Vote for Corbyn to Stop the Work Capability Tests

This is the text of another of my table-top pamphlets, this time against the notorious Work Capability Tests. These were also introduced by New Labour at the behest of Unum and other private healthcare providers.

These are not objective tests to assess who is well enough to support themselves. They are simply a callous, bureaucratic mechanism for throwing people with disability off the benefits they need to support themselves. These have included severely disabled people, including terminal cancer patients in comas!

This iniquitous system has been retained and expanded by the Tories – David Cameron and his Lib Dem lackey, Nick Clegg, and now Theresa May.

It is killing people. As I’ve mentioned far too many times before, about 600 + people have died in misery and despair after having their benefit withdrawn due to these tests. Stilloaks, Johnny Void, Mike at Vox Political and DPAC have put together lists and videos putting names to faces, to show the human reality of these statistics – whose mothers, fathers, sons, daughters, brothers and sisters were killed thanks to the Thatcherite insistence of cutting down on welfare.

The number of people, who have died after having been assessed as ‘fit for work’ is well above ten thousand, though the true figure may never be known. Mike and the other disability activists, who tried to get the figures were blocked by IDS and the DWP at every turn when they tried to get them.

Jeremy Corbyn has also promised to end workfare.

So vote for him. Don’t let the Tories kill more disabled people under the pretence of saving money.

Stop the Work Capability Test –
Before More People Die

by David Sivier

One of the very worst policies introduced by various governments as part of their campaigns to dismantle the welfare state over the past decade has been the Work Capability Test. This was introduced by New Labour in October 2008 along with a new benefit for the disabled and long-term sick, the Employment Support Allowance, which replaced Incapacity Benefit. The Work Capability Test is intended to show if the person claiming benefit really cannot work. It consists of questionnaire, in which boxes are to be ticked in answer to particular questions about the claimant’s health and disability. 2Ten of these tests were on the claimant’s physical health, and another ten are on their ‘mental, cognitive and intellectual’ fitness. There may also be a brief physical examination. The tests are performed by medical doctors working on behalf of a government outsourcing company. This was given to the French company, Atos, but the company was forced to terminate its contract a year early in 2014 following public anger at the system’s incompetence and maladministration. The contract was then given to an American company, Maximus. The tests may be repeated as often as the JobCentre Plus decides. If the disabled person scores low in the tests, they are judged fit for work. They lose their ESA and are told to apply for Jobseeker’s Allowance.

The tests are based on a monograph, The Scientific and Conceptual Basis of Incapacity Beneft, by Gordon Waddell and Mansel Aylward, of 2005 and a succeeding work, Is Work Good for Your Health and Wellbeing? By Gordon Waddell and Kim Burton. They were also strongly influenced by a 2001 New Labour conference, in which Aylward was a contributor, Malingering and Illness Deception. These led in turn to the publication of a Green Paper in 2006, A New Deal for Welfare: empowering people to work – an independent assessment of the arguments for the proposed Incapacity Benefit reform. Both Waddell and Aylward were professors at the Unum Provident Centre for Psychosocial and Disability Research at Cardiff University, which was funded by the American insurance giant from 2004-9. The Work Capability Test uses a form of Bio-Psychosocial model of assessment, developed in America by Unum Provident. This model of assessment is considered to have been devised by George Engel in 1977. In 2006 a paper produced by Professor Christopher Butler and his colleagues attacked the model as ‘wanting’ and inadequate. Waddell and Aylward’s 2006 paper has also been attacked and discredited by Emeritus Professor Alison Ravetz.

Unum, and pseudo-medical testing actually became part of the disability benefits system twelve years or so prior to the Waddell and Aylward’s paper, in 1993, when the-then Conservative Health Secretary, Peter Lilley, introduced tougher testing designed to evaluate whether claimants were totally incapable of work. They had previously been awarded benefit if they were unable to do their job. Lilley considered that this approach was to open to sentimental interference by doctors, and so set up an ‘Incapacity benefit medical valuation group’, whose members included Dr John Le Cascio, the second vice-president of Unum Corporation. Lo Cascio had recently been seconded to its British branch, Unum Ltd, based in Dorking in Surrey. In 1994 Lo Cascio was appointed to train the British doctors charged with carrying out the tests by the Benefits Agency Medical Services. New Labour claimed that the purpose of the Work Capability Tests has been ‘to get people back into work’. This was always a misleading claim. New Labour had a ten-year plan to remove one million people from the 2.8 million receiving disability benefits. Their Secretary of State for Health declared ‘We know that being in work can be good for your wellbeing’, echoing the title of the paper by Waddell and Burton. 13 Years before that, Lilley introduced the tests with the aim of cutting £2 billion from the benefits bill.

And Unum itself regarded the benefit cuts as a great commercial opportunity. In their report in 1994, Chairman Ward E. Graffam was enthusiastic about ‘exciting developments in Britain’, saying ‘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.’

Atos immediately decided that three-quarters of those in receipt of benefit were fit for work.16 Between the introduction of the tests in October 2008 and February 2012, the Department for Work and Pensions made over 1.36 million decisions on whether to award ESA following the administration of the tests on claimants. It declared 794,000 sick and disabled people ‘fit for work’. From the very beginning, the tests were criticised as being vastly inaccurate, and the treatment of claimants under it as cruel and degrading. ‘We Are
Spartacus’, a network of disability researchers and campaigners, denounced the way claimants were ‘wrongly assessed, humiliated and badly treated’. In response to repeated requests by disability campaigners, the DWP finally released the figures for the number of people dying over 11 months in 2011 while in receipt of ESA. 10,600 people in total had died. Of these, 1,300 had died after being taken off benefit following the decision that they were ‘fit to work’. Some of the people, who have died, committed suicide in despair at having their income terminated. One of these was a 47 year old man, who took a drug overdose. Others experienced a deterioration in their mental health due to the stress of assessment. Between 2008 and 2014, there were 600,000 appeals. This constitutes a third of all assessments, and in 2012-13 there were 465,000 appeals, with a success rate of 39 per cent. In some areas, lawyers had a success rate of over 80 per cent overturning decision by Atos against the claimant receiving benefits. 60 per cent of those, who had successfully appealed had scored zero. That is, Atos had declared them entirely fit for work. In 2013, however, the Conservative government took the decision to end legal aid for claims for welfare payment, which meant that fewer people would be able to afford to take the government to court.

In America, Unum Provident was fined $31.7 million in a class action lawsuit in California in 2003 for running ‘disability denial factories’. Two years later in 2005, John Garamendi, the California Department Insurance Commissioner, fined the company $15 million, declaring ‘Unum Provident is an outlaw company. It is a company that has operated in an illegal fashion for years’. The insurance commissioners of 48 American states had made a settlement with the company by 2006 that required it to review 200,000 claims and pay a $15 million fine. In 2008 the American Association of Justice declared that the company was the second most discredited insurance provider in America.

Despite public anger at Atos’ conduct of the Work Capability Test for ESA, the government in 2012 awarded the company another contract, worth over £400 million, for assessing whether disabled people were suitable for the Personal Independence Payment that was scheduled to replace the Disability Living Allowance in 2013. The Disability Living Allowance provided the handicapped with up to £130 per week to help them look after themselves. This was mostly awarded to help people cook, wash, and assist those with mobility problems. In the three years from April 2013 to 2016, this is to be phased out and replaced with the PIP, which is designed to get people back into work. The government was determined to cut spending on the PIP by twenty per cent during these three years, after the number claiming DLA rose by 30 per cent to 3.2 million people between 2002 and 2011. This was expected to throw 500,000 people off disability benefit.

As with their administration of the ESA fitness to work tests, Atos has proved to be less than efficient in its administration of the PIP. Those applying for the benefit may have to wait months before being notified that they are entitled. The cancer charity, MacMillan Cancer Support, stated that there were serious delays in the approval of payments. As well as leaving the terminally ill without this benefit, it also meant that they were unable to claim other vital benefits with which PIP was linked. As a result, some were forced in their desperation to take out loans from payday loan companies, which have a truly exorbitant interest rate. The number of problems with ESA dealt with by Citizens Advice rose by 54 per cent from 2011 to 2012, when the bureaux dealt with 450,000 of them.

Paul Farmer, the head of the mental health charity, Mind, criticised the tests for failing to consider the effects of mental health on people’s ability to work. In an interview with the Guardian in 2012, he said

The system is based on assumptions that claimants need to be forced back to work, rather than supported on their own terms, and that those not well enough to go back to work are somehow perceived as scroungers. These attitudes only serve to further damage individuals’ mental health and increase the time until they may be ready to return to work.

Richard Hawkes, the chief executive of Scope, another disability charity, stated that the tests ‘should be more than an exercise in getting people of benefits. It should make sure disabled people get the specialist, tailored and flexible support they need to find and keep a job.’ The House of Commons Work and Pensions Committee condemned the tests, stating that the system was so flawed it needed to be completely overhauled.

Guy Standing in his A Precariat Charter states that governments have been able to cut benefits for the disabled far more than for other groups, because they are a minority and so there is likely to be fewer objections to their treatment and lost votes. He also recommends that any firm hired by the government to provide services for the disabled should be bound by three commitments. The first should be to the disabled themselves; the second should be to the government; and the third should be to the whole of society, as the rest of us could be next. The employment contract awarded to such outsourcing firms should include penalty clauses requiring them to compensate the disabled claimant directly when they do not award them the correct benefits. This compensation should be much more than the benefits the disabled person did not receive. They should also be penalised for their mistakes. This would be a start, but it is not enough. The problem lies not with the companies administering the tests, but with the whole system of tests itself. The cause of the problem is attitude of successive governments, from John Major’s Conservatives, through Blair and Brown’s New Labour and then the Conservative-led governments of David Cameron, that the disabled should automatically have their benefits reduced, regardless of the poverty and hardship involved. The goal should be to provide benefits to support the poor and disabled, rather than cuts intended to reduce the tax burden for the rich. The Work Capability Test and the poverty and stress it inflicts should be stopped. Now.

Vox Political: Time to End the Work Capability Assessment

Mike over at Vox Political wrote this piece, Shouldn’t we call time on the Work Capability Assessment? reporting and commenting on an article by Bernadette Meaden of Ekklesia attacking the work capability assessment. He writes

On the day Mrs Mike was at first supposed to take a new Work Capability Assessment, then told it was cancelled (then received a letter confirming this – and then this writer attended the centre to make sure), Ekklesia has published a piece by Bernadette Meaden asking whether there’s any point to the process at all.

She writes: “It’s important to remember that these assessments are not a ‘medical’, as the public may believe. They are officially described as a ‘functional assessment’: they assess people as if they are machines, to see which bits are working and which bits aren’t. They disregard many medical symptoms such as pain and exhaustion, which is why people who are obviously seriously ill can be assessed as ‘fit to work’, why so many people appeal their decision, and why the government’s own expert adviser, Professor Malcolm Harrington, once described the WCA as ‘mechanistic and inhumane’.

“Not all the people who have been through a WCA will have been given a face-to-face assessment. Some will have received a decision based on their completion of the lengthy and complex ESA50 form, and supplementary information they have supplied. But for all who have been assessed, whether face to face or via bureaucracy, it will have been an added stress at a time when they may be coming to terms with a life-limiting diagnosis, or going through unpleasant treatment.

“To have your doctor say you are unfit to work, but to have the decision as to whether you will receive support in the hands of a medically unqualified DWP Decision Maker is not conducive to anyone’s health.”

He also reports the findings of Nick Dilworth, of iLegal, that under the new, even tougher Work Capability Assessment, fewer people have in fact been found fit for work. He suggests, however, that this is just a lull before Maximus takes over.

Mike makes the point that the estimates of the number of people being found fit for work are notoriously unreliable, as the DWP plays very fast and loose with the stats. And the Department is also extremely treacherous with clients. He tells his recent experience going with his partner, Mrs Mike, to hospital after she was told that she had to attend a Work Capability Assessment. Only to be told, in turn, when he rang up the hospital, that she wasn’t actually booked for one. He went to the hospital just to make sure. Many of Mike’s commenters have had a similar experience, but in reverse: they were sanctioned for not attending Work Capability Assessment, about which they weren’t actually told. Mike asks the obvious question of how much stress incidents like his have caused to disabled people, who weren’t lucky to have able-bodied carers?

And he makes it very clear that it’s time the WCA was repealed and replaced with something else, as also recommended by Bernadette Meaden and New Approach, an organisation to which Nick Dilworth belongs.

The Work Capability Assessment: A Prize Piece of Pseudoscience

Earlier this week I blogged on a piece by George Berger on DPAC’s site, describing the origin of the welfare to work philosophy by Gordon Waddell and Mansel Aylward for Unum, the giant American insurance fraudster. Berger notes that Waddell’s idea – that sick people were somehow malingering and adopting a role, which made their condition worse, was methodologically complete rubbish. It was also strongly influenced by Behaviourism, a school of psychology set up by B.W. Skinner in the 1920s. Mike’s article and Bernadette Meaden’s comments about the way the Work Capability Test treats people as machines, and disregards medical symptoms such as pain and exhaustion, is very much in line with the Behaviourists’ approach to the human mind.

The Behaviourists had a very reductive attitude to the mind: they didn’t believe in it. They didn’t like the concept of the mind, because it involved subjective experiences, which they didn’t believe could be part of objective science, because you can’t properly, objectively quantify them. It was the Behaviourists who developed the concept of conditioning, in which you could control an individual’s environment or stimuli, to alter his mind and behaviour. This resulted in the development of the Skinner box. this was a box in which pigeons were kept, and their environment totally controlled by the experiment, so as to condition the pigeon. In his utopian novel, Walden 2, Skinner developed his fantasy of a complete society populated by well-adjusted people, who had spent years in Skinner boxes.

The Simpsons sent up Skinner’s ideas in an episode, where one of the characters decides they want to give their wealth to fund a worthy project. A mad psychiatrist comes along, asking for the money so he can buy an orphan to stick into such a total environment. It’s a Skinner Box in all but name. When asked if this will benefit the child, the mad scientist says, ‘No, it’ll send him nuts’.

Quite.

Just how nasty the Behaviourists could be is shown in their treatment of ‘Little Albert’. To show how you could condition children through negative stimuli, they trained a toddler to be terrified of feather boas by giving him an electric shock every time he saw one.

The depictions of the brainwashing of political dissidents by the Federation in the BBC’s classic SF series, Blake’s 7, is partly based on the Behaviourists’ theories of conditioning. It’s also partly influenced, of course, by the Soviet Union’s abuse of psychiatry, which was revealed by Solzhenitsyn amongst other dissidents.

Behaviourism has now been discredited as a school of psychiatry. George Berger and others have also repeatedly shown that the Work Capability Test is also pseudoscience. It’s about time it was recognised as such, and thrown out.
– Along with this vile government that persists in using it.

George Berger on Gordon Waddell and the Origins of the Work Capability Test

A few weeks ago I blogged about a piece on Mike’s site, Vox Political, by Mo Stewart describing Unum’s role in formulating the fitness for work test. This is the prize piece of pseudoscience used by the DWP and Atos to deny people welfare benefits on the grounds that, no matter how ill or disabled they are, they are still somehow ‘fit for work’. In the most extreme cases, this has resulted in terminally ill people having their disability benefit removed and blandly informed that they will have to be reassessed. Just in case, you understand, that they get better.

One of the commenters on the piece was George Berger, who kindly informed me of his piece on the DPAC website tracing the origins of the fitness for work test in the bizarre theories of Gordon Waddell. Mr Berger commented:

It seems that the historical source is Waddell’s work on back pain and non-organic signs. That was imaginatively extended to “invisible illnesses.” The back pain work was heavily criticised by medical people in his specialism, yet he seems to have been protected by Aylward and maybe others. I did not know about the purely medical critique when I wrote this.

http://dpac.uk.net/2014/09/gordon-waddells-biopsychosocial-attack-on-disabled-people/

As you can see from the link, it’s entitled Gordon Waddell’s Biophysical Attack on Disabled People.

Gordon Waddell was a highly respected orthopaedic surgeon, who drew on George Engels’ holistic theories of the origin of disease. Engels believed that for patients to be made better, the healer should address all aspects of their condition, including its social and psychological components. Waddell, however, perverted this into the current government policy that sees patients as essentially malingerers. In his papers ‘Nonorganic Physical Signs in Low-Back Pain’ (Spine, volume 5, number 7, 117-125); and ‘A New Clinical Model for the Treatment of Low-Back Pain’ (Spine, volume12 number 7, 632-644), published in 1980 and 1987, Waddell stated that there were symptoms in lower back pain that had no physical cause. He believed these were entirely psychological in origin. These non-organic symptoms in turn produced depression, a feeling that treatment hadn’t worked, and encouraged the patient to adopt a ‘sick role’. Mr Berger quotes from Waddell’s 1998 book, The Back Pain Revolution, ‘that illness behaviour quite often ‘focuses on money and implies malingering,’ and that it ‘may depend more on… psychologic events than on the underlying physical problem’ (1998: 216, 227).’

George Berger states that Waddell’s scientific methodology is simply wrong, and that it was strongly influenced by Skinner’s Behaviourism, which in turn has been categorically demolished by none other than that great American radical, Noam Chomsky, amongst others.

Despite its falsity, it has been seized upon by New Labour and Tory governments determined to cut the welfare bill. Waddell’s ideas on pain and malingering were taken up by Atos at a conference in 2004. Another doctor, Christopher Bass, used his biopsychosocial theories to explain chronic fatigue syndrome, fibromyalgia, chronic low-back pain, repetitive strain injury and non-cardiac chest pain, as all essentially psychological malingering. Waddell’s ideas were taken up by UnumProvident, the American insurance fraudster, whose head, John LoCascio, attended a conference at Oxford on malingering and illness deception. The corporation then set up the UnumProvident Centre for Psychosocial and Disability Research at Cardiff University. Finally, in 2006 Waddell and A. Kim Burton wrote that ‘Work is generally good for health and well-being’, a line now repeated ad nauseam by the cretins now stuffing the DWP under Esther McVile and Iain ‘Tosser’ Duncan Smith.

There’s far more over in George Berger’s original article, and it’s definitely worth reading for anyone interested in a very scholarly destruction of this pernicious piece of pseudoscience.

From 2011: Private Eye on Unum’s Role in Shaping Government Welfare Policy

This is from the Eye for the 11th – 24th November 2011:

Jack McGarry, Chief Executive at Unum.

Welfare Reform

Mutual Benefits

Tricky questions are again being asked about the profits American insurance giant Unum stands to make from its massive media push on income protection cover, promoted as the answer to the latest tough welfare reforms.

Pulling stunts like persuading six bloggers to live for a week on the current average benefit of £95 and then write about it, Jack Mcgarry, chief executive at Unum UK (pictured), earlier this year warned: “The government’s welfare reform bill will seek to tighten the gateway to benefits for those people unable to work due to sickness or injury. Each year up to 1m people in the UK become disabled and the reforms mean that working people will be able to rely less on state benefits to maintain the standard of living they were used to prior to their illness”.

Well, Unum should know. Behind the scenes it has been helping Tory and Labour governments slash the benefits of disabled and sick people for years – going right back to Peter Lilley’s social security “Incapacity for Work” reforms of 1994. Lilley hired John Le Cascio, then vice-president of Unum, to advise on “claims management”. Le Cascio also sat on the “medical evaluation group”, which – according to Professor Jonathan Rutherford in the academic journal Soundings – was set upt to design and enforce more stringent medical tests.

At the same time, the UK wing of Unum was launching what it boasted was “a concerted effort to harness the potential” from predicted cuts in benefits, urging people to protect themselves with a “long-term disability policy from Unum”.

The Eye first questioned Unum about the possibility of a serious conflict of interest back in 1995. Dr Le Cascio said he didn’t “feel that way” and wouldn’t have taken the government job if he thought there was a conflict. That, of course, was ten years before Unum was found guilty in the US of “systematically violating” insurance regulations and fraudulently denying or “low-balling” claims using phony medical reports, misrepresentation and biased investigations (see Ad Nauseam, last Eye).

Fast-forward 16 years, and plus ca change. Unum’s tarnished reputation has done nothing to diminish its influence here and the Department for Work and Pensions (DWP) is still denying there’s anything amiss about Unum’s more meddling. In a lengthy reply last month to Norman Lamb, Nick Clegg’s chief adviser, the DWP neatly skirted questions about whether Unum was advising on welfare reform and about its unlawful activities in the US.

Yet Unum executives sat on both the mental health and physical function “technical working groups” set up under the Labour government in 2006, which reviewed and finally came up with the new, stricter “work compatibility assessments”, introduced for new claimants in 2008. In fact Unum and Atos, the huge French outsourcing company that holds the government’s multimillion contract to conduct the widely criticised assessments on behalf of the DWP (see in the Back, last Eye), were the only for-profit companies represented on the groups. Unum chief executive McGarry has now been appointed to the expert panel reviewing the sickness absence from work system announced by the government in February.

Prof Rutherford wrote that Unum had also been “building its influence” in a variety of ways over a number of years. He said that in 2001 Le Cascio was a key player at a ground-breaking conference at Woodstock near Oxford, title “Malingering and Illness Deception”. Malcolm Wicks, Labour work minister at the time, and Mansel Aylward, then chief medical officer at the DWP, were among the 39 delegates.

In the same year, Unum launched a public private partnership to act as a pressure group to extend influence in policymaking. And in 2004 it opened the £1.5m UnumProvident Centre for Psychosocial and Disability Research at Cardiff University. (The Centre has since be renamed and Unum says it no longer provides any funding – no doubt because of claims that academic integrity could be called into question by its influence).

Unum has been lobbying, sitting on expert groups and hosting meetings at party conferences of all colours ever since. And lo and behold, in May this year, Unum’s then medical officer Prof Michael O’Donnell jumped ship to become chief medical officer at Atos. He barely had time to catch his breath before giving evidence to the Commons committee looking at the welfare reform bill.

But Unum is once again denying any conflict of interest “since our current work with the DWP and our marketing campaign are different”. It said its current consultation work is about helping people return to work and its advertising campaign was educational and does not support tightening benefit changes.

Meanwhile disability activists who have fallen foul and been forced to appeal cuts in DWP benefits based on flawed Atos assessments, and campaigning groups like Black Triangle, think the whole thing stinks and are urging MPs to investigate.

So Unum is, like Maximus, another private contractor hired to implement government welfare policies, a company with a history of corruption in the US. And like many of the other companies involved in the government’s welfare reforms, it helps formulate the very same policies from which it stands to make a profit. Meanwhile, the sick and disabled are thrown off benefits due to their advice. And, as you’d expect, they’ve even got a connection of the past masters of cruelty, fraud and corrupt influence, Atos.