Petition demands fibromyalgia test be fit to work

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allowance, Department, Disability Living Allowance, DLA, DWP, employment, ESA, fibromyalgia, government, health, Mansel Aylward, medical, Mike Sivier, mikesivier, Pensions, people, petition, point scoring system, politics, rheumatologist, sick, social security, support, Universal Credit, Vox Political, welfare, work

The Department for Work and Pensions is being told to sort out its benefit assessment system after campaigners said it is rigged against people who suffer from Fibromyalgia.

The petition – ‘Change DWP Medicals for Fibromyalgia’ – may be found here.

Long-term readers will know that Fibromyalgia is one of the conditions suffered by Mrs Mike, partner of Vox Political writer Mike Sivier. She has hijacked this space to post the following message from the petitioners:

“In brief, the petition asks that Department of Work and Pensions medicals for Fibromyalgia be carried out by a qualified rheumatologist, and that the decision regarding the receipt of benefits not be based on the current point-scoring system.

“The full petition reads:

“‘We, the undersigned, call on the British Government to ask that DWP medicals for Fibromyalgia be carried out by a qualified rheumatologist, and that the decision made about the receipt of benefit not be based on a point scoring system.’

“‘At the moment the DWP are using an outside agency to carry out medicals on people with medical conditions, and using a point scoring system to decide whether or not people are entitled to benefits.

“‘Most of the medicals are carried out by a nurse or other healthcare professional in less than an hour by asking a few targeted questions. With a condition like Fibromyalgia, it takes a qualified rheumatologist to diagnose the condition and understand the treatment that needs to be implemented to attempt to manage the pain of the condition.

“‘A rheumatologist would understand the pain and associated problems that Fibromyalgia sufferers face on a daily basis. Yet the nurse or health care professional that fills in the forms for the medical sees someone for less than an hour with no understanding of the condition and how it affects each person individually.

“‘It is not possible for someone of this level to understand the issues that Fibromyalgia suffers face, and the medicals should at the very least be carried out by a rheumatologist.

“‘During the medical you are assessed on how much you can move in certain directions. At no point are they taking any interest in how much pain you are in whilst this is going on, or how many painkillers you have to take afterwards.

“‘A favourite question is, “How far can you walk without discomfort?” The answer for a most Fibromyalgia sufferers is over 200 metres if they absolutely have to. What they don’t ask is, “How much pain are you in?” Most Fibromyalgia sufferers are in pain before they start to walk; walking just increases the pain.

“‘The point scoring system is stupid and unfair and needs to be abolished. Fibromyalgia sufferers are being consistently turned down for benefits that they should be entitled to, as this is a condition recognised by the DWP – and I quote, “Professor Aylward, on behalf of the DWP, reaffirmed that the DWP recognises fibromyalgia as a real and disabling condition, and not just something that is ‘all in the mind.'” If this is recognised by the DWP as being a “real and disabling condition” then why are diagnosed sufferers being refused DLA and ESA?

“‘It has been reported that Fibromyalgia Sufferers often suffer more pain than people diagnosed with rheumatoid arthritis.

“‘Despite the DWP’s statement, Fibromyalgia sufferers are being discriminated against, as the condition is seen as “invisible”, like many other conditions.'”

To sign the petition, go to this site and click the “Sign the petition” button near the bottom of the page. For more Fibromyalgia, Chronic Fatigue Syndrome and Natural Wellness news, sign up for free HealthWatch newsletters.

That’s the end of Mrs Mike’s bit. As someone who lives with a person who has Fibromyalgia, dear reader, you may safely conclude that I know a fair few things about the subject myself. I sat in on Mrs Mike’s work capability assessment and I can vouch for the truth of the statements regarding questions asked during that interview and the physical examinations that take place.

Mrs Mike’s mobility was checked very thoroughly during her assessment but no interest has ever been shown in the fact that she spent the next three days on the sofa in our living room, unable to move because of the pain she was suffering.

The question about walking is far more subjective. Obviously, after the WCA, Mrs Mike couldn’t walk anywhere without discomfort but, even when she is well enough to move, pain always sets in within a few paces and the chance to sit down is regarded as a blessed relief.

Yet Mansel Aylward (for it was he) said the DWP recognises Fibromyalgia as a “real and disabling condition”.

While these tests are carried out by people who are not qualified to recognise the symptoms of the condition and the problems it causes, the DWP is only paying lip-service to its claims about Fibromyalgia.

Please sign the petition and help ease the lives of people with Fibromyalgia across the UK.

Follow me on Twitter: @MidWalesMike

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

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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?

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.