A response to Mansel Aylward's apology

I have just posted this on Black triangle :

Before the Coalition came to power , Steve Webb, Liberal Democrat work and pensions spokesman, commented in relation to the Labour Government’s Welfare to Work programme :

“The rhetoric sounds great – ‘We’re going to focus on what you can do and not what you can’t do’ – but we all know that what that really means in practice is getting tougher and setting the bar higher.” He added : “What worries me is the idea of a future Tory government going further, faster down this track and already budgeting for millions of savings, saying there’s obviously people who don’t need this money.”

How ironic !

With little protest , Labour’s Welfare to Work programme found seriously ill people, people with debilitating conditions and serious disabilities illegible for Employment and Support Allowance (ESA), the benefit that replaced Incapacity Benefit in October 2008. That is because they had been subjected to the notorious Work Capability Assessment (WCA) which took little account of variable symptoms, generalized pain, exhaustion or the underlying seriousness of a person’s condition.

According to a Citizens Advice Bureau report , those seriously ill and disabled people , found fit for work under the last Government and denied ESA , were subsequently written off, just left to cope with greatly reduced benefits on Job Seekers Allowance and little support. (Source : Not Working . CAB Evidence on the WCA.)

Yet introducing ESA and the WCA in 2007, Peter Hain, Labour, described them as “A new, progressive vision for our welfare system .”

As Debbie Jolly points out, up until then campaigners, protesters, advocates, activists and Centres for Independent Living (CILs) had managed to achieve :

The Independent Living Fund (ILF)
Disability Living Allowance (DLA)
Incapacity Benefit
Access to Work
Direct Payments
The Disability Discrimination Act

All the above achievements, the envy of the world, have now been drastically cut back and replaced.

Labour’s (and now the Coalition’s) extraordinary counterintuitive reasoning , towards disability, has its roots, says Jonathan Rutherford in the American right’s philosophy that the poor are the cause of their own poverty because they fail to take advantage of the opportunities “available” to them..

This all began in 1994 the Conservative Government brought in UNUM, the giant American Medical insurance Company, to advise them on welfare reform, a member of that group was Mansel Aylward, who in 1999, as Chief Medical Officer at the DWP, devised the new Personal Capability Assessment (PCA), contracted out to the American Corporation Atos Origin, where the ” emphasis was no longer on entitlement, but on what a person is capable of doing.”

The intellectual basis behind the PCA was UNUM’s “The Scientific and Conceptual Basis of Incapacity Benefits “, written by the apparently apologetic Mansel Aylward, which is based upon the biopsychosocial model of illness, designed to “liberate” the disabled from the ” medical model” . According to the biopsychosocial model, under which untold tens of thousands with people ME have suffered horrible abuse and even death : ” Disease is the only objective, medically diagnosable pathology. Sickness is a temporary phenomenon. Illness is a behavior social phenomenon rather than a health problem. The solution is not to cure the sick, but a “fundamental transformation in the way society deals with sickness and disabilities. ”

The transformation is this : ” Sickness is a social and cultural phenomenon rather than a health problem. The solution is not to cure the sick, but to transform the culture of welfare. No one who is ill should have a straightforward right to receive benefit.”, this extreme agenda ” was adopted by the former banker Labour brought in, David Freud , now Lord Freud , Parliamentary Under Secretary of State (Welfare Reform) .

Pushing the neoliberal agenda to triumphant heights, the Coalition maintains says the “only” way to save money is to slash welfare spending.

Effectively as many claimants as possible must be bumped off benefits. The disabled have been thoroughly demonized; the need to reduce ” welfare dependency” is shouted out , as loud as possible, to all who can hear. The consequences have been terrible, with the disabled bearing the brunt of cuts , as Patrick Butler writes :

Savage cuts to social benefits have shredded the welfare “safety net” and left many disabled families in a “struggle for survival”, according to a detailed study of the impact of the government’s austerity programme. It calculates that disabled people and their carers have seen their income collectively cut by £500m in the past two years, leaving many increasingly financially impoverished, socially isolated, and at risk of declining mental health.

Many disabled people’s quality of life will continue to deteriorate over the next three years, warns the study, as a further £9bn of predicted cuts todisability support are rolled out and local authority social care budgets shrink further.

“Although nearly everyone faces tough times in this current economic climate, disabled people are hit particularly hard as a result of lower income, higher costs, fewer support services and unpredictable health conditions,” the report, published by the thinktank Demos and Scope, the disability charity.

Denied even the basic right of proper medical care for decades , under the biopsychosocial regime that has now gone global, people with ME know more than most, how evil this regime is.

Does Mansel Aylward sleep well at night, I wonder ?

The experience of people with ME , who have suffered for decades under the psychosocial domination of the corporate medical insurance industry ,offers a stark insight into the smoke and mirrors that passes for Mansel’s “21st Century ” disability policy :

(By the way, only a terminally ill cancer patient or someone dying of AIDS what the degree of suffering is like in ME, there is no cure, no known treatment. And it can and does kill.)

The process is this :

In ME :

Change the Name : ME to CFS

Change the Criteria : Virus to Fatigue

Simplify the Criteria: So that ME is diluted down and is lost in an irrelevance of Fatigue and mental health jargon.

Change the Focus : Biomedical to Psychiatric

Move the Definition : To incorporate people with a mental health need.

Create a skewed approach : Based solely upon a limited psychosocial view of ME

Create Systems to sustain the flawed Ideology : Created vy the medical insurance industry, who have a massive financial stake in denying the physical reality of ME, either covertly or overtly

Set up psychosocial clinics that focus purely on mental health strategies and deny the physical reality of ME, staffed by workers who believe that ME is not a physical disease.

Ignore genuine need by switching the focus and making the person’s reality irrelevant: Do not look at ME within the context of a physical, untreated disease. In ME switch the focus from the real issue of illness, to rehabilitation and away from the physical needs of the person.

The outcome is a denial of people’s reality, the misapplication of Cognitive Behaviour Therapy and the channelling of resources away from where they are needed. The present reality of ME : ME is treated as if it is a mental health issue. The person with ME is subtly blamed for being ill and not doing enough to get better Their physical health is denied. Their level of disability is denied Their needs go unmet and people with genuine ME are neglected unseen and left without appropriate medical support leading to a never-ending life of illness and disability, unsupported by the social and medical systems that should be in place to help them.

In PIP :

Change the Name : DLA to PIP

Change the Criteria : What you “can’t do” , to what you “can do” Simplify the criteria: So that disability is watered-down and the complexity of disability gets lost in irrelevance. In truth disability is complex and needs detailed understanding

Change the Focus : Disability to Ability.

Move the Definition : To exclude the least disabled and possibly the most disabled,who cannot achieve independence, or those in residential care, from getting Benefit.

Create a skewed approach : Based solely upon a limited social view of disability, ignoring the medical and environmental aspects.

Create Systems to sustain the flawed Ideology : There are vested interests behind DLA policy development , who have a massive financial stake in denying the physical reality of disability, either covertly or overtly.

Set up a flawed Consultation Process, after already drafting the Bill to change DLA. Set up ATOS with a financial incentive to remove people from benefits .

Ignore genuine need by switching the focus and making the person’s reality irrelevant: Do not look at the impact of disability upon ability.

In PIP switch the focus from the real issue of disability to an out of context ability. The outcome is a denial of people’s reality, the potential misapplication of Cognitive Behaviour Therapy and the channelling of resources away from where they are needed.

The great error of PIP is looking at ability and denying physical disability . The inevitable result is that disabled people will be viewed , like people with ME :

• as not trying hard enough
• as being more capable than they are
• as having a false “perception” of disability
• of wanting to be disabled
• of not needing the help they actually do need

There is a place beyond anger. While my wife sits, hunched in pain, while there is nothing I can even make her to eat, while she sits tormented by noise, by movement, in silence, it is to read that Mansel Aylward has offered some kind of door step apology – while inside UNUM are as busy as ever handing out branded flash pens and goody bags.

Greg Crowhurst (c) Stonebird 2012

wisted Witch : New Statesman May 2008http://www.newstatesman.com/politics/2008/05/work-benefit-claimants-reform
Greg Crowhurst Joe Public Blog , The Guardian, June 30 2010http://www.guardian.co.uk/society/joepublic/2010/jun/30/incapacity-benefits-reform-scared

Melissa Viney, Bending the Rules, Guardian , October 28 2010http://www.guardian.co.uk/society/2009/oct/28/work-capability-assessment-incapacity-benefits

Citizens Advice , Not Working , 2010 http://www.citizensadvice.org.uk/not_working

Peter Hain, Labour and the Sick Note, New Statesman, 27 Nov 2007http://www.newstatesman.com/politics/2007/11/work-benefit-welfare-tories

Jonathan Rutherford, E pluribus Unum, The Guardian 17 March 2008http://www.guardian.co.uk/commentisfree/2008/mar/17/epluribusunum

Jonathan Rutherford, The welfare reform bill’s hour of need, The Guardian 22 June 2009http://www.guardian.co.uk/commentisfree/2009/jun/22/welfare-reform-bill-mental-health