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Archive for the ‘Omitted definition: Work’ Category

The ‘Psychologising’ of Illness and The Sanctification of Work

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I’ve been away a little while (longer than I intended), partly because I’ve been working on an article for the International Green Socialist online magazine. It turned into a larger project than I intended, but I hope visitors here will give it a go because I think it exposes some deliberate processes that have been going on behind the scenes of the new ‘reforms’ of health related benefits, to the disadvantage of the sick and disabled in this country. Despite its length I still feel there is more to be said about this and I hope to be following it up with more in depth analyses in the near future.

Fill your boots (as my darling daughter would say) here:

Illness as ‘Deviance’, Work as Glittering Salvation and the ‘Psyching-up’ of the Medical Model: Strategies for Getting The Sick ‘Back To Work’.

(You might need more than one pair :D)

Update: Noticed that the above link is not presently working so a copy of the article can be found here: https://dl.dropboxusercontent.com/u/32109159/Illness%20as%20Deviance.pdf

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My Freedom Of Information requests (links):

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28th July 2011: (response expected by 26th August)

http://www.whatdotheyknow.com/request/volume_of_correspondence_re_atos#incoming-197423

“Dear Department for Work and Pensions,

I have recently written letters, with requests for answers, to DWP
Ministers Iain Duncan Smith and Chris Grayling, concerning the
practices of Atos Healthcare. In response I received generic
letters from ‘The Correspondence Team’ claiming Ministers are
unable to respond due to the ‘large volume’ of mail they receive.

Could you please release to me the statistics on the amount of
mail, both written and electronic, that the DWP have received that
are connected with Atos Healthcare, ESA or the WCA?”

http://www.whatdotheyknow.com/request/identification_of_medical_resear#incoming-197479

“Dear Department for Work and Pensions,

The DWP states that the structure underpinning the Work Capability
Assessment is derived from “evidence based medical research carried
out by Atos Healthcare to determine the functional consequences of
specific clinical signs”.

When I emailed Atos Healthcare to request identification of this
medical research I was directed to contact the DWP for it. I was
surprised, as since it was conducted by Atos Healthcare one would
expect them to take responsibility for it. I pressed them further,
but they repeated that “any enquiry related to an area of Atos
Healthcare’s Business is a FOI” and that contractually the DWP is
responsible for dealing with these. Very surprising.

Regardless, I must then request from the DWP, as I did from Atos,
details of what this research constitutes. I would expect an
extensive and comprehensive body of research, including all
relevant material such as: Names of researchers involved, evidence
generated, methods, conclusions, meta-analyses etc in such forms as
reports, journal articles, conference reports and so on.”

2nd August 2011: (response expected by 31st August)

http://www.whatdotheyknow.com/request/statistics_request_the_distribut#incoming-198620

“Dear Department for Work and Pensions,

In March 2011 amendments to the ESA regulations resulted in the
modification of WCA descriptors and the deletion of some of these
as no longer relevant. As these descriptors are claimed to relate
to actual work environments I am requesting the following
employment-related data.

1. Does the DWP keep records of the various Occupational
Classification categories which those claiming a health-related
benefit (such as ESA or DLA) fell into prior to them giving up
work.

2. If so, can you please release figures to date for this?

3. If possible a further breakdown into the numbered sections of
those categories would be requested, so as to identify more closely
the distribution of occupations amongst claimants, demonstrating
type of work that is most/least prevalent etc.”

Note of explanation for the third request. At the 14th June meeting of the First Delegated Legislation Committe regarding the 2011 amendments to the ESA regulations, Stephen Timms MP made the following observation about the changed descriptors:

“Citizens Advice objected to the removal from the list of the requirement to be able to bend or kneel – apparently removed because we do not need to do that any more in a modern workplace (my italics).

Wow. Really? Actually I’ve just tried to write a sentence about that several times, and words fail to adequately express what I think. So, I thought perhaps a FOI request was in order. Will it reveal that all claimants had non-bending, non-kneeling occupations before becoming sick or disabled? Highly unlikely, but I await with suspense their response, and relish the chance to get my data-scouring tentacles into gear.

Perhaps the most pertinent aspect of this will be, as Mr Timms repeated, Mr Grayling’s affirmed intent to ignore all aspects of real world work while assessing people’s fitness for it:

“The one thing I am absolutely unreservedly and implacably opposed to in all of this is a real world test”

Link for the above quotes:

http://www.publications.parliament.uk/pa/cm/cmtoday/cmstand/output/deleg/dg01110614-01.htm

Written by bigleyma

August 2, 2011 at 3:23 pm

Criticism of WCA by Repetitive Strain Charity ‘RSI Action’

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http://www.publications.parliament.uk/pa/cm200809/cmselect/cmworpen/memo/decision/ucm0702.htm

Recommendations that RSI Action would like the committee to consider.

· That the WCA should reflect the intent of the primary legislation, and focus on work-based activities.

· That DWP should seriously consider developing a model to provide objective links between 21st-century working activities and the WCA.

· Improved guidance for the claimant should be developed, identifying the work-based nature of the WCA and the need to consider reliability repeatability and safety.

· The medical report form (ESA85) should be provided to the claimant as a matter of course at the assessment, to ensure that the claimant’s information has not been misrepresented.

· Health care professionals and decision-makers should be trained and provided with suitable information on all relevant medical conditions. The training material and information should be publicly available, and DWP should seek agreement with relevant charities and relevant medical experts.

· Healthcare professionals in decision-makers should recognize the expertise that disabled claimants have in their own medical conditions, when considering the impact of the claimants disability.

· The DWP and ministers should focus on reducing departmental error rather than fraud.

· The intense focus on benefit fraud should be reduced as it is causing victimisation of the most vulnerable in society.

The most important observation that they make is about the missing definition of work within a process in which it plays such a significant part. The WCA is meant to determine people’s capacity to perform work, but neither ATOS nor the DWP use the term in anything other than an abstract way. This of course is in stark contrast to the attempt to reduce illness to a series of intricately specific ‘actual’ functional capabilities. But work, also, is composed of actual functions, and much much more diverse in what it demands from a worker than the levels of activity to which the WCA refers. Work is not generic, it is very specific for the person doing it.

Work too is not carried out according to the worker’s capacity, it is carried out to meet the requirements of the employer. As the RSI Action memorandum states there has to be an acknowledgement of 21st century working practices.  Inherent within the ‘capability’ descriptors is an assumption that work is something people do in offices at their own pace, as there is an emphasis on ‘sitting’, pressing buttons/keyboards, and use of such everyday activities as watching tv, reading etc to prove some capacity for work.

What about the kitchen porter who has to endure standing for hours, lifting heavy piles of plates, commercial pans, having to clean down work surfaces at speed and mop floors at the end of their shift, travel home for a few hours rest before they have to go back in because they’re on a split shift. The hospital cleaner (have you see how fast they work?) who has to cover an immense area, wiping, cleaning, moving beds, again mopping floors (which is actually a complex physical activity involving a high degreee of musculoskeletal flexibility). Factory workers, standing for hours, repeated movements at speeds dictated by the machinery.

The concept of work contained within the WCA is very immature and naive at best. Ignorant some would say. But most likely it reflects the experiences of those who designed it, who probably have no conception at all what the wider field of work is like.

2.1.1.4 The DWP have no model of what work is in the 21st century, and what activities workers are expected to carry out, or how frequently these work activities would be repeated. Consequently there is no traceability between the WCA descriptors and work in the 21st century.

In other words the failure to apply the ‘capabilities’ to any real world actual conditions of work renders the Work Capability Assessment meaningless.

Written by bigleyma

July 22, 2011 at 2:45 pm