Posts Tagged ‘Benefits Agency Medical Services’

Private Eye from 1995 on Unum and Peter Lilley in the Tory Government

April 13, 2015

As the left-wing blogs have repeatedly pointed out, the Tories’ welfare reforms, in which the disabled are assessed and routinely denied benefit for being supposedly ‘fit for work’, are based on the quack pseudoscience of the American insurance giant, Unum. It’s pet doctors dreamed up the profitable idea that any and every kind of work was useful in helping the sick and disabled to recover. This was enthusiastically taken over by the Tories and New Labour, as it justified throwing hundreds of thousands off disability benefit on the spurious grounds that they could work.

The results have been horrendous. Severely mentally ill people have been driven to the point of suicide by the threat of losing their benefits. Doctors and psychiatrists have seen increased numbers coming to them suffering from stress due to assessments. Critically ill people, including those dying of cancer, have been told that their benefits have been stopped, as they are well enough to work.

In his ‘Footnotes’ column in Private Eye’s issue for Friday, 16th June 1995, Paul Foot published this article on Unum, which had been brought into John Major’s Tory government by Peter Lilley. Here it is:

Doctor On Call

To help him in his bid to save £2 billion a year by slashing the benefits of disabled people, Peter Lilley, social services secretary, has hired the vice-president of a big multinational private insurance company which is using the benefit cuts to boost its sales.

Overcoming the xenophobia to which he so often gives voice at Tory party conferences, Mr Lilley has appointed an American.

Founded in Portland, Maine, in 1848, the Unum Corporation describes itself as “the world’s leading light in disability insurance”. Unum Ltd, its British arm, is based in Dorking, Surrey. It issued its annual report last September, when chairman Ward E. Graffam enthused about “exciting developments” in Britain.

He explained: “The impending changes to the State ill-health benefits system heralded in the November 1993 Budget will create unique sales opportunities across the entire disability market and we will be launching a concerted effort to harness the potential in these.” In January, the full extent of Lilley’s plans to replace invalidity benefit with incapacity benefit revealed to the Commons. Estimated “savings” for the year 1996-97 were £410 million; for 1996-97 £1.2 billion; and for 1997-98 an astonishing £1.7 billion.

Obviously, with so much less government money going to sick and disabled people, the opportunities for private disability insurance were enormous. No longer could people rely on benefit income if they became ill or disabled. They would have to fend for themselves. Accordingly, UNUM Ltd, as its chairman had promised, “launched a concerted effort to harness the potential”. In April this year, a glamorous and expensive advertising campaign coincided with the new rules for incapacity benefit.

One UNUM ad warned: “April 13, unlucky for some. Because tomorrow the new rules on state incapacity benefit announced in the 1993 autumn budget come into effect. Which means that if you fall ill and have to rely on state incapacity benefit, you could be in serious trouble”. Lurid tables estimating weekly outgoings for an average family at £276, and benefit under the new rules at £100, urged people to “protect yourself with a Long Term Disability policy from UNUM”.

Crucial to the new rules were tougher medical tests to find out if people really are incapacitated. The Benefits Agency Medical Services (BAMS) recruited a new corps of doctors to carry out new “all-work tests”. The basic change in the tests was simple. In the past, disabled or sick people were entitled to benefit if they could no longer do their job. From now on, people are entitled to benefit only if they can do no work at all.

The new medical tests were fundamental to the “savings” Lilley hoped for. If the tests were too lax – if doctors were allowed to slide into sentimental slackness in assessing peoples’ ability to do any work at all – the whole purpose of the tests would be thwarted. So Lilley’s department set up an “incapacity benefit medical valuation group” to “monitor and validate the quality standards for the doctors involved in the all-work assessments”.

The most famous member of the group is Dr John Le Cascio, second vice-p0resident of the Unum Corporation, who has recently be seconded to the company’s British arm. Dr Le Cascio was also invited last year by Lilley’s department to help in the extensive training of doctors in the new techniques of testing. The DSS stresses that “the doctors don’t decide the incapacity benefit – that is done by an adjudication officer”. No doubt; but the officer makes a decision on the expert medical information provided the tests.

No press release was issued about Dr Le Cascio’s appointment. No one told taxpayers that the DSS is shelling out £40,000 to Unum Ltd for Dr Le Cascio’s services in the year from October 1994 to September this year. A DSS spokeswoman explained: “This comes down basically to a daily rate of £440 a day. That’s cheap for a consultancy, actually”.

The Eye asked Dr Le Cascio if he agreed there was an absolutely obvious conflict of interest in his position as validator and monitor of tests for a benefit, the cutting of which was being exploited to the full by the advertisements for his company. He replied:

“Well, I don’t feel that way of course, and if I did I wouldn’t have accepted the job. I was brought in for a specific reason, and that is to teach some of the medical principles which are contained in the design of the new test – that’s what I do, that’s my area of expertise. I’m a technical person and I can do that. To me, there is no sort of conflict as long as I do that job. I feel comfortable doing it, and I assume that those in the department feel comfortable with my contribution. The reason they’ve turned to me is because the commercial insurers have been working with this sort of valuation system for a long time and that’s where the knowledge lies.’

It was thus Peter Lilley and the Tories, who introduced Unum and the wretched work capability assessment. New Labour retained and expanded them, but the ultimately responsibility lie with the Tories. And the results have been horrendous. Mike estimated that about 52,000 people a year have been killed through benefit sanctions.

All so Lilley could persecute the poor and sick, and his friends in private insurance could make a quick buck.

Advertisements

From 2000: SEMA – the Atos of its Day

January 31, 2015

Private Eye in its issue for Friday, 19th May 2000, carried the story below on the establishment of the Work Capability Tests. These were originally a Tory idea, but where put into practice by Blair’s Labour after their election victory in 1997. The contract to administer the tests were awarded to Sema. Their conduct of them was so appalling that it was the subject of a report by the House of Commons social services committee.

Cringe Benefits

It was a Tory idea to begin with: how to make more money out of the disabled for a big private company.

After a “study of options” about what to do with the rather expensive government system for examining disabled people to see if they were entitled to benefit, the Tory government concluded that contracting out to the private sector was “most likely to deliver the improvements sought”.

Tory ministers agreed and the publicly-owned Benefits Agency Medical Services was divided into three areas “to encourage competition in terms of bids”. the Tory government fell in the spring of 1997, to be replaced by Labour with a huge majority and a secretary of state for social services, Harriet Harman, who had been eloquent in her condemnation of privatisation.

Ms Harman, however, was at once convinced of the case for privatising the testing of the disabled, and in February 1998 (in the interests of competition) she awarded the contracts for all three areas to one company, SEMA.

It was a juicy contract too. A government memorandum at the time announced that the three contracts would cost the government £305m, a figure, which the memo announced, “represented savings of £62m” compared with what the service used to cost the taxpayer.

One problem which soon became clear was that SEMA had no medical experience whatever. The British Medical Association, disgusted by the company’s treatment of doctors and patients, complained officially that SEMA executives “did not understand the complexities, having had no experience of employing doctors”. This obviously worried the company so much that when the five original bidders were invited to discuss the complexities of their new contract with the BMA, which represents most British doctors, two declined, including SEMA.

If it didn’t have any doctors or medically qualified staff, SEMA made sure it was well-stocked with “new” Labour lobbyists. It hired Westminster Strategy, which had a batch of such lobbyists on tap: Jo Moore, former Labour press officer; Mike Lee, who used to work for David Blunkett; and former chair of the Fabian Society and wanabee Labour candidate Mike Dauber. To clinch the business, SEMA acquired the then employment minister Andrew Smith as a speaker at its glittering conferences (see Eye 955).

Partly to make up for this lack of experience, SEMA engaged two companies as sub-contractors to do the new work, Nestor Healthcare Group and Nestor Disability Analysts. The board of the former was graced by a former Tory MP, Charles Goodison-Wickes, who quickly made way for the more acceptable Anne Parker, who chairs the Carers Association and is an examiner for the Child Support Agency. Nestor Healthcare has just branched into prisons, explaining in true “new” Labour tradition that “prisoner numbers are steadily growing”.

The performance of these SEMA subsidiaries and of privatisation in general, has recently been examined in detail by the House of Commons social services committee, whose shocking report has just been published. “To often”, says the report, “the organisation fails to deliver an adequate service … at its worst it puts claimants through examinations which are painful and distressing and gives poor advice.”

Bizarre examples of the doctors’ hostility to the people they are examining are provided by the report. In one case a patient was described as healthy because she could sit up watching television for up to two hours. In fact this patient could only watch television lying down. In another case a patient’s dirty fingernails were submitted as evidence of his ability to work in the garden – whereas in fact he could not even wash himself.

The conclusion makes sad reading for the “new” Labour lobbyists and privatisers of past years. There has been no improvement whatever. “Our inquiry has led us to conclude that, so far, the primary focus of SEMA has been on operational efficiency to achieve value for money rather than the delivery of a quality service.”

How has Labour responded so far to these devastating allegations? It has handed over a confidential contract for running the Labour party’s own membership records to … SEMA. And SEMA’s subsidiary Nestor has won a contract for the provision of an immigration centre for Group 4.

Since then, SEMA has been replaced by ATOS, who have now been replaced by Maximus, but still have the contract for administering the test for the Personal Independence Payments. ATOS made sure it avoided one of the criticisms of SEMA – that it didn’t have enough doctors or medically qualified staff. For patients and claimants, however, this has made absolutely no difference. The administrators of the Work Capability Test are still hostile towards those whom they are examining. Subsequent Tory policies, like those of Iain Duncan ‘Tosser’ Smith, have made this even worse. Maximus are going to be no different. Given the previous performance of the companies administering the test, they are likely to be worse.

There is even a lesson here for the recent recruitment of Sue Marsh, a disability campaigner, by Maximus. SEMA’s subsidiary, Nestor Healthcare, had on its board Anne Parker. As well as being an examiner for the Child Support Agency, she was also the chair of the Carers Association. This was doubtless to give the impression that the tests were to be fair, with the object of helping the disabled and their carers. It wasn’t, and isn’t.

This is the policy the Tories produced and are developing. It becomes nastier, more vindictive and humiliating every day. It’s high time the Tories were kicked out of office.