence Payment, PIP, politics, reassessment, Social Fund, statutory instrument, suicide, Tories, Tory, unemployment, Universal Credit, unum, Vox Political, welfare, Welfare Reform Act, Workfare


freudIf the Palace of Westminster ever had a rat infestation it must be personified in the body of David Freud.

This deadly pest, who is likely to cause disease and infirmity among many of the lower-earning members of society, began his political career when he was appointed by the Labour Party to review the welfare to work system – and he led Labour well off-track in doing so.

His recommendations called for more private sector involvement in the welfare system – which already had considerable interference from Unum and Atos, as readers of this and other blogs will be aware. He wanted to force most people receiving benefits to take part in some form of employment – or prepare for it – as a condition of receiving support.

This is, of course – counter-intuitive. If they could find employment, they wouldn’t be claiming benefits – so what kind of work would they be required to do? It turns out we discovered the answer during his tenure with the government: Illegally-coerced work. Slave labour.

Having done as much damage as he could with Labour, Freud jumped ship to the Conservative Party, like the rat that he is. It is as the Conservative Under-Secretary of State for Work and Pensions in the House of Lords that he has done the most damage.

It is well-known that the Tories have adopted his disastrous ideas wholesale, and the involvement of Atos, with its work capability assessment pushing the Unum-inspired biopsychosocial model of “it’s all in your mind” healthcare on the seriously-ill, has grossly inflated the death – and suicide – rate among Employment and Support Allowance claimants.

These deaths are on Freud’s conscience, just as much as they are on Iain Duncan Smith’s, Chris Grayling’s, Maria Miller’s, and Mark Hoban’s, to name just a few.

I mention the above because this loathsome creature is even now lurching towards the House of Lords to inflict even more damaging changes to the social security system in the form of a series of statutory instruments. For those who are unfamiliar with the Parliamentary process, these set out the rules that form the nitty-gritty, the details of legislation that are underpinned by Acts of Parliament. Crucially, they do not require an affirmative vote to pass into law.

Today he is bringing the following:

Universal Credit Regulations 2013 – seting out entitlement to, and calculation of, an award of Universal Credit, the new single payment for people who are out of work or working on a low income.

Because no vote is necessary, it is impossible to block this instrument. However, Baroness Sherlock is to move an addition to the motion: “this House regrets that the Regulations will not achieve their aim of making work pay for all and in fact will provide lower work incentives for 2.1 million households; will have the effect of penalising savers; will result in a cut in childcare support for working families; will result in cuts to the income of some of the poorest and most vulnerable in the country and will have a disproportionate impact on women and lone parent families; do not meet the needs of disabled people; do not provide adequate treatment of small businesses and the self-employed; and risk pushing many families into arrears and homelessness.”

In other words, they will do the exact opposite of whatever Lord Freud and his Tory paymasters are saying.

A similar amendment has been proposed to the Social Security (Personal Independence Payment) Regulations 2013, expressing concern about the impact of replacing Disability Living Allowance with the Personal Independence Payment (PIP), under the rules for entitlement and calculation they lay down.

Lord McKenzie of Luton will move: “this House is concerned about the impact of the replacement of Disability Living Allowance with Personal Independence Payment; is concerned about the lack of a full impact assessment on carers; regrets the lack of a cumulative impact assessment of all the changes hitting disabled people; regrets the fact that vital safeguards have not been introduced to ensure that additional pressure is not put on carers, that people do not lose their freedom to work and that they are not driven to already-stretched NHS or social care services; believes that while Disability Living Allowance needed reform it should have been started with the needs of disabled people and not with a budget cut; notes that some 600,000 fewer people will be in receipt of Personal Independence Payment by May 2018 compared to those who would have been entitled under Disability Living Allowance; and further notes that some 25,000 disabled people could be forced to give up their jobs because they can no longer afford the extra costs of getting to work.”

Don’t be under any illusions – the government will vote down these amendments. It will be up to us – those who are directly affected by these changes – to monitor what happens and reveal the truth of these statements.

There are other statutory instruments due to go through today. The Jobseeker’s Allowance Regulations 2013 and Employment and Support Allowance Regulations 2013 limit both benefits so they will only be payable based on a person’s National Insurance contribution record; those who do not qualify on that basis will instead claim Universal Credit.

The Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations 2013 address the administration of all these benefits, revising the appeals process so that claimants must first apply for a disputed decision to be reconsidered by a decision maker (i.e. an internal review) before they can make an appeal to an external tribunal. This is the much-lamented rule that, it has been claimed, will dump appellants onto Jobseekers’ Allowance – even though they cannot possibly find work – until their reassessment has taken place.

The Social Security (Payments on Account of Benefit) Regulations 2013 introduce two new types of payment to replace Social Fund payments, either for an advance payment of benefit or as a loan to buy a household item. They outline the criteria which the Secretary of State must use when determining whether or not to make them.

And the Social Security (Loss of Benefit) (Amendment) Regulations 2013 support changes introduced by the Welfare Reform Act 2012, including sanctions of up to 3 years’ loss of benefit that may be imposed following conviction for a benefit fraud offence.

It is clear that this is a toxic mixture of changes, designed to bring as much misery as possible down on an already-downtrodden sector of society.

Oh, and if this was not bad enough, it will be followed by a debate on the Building Regulations &c. (Amendment) Regulations 2012, which includes another Motion to Regret: “This House regrets Her Majesty’s Government’s decision… to change the provisions on electrical safety in the home, which will be detrimental to public safety.”

Detrimental to public safety. We have a government that sets out to do more harm than good.

Any peers taking part in these debates should be ashamed to be part of such a debased administration.

What they are doing is criminal – we discovered yesterday that this is exactly true, when Cait Reilly won her case against the illegal Workfare scheme that has been forced on thousands of jobseekers, and would have been forced on thousands more if it had not been challenged.

Unfortunately, this out-of-control government’s reaction was to change the law to suit itself.

This is what happens when villains are allowed to make up the rules.

Postscript: As I type this, I’m listening to Prime Minister’s Questions. He just mentioned the Conservative candidate in the Eastleigh by-election, using the now-boring “Ronseal” comparison as someone who “does exactly what it says on the tin”. Look at the amendments to the regulation before the Lords today; it is clear that the Tories do exactly the opposite of what it says on the tin.

Perhaps a better word than “Ronseal” would be “unhinged“.

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Mark Hoban: A message isn’t scaremongering if it’s true

09 Saturday Feb 2013

Posted by Mike Sivier in Benefits, Conservative Party, Disability, Labour Party, Liberal Democrats, Politics, UK

≈ 19 Comments

Tags

Atos, Atos Healthcare, benefit, benefits, biopsychosocial, Coalition, Conservative, court, Department for Work and Pensions, disability, Disability Living Allowance, disabled, DLA, DWP, Employment and Support Allowance, ESA, fibromyalgia, government, Group, health, Health and Social Care Act, IB, Incapacity Benefit, Labour, Liam Byrne, Liberal, Liberal Democrat, mark hoban, mental health, Mike Sivier, mikesivier, National Health Service, NHS, Parliament, people, Personal Independence Payment, PIP, politics, public accounts committee, sick, Tories, Tory, tribunal, Vox Political, WCA, welfare, work capability assessment, work-related activity, WRA, WRAG


Mark Hoban, sending even his colleagues to sleep in another Parliamentary debate.

Mark Hoban, sending even his colleagues to sleep in another Parliamentary debate.

Employment minister Mark Hoban has accused Parliament’s public accounts committee of “scaremongering” after it attacked the Department for Work and Pensions’ work capability assessment.

He said, according to the BBC: “Rather than scaremongering and driving down the reputation of the WCA, critics might like to acknowledge the fact that independent reviews have found no fundamental reforms are needed to the current process because of changes we’re making.”

That sounds a lot like self-justifying nonsense to me.

I wonder whether we may reasonably expect any better of him, when we know he edits comments on his own Facebook page to remove anything remotely critical. If you don’t believe me, just you go there and try it!

But okay, let’s give him the benefit of the doubt and try examining the committee’s criticisms at ground-level. We all know my partner, Mrs Mike, has been – and is continuing to go through – the assessment system. Let’s go through the committee’s conclusions with reference to her example.

The first conclusion was that “the decision-making process for new Employment Support Allowance applications and Incapacity Benefit reassessments all too often leads to the wrong decisions and is failing far too many people”. The decision after Mrs Mike’s assessment was that she should go into the work-related activity group for ESA. It was only after she had an interview with a WRA provider – six months after the assessment – that they told us the decision was wrong, she should be in the support group, and we should seek reassessment. So in our case, I find that the committee’s conclusion was ACCURATE.

Conclusion number two: “The Work Capability Assessment may unduly penalise people with specific health problems. The one-size-fits-all approach is not appropriate for particular groups, for example, people with mental health, rare or variable conditions. The process is too inflexible and makes it extremely difficult for individuals with particular conditions to demonstrate the impact of their conditions on their ability to work. Too often the process is so stressful for applicants that it can impact on their health.” Mrs Mike has fluctuating conditions – fibromyalgia, mental health problems, and a back condition that causes pain, although the level of that pain can vary from day to day. As I have demonstrated in my response to the first conclusion, she was put into the wrong group – in the opinion of a work-related activity provider employed by the Department for Work and Pensions. That’s pretty conclusive! I was present at the work capability assessment interview and can assure any doubters that it is an extremely stressful process – not just physically, because claimants have to prove the limits of their physical abilities, but also emotionally. It took her days to recover her composure after the assessment. There are continuing issues to do with mental health, as the current nature of the process – leaving people waiting for months at a time before a decision, or until they can move on to the next step, then the disappointment of being told there was a mistake and they have to go through the whole process again – seems engineered to create mental instability. Therefore I must find that in this case also, the committee’s conclusion was ACCURATE.

The next conclusion states: “The Department does not know the full cost to the taxpayer of the overall decision-making process for Work Capability Assessments. Whilst some costs are known, such as the £26.3 million paid to HM Courts and Tribunals Service for its work on appeals, there is little information on the cost and impact on the National Health Service or on some of the internal interactions within the Department.” Whilst it is true that Mrs Mike has been to see her doctors (physical and mental) since her assessment took place, and throughout the ensuing mess, I would not try to put a price on that extra process. Therefore I cannot say for sure whether this conclusion is accurate or not. However, we all know that a high proportion of appeals are won – more than 90 per cent of those in which the claimant has sought legal representation, in fact, so it is reasonable to believe that the government is paying a high price to the courts. On that basis alone, it is reasonable to question whether the government is getting value for money.

Conclusion four: “The Department has failed to develop a competitive market for medical services. The market for medical service providers is under-developed and Atos Healthcare is currently the sole supplier for all the Department’s medical assessments. It has also been awarded two of the three current contracts for the Personal Independence Payment. The Department is too relaxed about the risk to value for money resulting from a dependence on a monopoly supplier, and on the limitations this has on the Department’s capacity to remedy poor performance.” Personally, I am unhappy with the thought that a profit-centred marketplace should be created around people’s health. This is why I opposed the Health and Social Care Act that has caused so much harm to the NHS in England since it became law. However, the point that it is hard to remedy poor performance when a single company holds a monopoly on assessments is reasonable. Mrs Mike’s assessment was carried out by Atos. That assessment reached a wrong conclusion. Who will carry out her reassessment? Atos. You see the problem.

Worse than that, though, is the underlying issue – that Atos has been briefed to push as many people off-benefit as it can. This is why the work capability assessment is based on the “psycho” part of the biopsychosocial model, itself a discredited medical theory. The aim of the assessment process is to tell claimants that their illnesses or disabilities are all in their minds, and that in fact they are perfectly capable of work. Considering the Labour Party’s policy is reprehensibly shoulder-to-shoulder with that of the Coalition in this regard (Liam Byrne very recently said Labour would continue reforms of social security benefits along similar lines) there seems very little hope for people with disabilities in the future. I find the committee’s conclusion ACCURATE in the case of Mrs Mike, and note with trepidation that the future seems bleak, no matter what government we have in the future.

I do not intend to address the fifth and sixth conclusions as they seem to be operational matters within the Department for Work and Pensions. Before Mr Hoban claims any victories, I should add that all the reports I have seen tend to bear out the comments of the public accounts committee.

But the final conclusion states: “The Department must improve its internal processes to improve the quality of decision-making and contract management. The size of the Department and its impact on individuals and on the public purse requires us to have the utmost confidence in the capability of the Department to deliver. Robust systems are a crucial part of this. We are concerned that the Department is unduly complacent regarding the quality of the decision-making process, particularly given the hardship which can be caused to individuals when the decision is wrong.” Clearly, neither I nor Mrs Mike have any confidence in the DWP’s ability to deliver the right decision regarding a person’s ability to work. Therefore I find the committee’s comment about complacency ACCURATE. The hardship which can be caused to individuals is something my partner and I are being forced to face at the moment – as a possibility, should a reassessment decision go against her. We are all familiar with cases in which people have either died from the worsening of their health conditions (conditions denied by the DWP and Atos) or from suicide provoked by a worsening of their mental health due to the assessment process and fear for the future of themselves and their families. These are real issues.

By suggesting such fears are “scaremongering”, Mr Hoban hugely weakens his own case.

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Unum, Atos, the DWP and the WCA; Who gets the blame for the biopsychosocial saga?

18 Friday Jan 2013

Posted by Mike Sivier in Benefits, Conservative Party, Disability, Labour Party, Liberal Democrats, Politics, UK, unemployment

≈ 20 Comments

Tags

All Work Test, appeal, Atos, benefit, benefits, biopsychosocial, Cardiff University, Centre, CFS, chief medical officer, Chronic Fatigue Syndrome, Chronic Pain, Coalition, Conservative, Department, Department for Work and Pensions, descriptor, disability, disabled, doctor, DWP, Employment and Support Allowance, ESA, fibromyalgia, fit for work, George Engel, government, health, Helen Goodman, House of Commons, IBS, Irritable Bowel Syndrome, John LoCascio, Kate Green, Labour, Liberal, Liberal Democrat, LIMA, Logical Integrated Medical Assessment, Lyme disease, Mansel Aylward, ME, Mike Sivier, mikesivier, Multiple Sclerosis, Myalgic Encephalomyelitis, New Labour, Parliament, Pathways, Pensions, people, Personal Capability Assessment, politics, Professor, Psychosocial, Research, sick, Tories, Tory, unemployment, unum, UnumProvident, Vox Political, WCA, welfare, work, work capability assessment


Mansel Aylward, former chief medical officer at the Department of Work and Pensions, now director of the (UnumProvident) Centre for Psychosocial and Disability Research at Cardiff University: Architect of misery?

Mansel Aylward, former chief medical officer at the Department of Work and Pensions, now director of the (UnumProvident) Centre for Psychosocial and Disability Research at Cardiff University: Architect of misery?

If we know anything at all about the Work Capability Assessment for sickness and disability benefits, we know that it doesn’t work. In fact, it kills. There is a wealth of evidence proving this, and if any readers are in doubt, please take a look at the other article I am publishing today, MPs tell their own Atos horror stories.

Much has been made of this fact, without properly – in my opinion – addressing why it doesn’t work. The apparent intention is an honourable one – to help people who have been ‘parked’ on disability benefits back into work, if it is now possible for them to take employment again, and to provide support for those who cannot work at all. What went wrong?

Let’s start at the beginning. The WCA is, at least nominally, based on the biopsychosocial model developed by George Engel. He wanted to broaden the way people think about illness, taking into account not only biological factors but psychological and social influences as well. He contended that these non-biological influences may interfere with a patient’s healing process.

The idea has been developed to suggest that, once identified, the non-biological factors inhibiting healing would be neutralised via a variety of support methods. Stressful events in a person’s life or environmental factors are acknowledged as having real effects on their illness, and it can be seen that this confers a certain amount of legitimacy on symptoms that are not currently explainable by medicine.

Engel stated, in 1961, “Many illnesses are largely subjective – at least until we as observers discover the parameters and framework within which we can also make objective observations. Hyperparathyroidism… was a purely subjective experience for many patients until we discovered what to look for and which instruments to use in the search.” He also warned that people engaged in research should “see what everyone else has seen and think what nobody else has thought” – as long as they don’t automatically assume that their new thought must be correct.

The Engels theory forms the basis of the system of insurance claims management adopted by US giant Unum when its bosses realised that their profits were being threatened by falling interest rates – meaning the company’s investments were losing value – and a rise in claims for “subjective illnesses” which had no clear biological markers – Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), Fibromyalgia, Chronic Pain, Multiple Sclerosis, Lyme Disease, even Irritable Bowel Syndrome (IBS).

As I wrote on Wednesday, Unum adapted the biopsychosocial model into a new medical examination that stripped it of its ‘bio’ and ‘social’ aspects in order to concentrate on the ‘psycho’ – with a relentless emphasis on an individual claimant’s beliefs and attitudes.

The new test aggressively disputed whether the claimant was ill, questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims.   The thinking behind it was: Sickness is temporary. Illness is a behaviour – all the things that people say and do that express and communicate their feelings of being unwell. The degree of this behaviour is dependent on the attitudes and beliefs of the individual, as well as the social context and culture. Illness is a personal choice. In other words: “It’s all in the mind; these people are fit to work.” (as I mentioned in When big business dabbles with welfare; a cautionary tale)

Already we can see that this is a perversion of Professor Engel’s theory, using it to call an individual’s illness into question, not to treat it. Yet this is the model that was put forward to the Department of Social Security (later the Department of Work and Pensions) by its then-chief medical officer, Mansel Aylward, in tandem with Unum’s then-second vice president, John LoCascio.

Together they devised a new ‘All Work Test’ that would not actually focus on whether an individual could do their job; instead it would assess their general capacity to work through a series of ‘descriptors’. Decisions on eligibility for benefit would be made by non-medical adjudication officers within the government department, advised by doctors trained by Mr LoCascio. Claimants’ own doctors would be marginalised.

When New Labour came to power, Mansel Aylward was asked to change the test to reduce the flow of claimants with mental health problems. In came the ‘Personal Capability Assessment’, which again focused on what a person was able to do and how they could be supported back into work.

It is at this point that US IT corporation Atos Origin (now Atos Healthcare in the UK) became involved. The task of administrating the PCA was contracted out to a company which was taken over by Atos, meaning its employees – who had no medical training – could now assess claims for sickness and disability benefits, using the company’s Logical Integrated Medical Assessment tick-box computer system. These evaluations proved unreliable and the number of successful appeals against decisions skyrocketed.

So in 2003 the DWP introduced ‘Pathways to Work’, in which claimants – now labelled ‘customers’ – had to undertake a work-focused interview with a personal advisor. If they weren’t screened out by the interview, they would go on to mandatory monthly interviews where they would be encouraged to return to work and discuss work-focused activity. I can assure readers, from personal experience with Mrs Mike, that this activity remains a prominent part of the DWP’s sickness and disability benefit policy.

Mansel Aylward is no longer at the DWP, though. In 2004 he was appointed director of the UnumProvident Centre for Psychosocial and Disability Research at Cardiff University (it has since dropped the company title from its name). Was this as a reward for services rendered in getting Unum and its practices into the heart of the UK government?

Let’s have a look at some of the ‘descriptors’ that are being used to determine a claimant’s – sorry, customer’s – fitness for work in what is now called the ‘Work Capability Assessment’. I am grateful to Helen Goodman, Labour MP for Bishop Auckland, who provided this information during yesterday’s debate on the Atos WCA in the House of Commons. She said a person who…

“Cannot mount or descend two steps unaided by another person even with the support of a handrail”;

“Cannot, for the majority of the time, remain at a work station, either…standing unassisted by another person…or…sitting…for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion”

“Cannot pick up and move a one litre carton full of liquid”;

“Cannot use a pencil or pen to make a meaningful mark”;

“Cannot use a suitable keyboard or mouse”;

“Is unable to navigate around unfamiliar surrounding, without being accompanied by another person, due to sensory impairment”;

“Is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, not able to reach a toilet quickly”;

“At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration”;

“Has an epileptic fit once a fortnight”;

“Cannot learn anything beyond a simple task, such as setting an alarm clock”;

“Has reduced awareness of everyday hazards leading to a significant risk of…injury to self or others; or…damage to property or possessions such that they frequently require supervision”;

“Cannot cope with minor planned change” such as a change to lunchtime;

“Is unable to get to a specified place with which they are familiar, without being accompanied by another person”

… is “fit for work”.

A person in the following category is also deemed fit for work, if: “Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual.”

Kate Green, Labour MP for Stretford and Urmston, added: “My constituents told me categorically last week that they believe that the whole system was deliberately designed and operated to trick them — to make them incriminate themselves and to catch them out.

“They firmly believe that the system is deliberately designed, not to assess and then help them into work if they are fit for it, but simply to stop paying benefits wherever possible.

“There are far too many instances of trickery and misleading people and of distorting what they have done, said and reported and drawing conclusions from that. That is happening far too often.

“It is an absolute disgrace that we should run a public assessment process in such a discredited way.”

It seems to be a result of Professor Aylward’s work that the main influence on government welfare reform has been a perversion of a perversion of a theory that has not been shown to work. Authentic evidence is disregarded by those in power, who clearly continue to persecute the sick while feeding the profits of private concerns.

I wonder what he would have to say, if he were to be confronted by the evidence of what his policies have done to the sick and disabled of this country – as spelled out, in the House of Commons, by MPs from many parties.

Afterthought: It should be noted that Professor Aylward is on record as having expressed doubts about the Work Capability Assessment and the current system, as run by the government, with the caveat that he has not been involved for several years.

He told the Black Triangle Campaign: “I will make myself aware … but I think that I’m a man of integrity … and if I think that the Work Capability Assessment … test or whatever … is not proper … I will speak out against it.”

In the light of what happened while he was at the DWP, I leave it to readers to judge whether he will.

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When big business dabbles with welfare; a cautionary tale

16 Wednesday Jan 2013

Posted by Mike Sivier in Benefits, Business, Conservative Party, Crime, Disability, Health, Labour Party, Liberal Democrats, Politics, UK, USA

≈ 11 Comments

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Atos, benefit, benefits, biopsychosocial, chronic, Coalition, Conservative, Department for Work and Pensions, descriptors, disability, Disability Living Allowance, disabled, DLA, DWP, Employment and Support Allowance, ESA, fatigue, fibromyalgia, Francesca Martinez, Frank Field, government, health, Incapacity, Incapacity Benefit, Jack Gilligan, John LoCascio, Labour, Liberal, Liberal Democrat, Lyme disease, Mike Sivier, mikesivier, model, Multiple Sclerosis, New Labour, pain, people, Peter Lilley, PIP, politics, sanctions, sick, syndrome, Tony Benn, Tony Blair, Tories, Tory, unum, Vox Political, WCA, welfare, work capability assessment


unum“Jack Gilligan, who was the Democratic governor of Ohio… said ‘You know there will never be democracy in America when big business can buy both parties and expect a pay-off, whichever one wins. And you know, a touch of that may possibly have spread in this direction.” Tony Benn.

I have been researching the relationship between US insurance giant (and lawbreaker) Unum and successive UK governments – Conservative, New Labour and Coalition – and the minimal research I have managed so far tells me that, if there’s one thing the Labour Party needs to do to ensure its electability in 2015, that thing is the expulsion of Unum and all private insurance firms, their subsidiaries, partner companies, and people who have worked with or for them, from any position of influence. Kick them right out!

Any government that fraternises with these vampires puts corporate profits above the well-being of its citizens. That is clear from what I have read. I want to go into certain aspects in detail, but before that, you deserve to know the details, so I’ve written a little story for you:

Once upon a time, a big insurance company had a little problem. It had been making money hand-over-fist by investing people’s premiums in high-interest portfolios, but interest rates were falling and new kinds of ‘subjective illness’ had arisen, for which medical science was not prepared – ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia, multiple sclerosis, Lyme disease.

The solution devised by the bosses was to reduce the number of successful claims it paid out, by aggressively disputing whether the claimant was ill. So the company skewed its medical examinations to its own favour by questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims.

“Sickness is temporary,” they said. “Illness is a behaviour – all the things that people say and do that express and communicate their feelings of being unwell. The degree of this behaviour is dependent on the attitudes and beliefs of the individual, as well as the social context and culture. Illness is a personal choice.” In other words: “It’s all in the mind; these people are fit to work”.

Around the same time, a small country had a big problem with people claiming out-of-work benefit because they were ill. This was not a problem because they were lying about being ill – fraud amounted to less than one per cent of claims. Nor was it a problem because too many people were claiming – benefit levels were among the lowest of any countries nearby, and claims were on a par with those other countries.

No, the problem was that the man running the system, whose name was Peter**, wanted to make money out of it.

So he hired the boss of the big insurance company, whose name was John***, and asked him to help out. John said, “We have a great test that you can use! Instead of asking whether someone can do their job, you assess their general capacity to work, with a series of – we call them – descriptors. One could say the person ‘Is unable to cope with changes in the daily routine’, ‘Is frightened to go out alone’. Then the results get passed on to different people – adjudication officers – who judge whether they deserve your benefit. But the clever bit is that these officers aren’t doctors – the customer might be saying they’re sick but medical evidence has nothing to do with what the test is about! We’ll train your adjudicators – for a price. We’ve even got a sexy name for the test: It’s bollocks!”*

Off went Peter to try it and, lo and behold! The rise in claimants came to a halt, as if by magic. But it wasn’t magic. It was bollocks.

Meanwhile, the insurance company was making out like a bandit. Not only was it now at the heart of the small country’s government, it was able to make money from the claimants as well. Before the new rules came into effect, it advertised for customers, saying the new system meant “if you fall ill and have to rely on state incapacity benefit, you could be in serious trouble!”

Before long, the big insurance company found it was even bigger, with a quarter of all its post-tax income being paid by people in the small country.

Meanwhile, back at home, people had started to complain about the big company. It was a big, NASTY company, they said, because it had forced them to accept less when they claimed than their policies offered. The government there found that the big company had relied too much on in-house professionals; had constructed doctors’ or examination reports unfairly, for its own benefit; had failed to evaluate claimants’ conditions in their totality; and had placed an inordinate burden on claimants to justify why they should receive the benefits for which they had paid. Many claims were found to need re-examination.

That did not make a scrap of difference to the people running the sickness benefit system in the small country that had asked for the big nasty insurance company’s help. An election had happened and Peter had been asked to leave, but the new people in charge, Frank**** and Tony*****, were keen to capitalise on what had gone before and transform their welfare system into a new marketplace – a source of revenue, profitability and economic growth.

With help from the big nasty insurance company, they decided that the solution was not to cure the sick – or even to prevent their sickness in the first place – but to convince them that work is therapeutic, aids recovery and is the best form of rehabilitation. In other words, bollocks*. This way, with the help of the big nasty company’s bollocks* tests and adjudicators who based their decisions on bollocks*, they could say the problem was with the person who had the illness. Their behaviour and beliefs became the focus of the government’s moral judgement and action. If they did not change their ways, then sanctions would be used as a “motivational tool” – and people would be starved back into work.

And that, dear child, has continued to this very day! People claiming sickness or disability benefits in the small country, which is called the United Kingdom, have to take a test in which medical evidence plays a tiny role, run by people who are not doctors and judged by people who are not doctors. Many of these decisions have been found to be unfair, and have often been found to have failed to evaluate claimants’ conditions in their totality – which is why people with terminal cancer have been found fit for work. Many claims have been found to need re-examination.

You can see the hand of the big nasty insurance company at work, can’t you!

That is because the big nasty insurance company, which is called Unum, has been at the heart of the small country’s government ever since it was first invited in. And they intend to live happily ever after, at the public’s expense.

“A lot of people think that disabled people don’t have sex, but this is not true, because the government are screwing us hard.” Francesca Martinez, The News Quiz, BBC Radio 4, January 11, 2013.

*I should apologise for the fault in my computer. Every time I try to type – I’ll just cut and paste it in here – “the biopsychosocial model” or any combination of those words, it comes out “bollocks”. Sorry!

**Peter Lilley

***John LoCascio

****Frank Field

*****Tony Blair

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