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bigleyma is thinking…

DWP-Related-Suicide Rate Increasing?

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I seem to remember on one occasion a spokesman for the DWP, (possibly a Minister, but they seem to change fairly frequently now) referring to warnings about increasing mental health problems associated with the WCA, and dangerous effects on the vulnerable that could ‘tip them over’, contempuously dismissing such ideas as ‘scaremongering’. In the typical reverse-logic of an abuser, they went on to claim that it is the ‘scaremongering’ which is the problem, since it is it that is causing people anxiety and worse, not the actual process they’re being forced to go through.  Let’s examine that idea for a moment through the lens of common sense…

They were claiming that notions of fear, undoubtably anxiety-provoking though its accepted they can be (especially when suffering mental health problems) have a more deleterious effect than being told you are fit when you’re not, and having the only support, (and other support that is contingent on that status) removed, leaving you extraordinarily vulnerable, your only hope to obtain work that you are patently not confident of being able to do, in a time of high unemployment. Fear can be deadly, yes, when it comes to suicide-ideation. But the actuation of that fear, the bearing it out in the actual circumstances you are thrown into against your will, is the real killer.

I’ve become apprehensive about what I’m going to see on social media daily now. In this latest case, which follows on quite soon after that of Tim Salter, there can be no doubt about what caused Shaun Pilkington to shoot himself, as there was similarly no doubt about what caused Tim to hang himself, and no doubt about why Stephanie Bottrill walked onto the motorway that day. I’m glad that the Mirror described Stephanie as a suicide ‘victim’, because that’s what these people are – victims. And to all intents and purposes they are increasing at a disturbing rate. It’s such a high price for our society to pay for this pushing through of a patently contrived, ideologically driven ‘process’ that has been designed for no other purpose than to facilitate the ‘culling of benefits’, by a government which not only lacks concern for its most disempowered citizens, but appears to view their lives as dispensable in the context of their ruthless savaging of ‘welfare’.

All three victims noted above were already impaired in some way health-wise, already at a disadvantage in an employment market which with sickening predictability demands that potential employees be  ‘flexible’, ‘energetic’ and ‘willing to give 110%’. But they were also all in their fifties, a demographic group historically disadvantaged in the labour market against the young, who are viewed as more malleable, more willing and less likely to succumb to illness by potential employers. Doubly disadvantaged then. And isn’t that the profound shamefulness of these policies, that they are targetting those who have compound disadvantage, the most vulnerable  of all of us?

MIND film captures misery of WCA for those struggling with Mental Health

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Tyneside MIND have produced this compelling account of what it’s like for those suffering mental health issues to have to undergo the unforgiving, indifferent and humiliating ordeal that is the DWP’s Work Capability Assessment. For those who have been through that experience or who are currently experiencing that kind of vulnerability, viewing may not be advisable, but it is very important that material like this is disseminated widely to counter the government’s unsupportable claims of legitimacy for their WCA process.

MIND’s Campaign page associated with this film, where you can sign to hear about this and other campaigns can be found here.

Mumsnet & UNUM, A Letter

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UNUM are topical just now, since it was revealed that they are currently involved in a closed ‘fringe event’ at the conferences of all three major political parties taking place at the moment. This is a matter of considerable concern to disability, and associated, activists who view it as further attempts by the insurance company to secure their influence over our health-related benefits no matter which party assumes power at the next election.

Coincidentally, I chanced upon a Mumsnet forum a couple of days ago. It was a Q&A session, on the topic of returning to work/carrying on working with cancer, an obviously sensitive topic. Questions were answered by the head of rehabilitation from UNUM, and centre head of  ‘Maggie’s Cancer Care’, a psychologist.

Among the published questions, which generally were seeking help, one stood out in raising the ‘issues’ about UNUM that many of us find deeply troubling; the influence that many among us believe they’ve brought to bear upon our welfare system since the early 90s, in order to ultimately ‘make a killing’ in selling ‘Income Protection’ to anxious workers unnerved by a severely undermined social security system. I think that about sums it up.

Though, no doubt, there are people working for UNUM, perhaps in areas such as rehabilitation, who believe they are working for the good of their clients, the truth must be faced that this is not a company whose general demeanour I would think Mumsnet would find acceptable since they claim they

“…do not accept advertising from a number of companies including Nestle, because of their aggressive marketing of formula in breach of international standards, and for a number of products, including formula milk, cosmetic surgery or anything that we believe does not sit well with our philosophy…”

So I’ve emailed them today, and am posting the contents here because, as Mumsnet inform us, they do receive thousands of emails and I don’t have a great expectation that mine will have any particular chance of being noticed. At least posted here more people will be able to see, particularly, the list of links at the end, which are individuals who are currently taking UNUM to court for what they contend is an illegitimate non-payment of their insurance benefits, into which they have paid over many years.

The Letter

Dear Mumsnet,

Great respect is due Mumsnet for being an enterprise which has adopted an ethical attitude towards advertising, evidenced by your rejection of companies such as Nestle, and those products which you consider have a negative effect on women’s health or self-esteem.

In light of this I felt compelled to write to you about the insurance company, Unum, with whom you recently ran a Q&A session in your ‘Mumsnet Talk’ section, about return to work while/after suffering from cancer. (Link included)

This company has a more than questionable reputation in the States, having been found guilty of denying health insurance claims wholesale, and operating like a ‘disability denial factory’. Their history in this is freely available on the internet. They also stand accused by many disabled activists in the UK of infiltrating government since the 1990s in order to profit from the increasing withdrawal of benefits from the sick and disabled, as evidenced in the current ‘row’ over Atos Healthcare and the Work Capability Assessment. It is Unum’s ‘model’ which was adopted by, initially, the Conservative government, in order to ‘pare down’ eligibility for health related benefits.

Unum claim to have ‘cleaned up their act’ in the U.S. but the barest research proves that they are still ‘up to their old tricks’ of renaging on claims which people have in good faith paid in into in order protect them, should ill health prevent them working in the future. Its painfully ironic to see them use the language of ‘support’ in your Q&A, when the most evident thing about their company is their disgraceful actions in denying huge numbers of their customers the legitimate payouts that they are due.

Sick people are suffering in the States because of this company. People now in the UK are suffering too, in increasing numbers, because UNUM conspired with our government to utilise UNUM’s model towards the reduction of benefits for those who are by any reasonable measure entitled to them.

You might ask what’s in it for UNUM? The answer is that they seek to prosper from this lack of state support for the sick and disabled; the fear, essentially, that this is engendering, by selling their own ‘Income Protection’ product. If you’re not feeling a little sick by now, then please read the links I’ve put at the end of the email, because these are real people who are right now suffering at their hands.

UNUM, much like this present government, speak the language of ‘support’ while doing the opposite, removing it. And they’re doing it to the most vulnerable of the population.

Here is a list of just some of the law suits currently (2013) being actioned across the United States against UNUM, by sick people, some of whom have lost homes and faced bankruptcy on account of UNUM’s denial of their payouts. There are many, many more instances stretching back well over a decade.

I hope that you will reconsider any association with this company, who have one face for the public, but quite a different one behind the scenes.

Yours sincerely,

—————————————————————————————————————————————————————————————–

The List

South Carolina: Amy Avery (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4959-unum-lawsuit-alleges-bad-faith-insurance-practices

Seattle, Washington: Rachel Jacobson (Hypereosinophilic Syndrome, heart attack, chronic asthma, other conditions)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4853-lawsuit-says-unum-altered-medical-documents-to-deny-claim

Illinois: Clark Weimer Jr (Degenerative disc disease in the lumbar, thoracic and cervical spine)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4931-unum-policyholder-struggles-to-get-benefits

Florida: Marie Jean (Disabling chronic dyspnea with angina, shortness of breath, pulmonary nodules with hypoxia, arthritis, radiculopathy, myalgia, hypertension, GERD, cardiomegaly with mitral valve prolapse, and other conditions)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4893-unum-hit-with-another-lawsuit-for-cancelling-benefits

Michigan: Michael Sosinski (Brain injury, loss of hearing, brain hemorrhage, cognitive dysfunction)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4877-lawsuit-says-unum-unfairly-terminated-disability-benefits

Michigan: Mary Mora (Fibromyalgia)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4812-unum-denies-benefits-to-michigan-woman-with-fibromyalgia

Michigan: Sinoun Liv (Chronic debilitating back pain following surgery, nerve damage)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4760-spinal-patient-denied-insurance-benefits-sues-unum

Michigan: Larry Tate (Debilitating IBS, Scoliosis and other conditions)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4745-son-s-benefits-key-factor-in-unum-disability-insurance-lawsuit

Georgia: Peggy Powell (Major Depressive Disorder, PTSD, and other conditions)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4667-ptsd-sufferer-sues-unum-over-denied-insurance-claim

Massachusetts: Mary Paulk (Lumbar Spondylosis with degenerative disc disease)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4649-lawsuit-seeks-long-term-disability-benefits-from-unum

Florida: James Randall (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4608-florida-man-wants-unum-disability-insurance-benefits-instated

California: Victoria Arendain (Total disability due to back problems treated by multiple surgeries)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4587-disabled-woman-sues-unum-for-sudden-benefit-termination

Indiana: Lisa Russ (Numerous physical impairments, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4574-disabled-woman-seeks-back-benefits-in-unum-insurance-lawsuit

Florida: James Maxey (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4550-unum-sued-for-wrongful-termination-of-disability-benefits

Florida: Kevin Kyarsgaard (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4523-unum-customer-seeks-past-future-benefits-in-disability-insurance-lawsuit

South Carolina: Andre Griffin (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4490-lawsuit-alleges-unum-claim-denial-based-on-biased-information

West Virginia: Katie Hall (Husband’s Death Policy Benefits)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4465-judge-dismisses-unum-lawsuit-seeking-insurance-payout

(Dismissal due to the issue having been fully dealt with and settled.)

California: Dr Alan M. Gross (Eye surgeon whose diabetes caused blurred vision and hand numbness, complicated by co-morbidy of bone disease in feet)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4340-orthopedic-surgeon-sues-unum-for-denying-disability

Texas: Byron (Diagnosed as permanently disabled, serious heart condition. Unum claimed his doctor said he was fit for work, proven to be an untruth.)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4267-unum-insurance-gives-heart-patient-one-day-s-notice-of-termination

Los Angeles: Ruben Don (Disability, unspecified)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4202-class-action-lawsuit-accuses-unum-of-shortchanging-policyholders

California: Leah Bilyeu (Chronic fatigue)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4180-california-woman-takes-on-unum-disability-denial

California: Tanya Mondolo, (Avascular Necrosis (bone death) and fibromyalgia, both caused by chemotherapy treatments for Leukemia.)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4027-court-orders-unum-to-pay-policyholder-s-legal-fees

The following three are mentioned in the link that follows them:

Portland, Oregon: Judy, (Nurse whose staff infection immoblised her for a year. Unum approved her claim, but never paid her any money. Has lost her home & medical bills continue to mount.)

Pennsylvania: Elvira (Guillain-Barre Syndrome. Initially UNUM paid her fees while she awaited government disability. When that was through demanded she pay back money they’d paid her. Lost her home, having to file bankruptcy.)

Oregon: Mason (Heart attack, Drs said he needed five more weeks off work due to delayed healing. Unum rejected doctor’s opinion.)

(Understandably) Unidentified Woman (Anal Cancer. Radiation therapy led to complete loss of control of bowels, resulting ‘accidents’ mean she must shower and wash clothes when they happen. UNUM said she was completely able to continue to work if there was a bathroom within 100 feet of her)

http://www.topclassactions.com/lawsuit-settlements/employment-labor/3730-unum-reverses-benefit-denial-for-woman-with-anal-cancer

And on, and on…

http://www.topclassactions.com/lawsuit-settlements/employment-labor/4003-more-unum-insurance-complaints-flood-in

Which is why…
Unum was listed as number two in the American Association for Justice (AAJ)’s “Ten Worst Insurance Companies in America” in 2012.

Written by bigleyma

September 26, 2013 at 5:13 pm

Londonderry Man in Permanent Vegative State Asked If He Is Fit For Work

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My attention was drawn to this case reported on the BBC News website, the latest to come to light regarding the DWP’s assault on the sick and disabled . Its one of the more extreme examples, concerning a young man from Londonderry whose family have had to deal with ‘enquiries’ about their son’s ‘fitness’ by the Social Security Agency. They still use the more apt term ‘social security’over there apparently, while the rest of the UK has been indoctrinated to adopt more work-oriented descriptions for this kind of support. Their son is in a permanent vegative state following a gang attack, suffering severe brain injuries that require round-the-clock care. This has not prevented the Agency from repeatedly sending him forms to fill in for ESA assessment. Not content with the family’s original comprehensive response, which included his specialist neurosurgeon and GP’s report, they then sent out a second form.

“There is a lot of trauma for the family and it’s not eased when forms like this really rub salt in the wounds.”

What struck me in the usual response that the Agency gave to the BBC was the familiar expression that they are “unable to comment on individual cases”. We are so used to seeing this statement that we never question its validity. It is the same opening line you will get if you write to the Secretary of State for Work and Pensions, or any of the personnel responsible for these processes. It has the ring of ‘plausible deniability’ about it. It sounds plausible, and allows them to erect a shield of deniability around any individual’s case, implying that there is some rule (akin to data protection) preventing them from commenting. But that’s rubbish isn’t it? Because families and patients (victims) everywhere are commenting like billyo, all over the place, and at every possible opportunity. So its just part of the scam that allows them to do whatever they want, make as many mistakes as they want, cause as much damage as they want, and simply get away with it.

Written by bigleyma

August 27, 2013 at 12:00 pm

Atos: “Leave Your Clinical Skills, (and Your Principles) at the Door”

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Deputy Medical Director of Sally’s Atos Centre:

 “You’d better throw your principles out the window otherwise you won’t be able to work here.”

 

 My previous post outlined my conclusion that Atos acts as a ‘shield’ for the government, and that by having them as a ‘middle man’ between claimants and the DWP facilitates the deflection of criticism that should rightly be aimed at warped government policies. In this recording for LBC Radio Sally, a former Atos employee, describes her experience with that ‘horrendous organisation’, which she alleges cares as little for its employees as it does the vulnerable people pushed through its WCA process.

Clinical skills not required

This timely appearance of a radio interview with ex-Atos nurse ‘Sally’ goes a long way towards validating my assertion. Sally is yet another ‘whistleblower’ emerging from this firm, and her testimony is even more damning of the bad practice that is rife within, indeed is deliberately built into, their process. It is one she describes as being factory-like, with

“…no regard for your clinical skills…and most of the people who go there haven’t got any because they’ve been out of practice for so long.”

For example most GPs occupied in an Atos role, she asserts, are “…retired or semi-retired, nearing their time…”. Considering the high remuneration for doctors taking up these positions its not unreasonable to suppose that many facing retirement might see it as somewhat of a ‘pension booster’.

 Aside from GPs she criticises the substandard quality of many of the (highly paid) doctors who tend in one way or another to be among the less competent, or less experienced, of medical professionals. This, she says, is because the majority (estimated by her as between 90-95%) are foreign nationals unable to secure NHS employment, or who have failed exams that might qualify them to work legitimately in our healthcare system.

Fiddling the data

Sally also confirms previous allegations about how ratios are set, the ‘targets’ that pre-determine how many claimants should go into each group, so that considerable file ‘juggling’ must be done to make sure those targets are kept to. That revelation met with a gasp of shock by the interviewer, she goes on to say “If you didn’t get those figures right, within your file, then there was repercussions on you…”, and likely ‘disciplinary’ action taken. Its glaringly obvious to anyone that if you’re working to targets you’re not authentically assessing the patient, you’re focusing instead on how people’s data can be manipulated to fit the rigid categories set for you. If you’re led by that then you can’t possibly be led by the evidence in front of you, the claimant’s unique health circumstances.

 The part most relevant to my post, however, is when she questions why the DWP does not employ the doctors and nurses directly, a common sense idea, which, considering the huge profits creamed off by Atos, would be more economically sound.

I think the answer to that is now plainly clear.

It is clear too, that those medical professionals employed by Atos are not there for utilisation of their medical skills, but merely to lend an aura of respectability to a process that has no medical legitimacy, nor even medical relevance, whatsoever.

Written by bigleyma

July 28, 2013 at 11:10 am

ATOS and the DWP – A Performance With Smoke and Mirrors

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Just a Few Bad Apples Reports

The government has been forced by public opinion, alongside a veritable tipping point of overturned decisions, to turn a critical eye on their WCA administrator, Atos. They’ve announced that Atos must produce a performance improvement plan’ since too many of their HCP’s reports are below desired standard. Not, they quickly emphasise, that they are ‘wrong’, simply that they are not putting forward their case clearly enough. The ‘reasoning‘ underpinning a portion of ‘recommendations’ lacks ‘detail’, it seems. No mention of outright misrepresentation, or glaring errors, just the ‘quality’ of report-writing that is not robust enough to underpin the concluding recommendation (upon which DWP officers make their decisions).

Since all emphasis is on substandard ‘report writing’, with no suggestion that decisions derived from them were incorrectly made, I can only interpret this move as an attempt to make those reports ‘foolproof’ against tribunal scrutiny rather than to have them reflect more honestly the applicant’s authentic circumstances with regard to their impairments.

Progress?

Many among the disabled activists and those campaigning on their behalf see this news as a positive development. And it certainly is ‘something’, rather than ‘nothing’. As others have pointed out it is pathetically little, and is nothing like the wholesale denouncement that most would wish for. Sadly, even this last perception is wide of base when it comes to the WCA, and its construction and delivery.

In this situation the position that Atos hold in the system of administration of welfare to the sick and disabled is akin more to ‘useful corporate idiot’ and proof of this is available for anyone to see in the government’s own ESA Regulations.

The Convenient Shield of Atos

Atos is the government’s shield in the symbiotic relationship between them and the DWP. From this relationship Atos draws status, legitimacy and above all massive profits. In this way it is similar to the companies who administer the Work Programme, which itself has been proven to do little more than line private pockets with massive amounts of public money (its actual results assessed as “worse than doing nothing”).

Sadly Atos’ activity, by contrast, definitely does more than nothing. It helps to cast people, whose only offence is to be ill, off health related benefits and either into destitution, or to join the competitive arena of seeking work against the able-bodied and healthy. The latter will, after a year, proceed onto the afore-mentioned, and certified useless, Work Programme, where they are likely to be ‘parked’ in favour of those it is more easy to find work for.

Atos Just Make the I.T., That’s All

What the government get in return from Atos, which is a ‘black box’ in itself, since scrutiny is inhibited by ‘commercial confidentiality’, is a defensive buffer against criticism of their policies. Atos are, in the final analysis, only the administrators of the government’s instrument. The government, through their ESA Regulations, say “This is how you assess people”, “These are the criteria to be used”. The computer driven LIMA system is simply the interface through which the government’s set criteria is ‘operationalised’, made digital. The WCA, as delivered, is an IT construct that is merely the government’s word made technological flesh, the digitalised manifestation of DWP-designed instructions. Because: Atos is an IT company. That’s what they do. They apply their undoubted expertise and experience to produce computerised IT ‘solutions’ to meet real world criteria. They don’t invent the criteria themselves, its provided to them, in this case by the UK government’s DWP.

The DWP Created the WCA

So what’s happening now? Its taken deaths, suicides in increasing numbers, at least two solid years of intensified activity by mainly sick people, who are derided as ‘extremists’ for their efforts, to arrive at this point. This point at which the evidence is so damning, so incriminating, that the facade of legitimacy of the WCA can no longer stand. The outrage that Atos draws from a sizeable portion of the public has become publically visible. But the shield which is Atos, which protects the government, which deflects from government criticism of their instrument, their descriptors, their model of sickness/disability, their deliberately designed construction of what they  will acknowledge as a sick or disabled person in need of help, still stands.

The Slickness of the Hand Deceives the Eye

Direct all your ire at Atos, they say, have said, these past years. It is the administration which is flawed, not the foundation, they claim. But that is not the case. In truth Atos are simply IT specialists who have accurately interpreted their government bosses’ instructions and are now ‘taking one for the team’. And its not a particularly harsh ‘one’ at that; some reports are not up to scratch, its a ‘quality control’ issue, bring in more ‘experts’, retrain the assessors. What a wonderful misdirection, a stage magician’s sleight of hand using smoke and mirrors. Atos is as insubstantial in the WCA process as smoke. The cards are, and have always been, the government’s own, designed, printed and laminated by them in the dark, shadowy recesses offstage. Their construction of the WCA (with the help of dispreputable insurance company, UNUM) will never be seen as long as a company like Atos is available to take the flak. And if Atos are ‘phased out’, as it seems is being prepared, the new Atos will then be the expediter of the government’s hidden programme. A programme that has a compound objective:

  • To choke off the outflow of public money to the sick and disabled, and, as a direct consequence, deter people from perceiving themselves as ill, worthy of support, and therefore inhibiting their take-up of entitled benefits. But possibly incentivising them to take up private insurance instead. (See Unum below)

  • To pull away the safety net of social security, without disturbing the inflow into government coffers of National Insurance contributions. (Another magician’s trick, coincidentally UNUM’s choice of visual metaphor for their ‘Backup Plan‘ tv ads -‘Whip away the tablecloth, but leave the crockery undisturbed’)

  • To change the very definition of sickness/disability itself, limiting qualification for benefits to only the most, and I mean most, seriously impaired – the paraplegic, those with only six months to live (I struggle to find any other categories deemed worthy, at this point).

And meanwhile, even more public money is directed into corporate coffers, through the commissioning of ‘consultants’ Price-Waterhouse-Coopers, brought in to ‘provide independent advice’ on this purported ‘quality-assurance’ issue.

Fortifying the Bad Decisions

Does anyone really think this government agenda, this pogrom programme is going to be affected in any way by cleaning up a few reports, improving grammatical and ‘reasoning’ skills? Its more akin in actuality to a further sharpening of the blade that is already being used to cull the sick. This is what Grayling meant when he resolved to address the problem of so many overturned decisions at tribunal. Its not about getting the decisions right at assessment stage, as any reasonable person would conclude. Its about making the bad decisions stick.

Atos are the necessary blind that disguises government intent. The sad thing is that all that is required is to draw back that blind and the intent is there for all to see, in the government’s own ESA Regulations. “No need for bending, kneeling in the modern workplace”. I’ll leave you to contemplate that absolute gem of contorted, deluded thinking by your government, and consider whether you think it meets the rigours of your own experienced reality.

Written by bigleyma

July 24, 2013 at 2:59 pm

Professor Wessely: Knocking the Docs & Overstepping the Mark

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I feel that my last post ended on a somewhat cryptic note  regarding Professor Wessely, and that I need to support the claim I made about the  undermining of physical medical authority within his ‘doctrine’. This I feel I have previously done to an certain degree with regard to Professor Aylward and his colleagues (here and here), though the potential certainly exists for more to be highlighted.

An insight into what could be termed the ‘under-the-radar‘ approach to undermining the integrity of medical personnel, such as GPs, is provided by Professor Wessely’s article for Unum’s Annual Chief Medical Officer’s Report 2007 entitled “Why and When do Doctors Collude With Patients?” (The CMO for this publication was Michael O’Donnell, now occupying the same role with Atos Healthcare.)

Subtle But Significant

This notion may seem to be introduced with apparent goodwill, even humour, but the important fact is that it is introduced at all. The question should always be asked about corporately financed material “Who is set to benefit from the dissemination of these ideas?”. Is there anything to gain on the part of the Insurance firm Unum who produced the report? – Such as carving a first chink in the hitherto resilient armour of the authority of physical medicine, perhaps. This, by suggesting that doctors can be psychologically ‘vulnerable’ to forms of ‘collusion’ with those in their care in ways which might work against the patient’s welfare.

Might it not in fact be an attempt to first, construct such a thing as this type of ‘psychological failing‘ of a doctor, and second, draw it into the classification of ‘iatrogenesis‘, a term historically limited to the adverse effects on patients of drugs, medical error, or negligence through decisions taken by medical personnel. Note should be taken of Professor Wessely’s reference to the naivety of  ‘ethically pure’ young doctors, new to practice, who will come to the realisation that “in real life things are not neat and simple, but grey and ambiguous”, ultimately, presumably, succumbing to this ‘necessary collusion’. Some of the reasons for colluding that Wessely lists give anything but a favourable impression of our medical practioners, including as it does such things as  financial reward, lack of time and fear of complaint.

Poor NHS. Also deluded.

Just prior to introducing Professor Wessely’s article Michael O’Donnell bemoans the way that “our NHS managers [are] fixated on providing those treatments which can be measured” such as operations and injections. As opposed perhaps to psychological interventions which rest solely on, and the success of which is evaluated only by, certain ‘experts’ in that field. He then states that “until return to work is included as the objective and final measure of success, it seems likely that the NHS will continue to miss the point.” This is of course an ‘objective’ perspective, and nothing whatsoever to do with the fact that it serves insurers such as Unum’s best interests (and saves them money) to get the sick back to work.

Wessely’s ‘Previous’

If what I’m claiming seems a little exaggerated, or ‘conspiracy theory-ish’ perhaps you should also take a look at this paper by Professor Wessely from 2003. The main thrust of of which is that doctors who accept the possibility that their patients suffering from (ahem) ‘Medically Unexplained Symptoms’ (MUS) may actually be physically ill are in danger of committing an ‘iatrogenic’ offence against them. He does this by arguing that patients with ‘MUS’ conditions (an important and expensive group he alleges) are in effect made worse by doctors taking their illnesses seriously and organising physical investigations and treatments. There are, Wessely concludes, “points within the doctor-patient encounter where MUS may be iatrogenically maintained“. In simple terms, doctors need to stop ‘colluding’ with these patients because it is doing them harm.

Note: Professor Wessely’s list of MUS illnesses in the paper (detailed below) correlates very closely with those listed by fellow psychiatrist Dr Christopher Bass at the 2004 Atos Conference referenced in my earlier post. (Though he omits chronic back pain in favour of irritable bowel syndrome)

Non-cardiac chest pain

Fibromyalgia

Chronic fatigue syndrome

Repetitive strain injury

Caution: Unbridled Arrogance Ahead. 

An unexpected  interjection to the article under the sub-heading ‘Social’ is yet more evidence of just how entitled proponents of the Biopsychosocial model perceive themselves to be in stepping out of their own field and usurping theories from Sociology to twist into their arguments. Aylward from his ‘Medical’ expertise, and Wessely from Psychiatry. It is very telling indeed that there are no qualifed Sociologists involved in the Biopsychosocial lobby. A small matter of ethics, perhaps.

Wessely’s A Sociologist Now?

In this instance Wessely attempts to appropriate Ivan Illich’s notion of ‘Social Iatrogenesis and ‘invent’ his own version for his own purposes.
Illich explains the meaning of his term as referring to the “impairments to health that are due precisely to those socio-economic transformations which have been made attractive, possible, or necessary by the institutional shape health care has taken“.  Note the use of the word ‘institutional’ here.
Illich’s main concern is that autonomy has been removed from the people, and he speaks about the danger of ‘radical monopolies’ such as is expressed in the idea that “When cities are built around vehicles, they devalue human feet“.

Illich asserts that “Ordinary monopolies corner the market; radical monopolies disable people from doing or making things on their own”. Disregarding this core idea, Wessely feels entitled to put his own spin on ‘Social Iatrogenesis’. Describing it as “a term for illness caused or prolonged by wider sociopolitical inputs” he uses it to discredit ‘Patient Support Groups, no less! It would be quite one thing were he a qualified Sociologist to make that assertion, and accordingly be ethically required to back it up with a full argument as to why that could be a reasonable (though inexplicably contradictory) interpretation of Illich’s theory. It is quite an extraordinary presumption to appropriate that theory towards the opposite aim of its originator.  Patient Support Groups are nothing if not an attempt to restore a measure of  autonomy to ‘the people’ within what has become an ever more  bureaucratised, institutionalised healthcare system.  This is nothing short of  abominable arrogance on Wessely’s part, but oh so very symptomatic of this group of ‘experts’ including Aylward et al.

Could He Possibly Be More Wrong?

Wessely just couldn’t be more wrong in citing Illich in this context, when the latter complains that the spread of medicine “turns mutual care and self-medication into misdemeanors or felonies”. Please compare against Wessely’s rubbishing in the Unum Report of any steps that that an individual may take outside of traditional medicine to ‘self-medicate’. These potential treatments he disparages as ‘”cod-immunology [mixed with] pseudo radiation science interspersed with New Age homilies” directing us towards that reknowed ‘quack-busting’ site ‘BadScience.com’. Hardly comments or sentiments in line with Illich’s philosophy is it? No, it’s quite the opposite. Perhaps Professor needs to sign up for a beginner’s course in Sociology, or better still refrain from playing with concepts that he doesn’t understand.

I’ll leave the final word to Illich on “nosology” (the system of classification of diseases, which he notes “changes with history”)

 In our society nosology is almost totally medicalized; ill-health that is not labeled by the physician is written off either as malingering or as illusion.

Oh deary me, Professor Wessely, oh deary me…

Written by bigleyma

October 5, 2012 at 11:54 pm

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