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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

My Response to Professor Aylward’s statements to BT and DPAC

with 7 comments

A response to Professor Aylward’s statement to Black Triangle and DPAC outside the IFDM2012 conference, on 11th September 2012.

“Few people have been involved in as many return to work or rehabilitation initiatives as Professor Mansel Aylward” [1]

I was, quite frankly, staggered to read Professor Aylward’s response to the questions posed to him about his usage of the Bio-Psycho-Social (BPS) Model and his apparent denial that his ideas have been deliberately used in the way that I and others have asserted; which is to establish a process, the Work Capability Assessment (WCA) by which the majority of the sick can be illegitimately found fit for work.

In my article on the subject [2] I believe I argue convincingly quite the opposite to Professor Aylward’s current assertions, providing examples that indicate how this has been achieved. It is an ideas trail which leads directly back to the esteemed professor and his (and his various colleagues), efforts, (in concert with the insurance firm, Unum), to revolutionise the way in which our health related benefits are administered – with its overwhelming emphasis on ‘proving’, in the words of Chris Grayling, almost everyone capable of ‘some work’. What the WCA most certainly is not, contrary to claims otherwise, is a fair, impartial and objective method of assessing someone’s capacity for work. And one who must take a large part of the responsibility for that situation having arisen is Professor Aylward himself.

Ruthless promotion of the BPS model

Examining Professor Aylward’s recent defence of his position on BPS, and the links that have been made between his work and the rearrangement of our welfare system, it would seem that he is now claiming to have had no influence upon the changes which have been wrought. This is an astonishing claim in light of the manner in which he and others of his cohort have ruthlessly promoted and applied some very specific ideas about illness. These academics, including Professor Aylward, within what I have previously termed the ‘BPS lobby’, have consistently and persistently pushed their ‘new’ notions about illness and disability until they, first successfully penetrated, and then became the sole authoritative discourse within official literature in this area.

They were able to do so through drawing on their privileged positions as leaders of medical and scientific authoritative discourse and doctrine. We should remind ourselves too that welfare policy is to all intents and purposes a form of law, which in the case of welfare benefits is very strenuously applied. Results of failure to comply are severe, and punished mercilessly by the modern system. Those stigmatised as ‘scroungers’ or ‘malingerers’ are afforded zero tolerance and enthusiastically chased to ground and pilloried in our contemporary society. All the more reason, then, for the ideas which have fed into those administrative instruments by which people’s health is assessed to be above criticism, and fair and just, avoiding adding to any stigmatisation of illness and disability.

On 11th September Professor Aylward claimed to ‘sympathise’ with the ‘grievances’ raised by the disabled community. He hints that the address he had just given about the BPS model contained criticism of its current application with respect to disabled people; that he now finds it ‘unsatisfactory’, because it “no longer addresses the exclusion of disabled people from society“. When did it ever, professor? It is not the BPS model itself that people are outraged by, sir, but the uses to which it has been put. And that has been to further ‘exclude’ sick and disabled people from society by further disabling them through adding demonisation to their stigmatisation, and financial penury to their already disadvantaged economic situation. And all this has been accomplished via the Atos administered WCA, built as it was on ideas about ‘illness’ culled from your literature, and that of the insurance firm Unum, whose processes have been aptly described as ‘disability denial factories’.

Meaning of the ‘social’

Professor Aylward wishes that people would believe that he had never taken any other view than that “the social element has been neglected” in the application of ideas from BPS.

But what exactly has been the professor’s use of the ‘social’? That he proposes that this has been neglected in the application of BPS is something I agree with wholeheartedly. The potentially hazardous effects of that most ‘social’ activity of work have been elided, quite deliberately, by he and his colleagues. In fact Professor Aylward has gone to extreme lengths to persuade both medical practitioners and the wider public alike that we all have the wrong idea about work posing possible hazards to health. The positive benefits of work have been hammered home regularly in the publications and research conclusions at every possible opportunity. Not only that but Professor Aylward has decreed that all dialogue about work should be changed, all those ‘erroneous’ ideas that work contributes to poor health must be reclassified as ‘myths’, and work reconstituted in our minds as an essential component of recovery from illness; for everyone, no matter what degree of illness they suffer.  [3]

Considering the strong emphasis on ‘work’ in that aspect of his literature, is this the form of the ‘social’ that Professor Aylward is drawing upon? It appears not. On the release of his co-authored scientific book ‘The Power of Belief’ [4] Professor Aylward gave a presentation around its themes to a joint meeting of the British Psychological Society and Association of British Psychologists. In a graphic which describes the three elements of BPS the ‘social’ is defined by three keywords. Beneath the vague, undetermined ‘culture‘ and ‘social interaction’ we find: ‘the sick role’. [5.,Slide 18]  For anyone unaware of this concept, it promotes, among other things, the notion that a sick person has much to gain from ‘playing’ the sick role. Patients are portrayed as accruing certain advantages from being ill (or merely claiming to be so). These are so-called secondary gains such as ‘exemption from ‘performing’ in society, and from social responsibilities, as well as receiving attention and help that those who do not claim sickness cannot. Those are the ‘rights’ that sick people enjoy. On the other side is the obligation to do everything a person possibly can to get better and participate fully in society. The problem around this, of course, is the assumption that illness can always be recovered from, that the sick will always heal. This is a notion which is not only unhelpful, but is positively harmful when the sick role is attached to the long-term, chronically ill. This, however, is the very aspect of ‘the social’ which Professor Aylward evidently gives priority to in his theories. And it is exactly that idea which is incorporated within the WCA, whereby chronically sick people, with progressive and sometimes terminal illnesses are being forced into a perpetual round of reassessment, the black magic roundabout administered by Atos, just in case they have magically become ‘well’. When we have a situation of someone with Down’s syndrome being asked at their WCA how long they have had that ‘condition’, it is not hard to visualise that she too will be continually reassessed to see if her ‘condition’ improves over time.

Atos, too, endorse concept of ‘secondary gains’ when assessing illness

This idea of the ‘sick role’ is mirrored in an Atos publication of 2004. [6] If any doubt remains about the way in which Atos regards those who are subjected to its formulaic tick box assessment process then this publication will dispel them. A side panel of the document authored by Dr Christopher Bass is entitled familiarly “Symptoms that defy explanation” and includes a helpful list of conditions that fall within this category, including

Chronic Fatigue Syndrome

Fibromyalgia

Chronic back pain

Repetitive Strain Injury

Non-cardiac chest pain

Dr Bass then proceeds to make much of this concept of ‘secondary gains’ that presumably accrue from claims to these particular types of ‘common’ illnesses, describing them thus:

Work absence as a reward for years of struggle; turning a socially unacceptable disability into a more acceptable ‘organic’ disability caused by injury or disease beyond their control. They can blame their failures on the illness; elicit care, sympathy and concern from family and friends; avoid work or even sex; and there are financial rewards associated with disability“.

I don’t think I’ve ever seen this defamatory notion expressed quite so blatantly towards the members of the sick and disabled community. But then again, this is Atos, who have proven themselves to be Teflon against all legitimate complaints that have been made against them.

I can’t help but wonder how many of these sufferers from ‘unexplained illnesses’ have spent their final months in desperate circumstances after being denied their benefits by Atos.

We think therefore we are…

That ‘version’ of the ‘social’ aside, in practically all Professor Aylward’s work there seems to be nothing but the remorseless application of the psychological, at the expense of any consideration of the social.

The Power of Belief[4], was published at the time of the Unum funding of the Centre at Cardiff University under his directorship. An illustrative chapter title from this collection is “Explaining unexplained symptoms: The role of beliefs in clinical management’. This volume is a multiple contributor work which centres solely on the idea that how people regard their illness is the most important factor in determining the course of it. Not their physical limitations; their pain; the barriers their condition puts up between them and everyday social functioning; the distress arising from having an impaired physical (or mental) interface with which to negotiate a society which caters only to the able-bodied. No, none of these have as much validity or significance in a sick person’s life than what they ‘think‘ about the state of their bodies. This one notion makes it possible to place the blame for someone’s inability to function successfully in the world squarely on their own shoulders, and has made possible, too, the idea that people can ‘recover’ if they only adopt a positive attitude towards that end. This latter idea too, not only holds a special significance within both the professor’s personal ideology and his literature, but is highly implicit in the justifications for the increasing numbers forced off Employment Support Allowance who are portrayed as needing to have ‘tough love’ applied by their government, lest they ‘fester’ on benefits.

An interesting reference is made within the book’s introduction to the rise in ‘symptom based conditions‘ and, as I will cover in a follow up to this piece, this is a concept which has been treated by Professor Aylward in two totally contradictory ways, at different points in time, an action which can only seriously call into question his motives for doing so.

Medicine is the ultimate authority, except when it doesn’t concur…

I have previously written [2] about the inconsistency of the way ideas from the BPS model are used by Professor Aylward and his colleagues -that they are inevitably used in a plastic way, and opportunistically. When the argument calls for ‘authority’ to substantiate their ideas, such as suggestions that some illnesses lack validity, medical aspects are drawn upon, as is implied in their reference to ‘medically unexplained’ conditions. In all other cases the ‘medical’ model or ‘bio’ aspect is disparaged or minimised, as, too, are medical personnel. GPs and specialists, are robbed of their authority; and their capacity to determine a person’s capability to function is questioned. In fact doctors must now be themselves ‘indoctrinated’ to some extent into the ‘new paradigm’ [7.]. This, to date, they are apparently resistant to, committed to their self-identification as patient advocates. This taken-for-granted factor, though, is seen as only one influence on them, since many are accused of being of weak character or of ignorance, through ‘fear’ of repercussions from patients should they deny the requested sick note [8], or through their lack of awareness of the positive part that work supposedly plays in recovery for their patients They are denied, within BPS ideology, the capacity to exert any form of judgement in any given patient’s situation over whether work would be a help or a hindrance to getting well. Their reticence to wholeheartedly swallow this new paradigm is constructed as a (misdirected) stubborn commitment to an irrelevant ‘medical’ perspective on sickness and disability. It is difficult to perceive this as anything other than an attempt to downplay medical authority when it does not suit the ideology or the ends that the Professor Aylward and his BPS lobby are seeking.

SNORB – Indoctrination for the doctors

What is SNORB?  The acronym stands for ‘Sick Note or Bust’, a slogan whose meaning is difficult to grasp. Perhaps it makes more sense to GPs, who are its intended targets. Could it perhaps be meant to represent the attitude of patients who are determined to ‘get signed off’ at all costs? Regardless, SNORB is an initiative created by Professor Aylward’s Cardiff Centre and is part of a campaign to ‘turn around’ GPs’ thinking and change their behaviour around the issuing of sick notes to their patients. Its existence came to the fore through examination of yet another presentation given by Professor Aylward, containing the inevitable repeated themes which seek to link work and health as mutually beneficial partners. This time it was at a ‘Rehabilitation Workshop’ – for insurers, with a panel composed of representatives from the major insurance companies, NFU Mutual, Legal and General and Axa. It’s title is ‘Health and Work: The Moral Obligation’ [9]. As indicated the themes consist of ‘Work is the main (only?) route to wellbeing’, and ‘The most significant obstacle to recovery is found within the psyche, in people’s beliefs about illness’, and so on ad nauseum. The BPS lobby pave the way for a later discrediting, or minimising, of that which they intend to disparage by framing it in terms of a ‘mystery’ or ‘paradox’ or as a set of ‘myths’. Thus (in this presentation, slide 8) an alleged ‘Health paradox’ of improvements asserted to have been made in health outcomes versus increased insurance claims is constructed. As pointed out also in my article [2.], conclusions made about health by these academics are demonstrably flawed, relying on interpretation of data which favours simplistic over-generalisations that overlook such things as unequal distribution of illness across classes, or hierarchical levels of employment, or indeed geographical location. Once, however, the seed of doubt has been planted, and a shroud of mystery has been cast, it is a small matter to finish the job of delegitimisation, to render invalid commonly understood notions about illness or disability through proposing a ‘solution’ which by contrast appears clear, pragmatic and founded in comparative rationality.

SNORB is introduced to this insurance fraternity following the heading ‘Why GPs don’t want to know’, under suggestions for the removal of ‘barriers’. A description of SNORB ‘training’ materials for GPs would not do it justice and a visit to the website [10.] is necessary to fully appreciate the manner in which our doctors are being encouraged to conduct their dialogue with patients about work. I do not use the term ‘indoctrination’ lightly in this instance.

‘Objectivity’ sometimes vital, sometimes not – Two contradictory presentations.

The BPS lobby take a similar attitude to ‘objectivity’, the cornerstone of any professed scientific method, as they do to ‘medical authority’. When it suits the professor’s desired aims to emphasise the importance of ‘objectivity‘, for example in order to diminish the validity of certain conditions, those categorised in his account as ‘subjective‘ or ‘symptom based’ (ie depend largely on personal accounts of pain, discomfort and distress), then this is done. But when the desired effect is to inject some doubt into existing ways of assessing capacity in illness, (ie via the ‘medical model’) Professor Aylward depicts ‘objectivity’ as far less reliable or even achievable.

At one end of this scale a presentation which the professor gave in Amsterdam in 2007 for occupational and insurance physicians, ‘The Assessment of Work Capacity in the United Kingdom’, [11.] begins with the astonishing claim that “The assessment of Work Capacity is frustrated by the meaningless pursuit for objectivity“. The presentation ends with a call to “Abandon the forlorn pursuit of objectivity” and “Embrace the bio-psycho-social paradigm shift”. The cult-like appearance of these last two phrases comes as no real surprise since their objective is to bring about a kind of brainwashing effect into a new ‘way of thinking’. Revealingly, a note attached to the presentation declares that incapacity benefits are a “big area of reformby which the employment rates of sick and disabled people may be increased. Are we really expected to believe that the professor has not had continuing involvement, indeed influence, in these reforms?

Contrarily, Professor Aylward’s presentation at a Sydney conference three years later, entitled ‘Realising the Health Benefits of Work’ [12.] to ‘leaders’ from Australian government and industry depicts ‘objectivity’ quite differently. Here it is presented as a taken for granted final arbiter of fact. In this case it is used, as it so often is by the BPS lobby, to undermine the validity of a range of health conditions, including mental health, musculo-skeletal and cardio-respiratory conditions. Such illnesses are minimised by alleging that they show “Limited objective evidence of disease”.

WCA – an ‘objective’ tool for assessing ‘Work Capacity’

It is disconcerting, when the professor is so particularly adamant about so many of his

assertions to see how flexible a concept ‘objectivity’ becomes in his hands, being capable of being raised or dismissed at will, apparently dependant on which underlying agenda he intends to fulfil. Considering that the major claim to legitimacy of the WCA is that it is impartial, through being built upon objective scientific principles, if as he asserts ‘objectivity’ in the assessment of Work Capacity is unattainable, then this completely undermines it as an authoritative instrument, and proves it to be a fraud. A fraud with devastating consequences for tens of thousands of innocent sick and disabled who are being denied support on its basis.

It may seem like splitting hairs to draw attention this way to the use of words. But when words are used to convince governments to undertake policy changes which aim to remove support from an estimated million people there really had better be clear, robust and consistent arguments to support them. If I were to challenge the government on an issue, and let’s imagine for a moment that it bothered to give me a reasonable reply, it would take a familiar form. Statistics would be quoted, plausible arguments raised. I would be pointed in the direction of those who had produced the research and whose credentials I should trust to have produced honest, impartial, and yes, objective work.

This cannot be said to be the case with the WCA. What we have instead is a process whose intellectual origins are worse than dubious, permeated (and therefore tainted) with vested interests of one type or another, and the academic substance of which is wanting and inconsistent at best, seriously biased and compromised at worst, contaminated by an association with private profits. As a result of it the government is pushing people off benefits faster than Disney threw lemmings off a cliff. This is Professor Aylward’s legacy, and he is clearly attempting to extricate himself from his indisputable and powerfully influential involvement in facilitating it.

Refuted connections

One of the ways that Professor Aylward is now attempting to distance himself (which in my follow up to this piece I will show is not a first for him) from what is becoming incontrovertible proof that the WCA is a fraud perpetrated upon the vulnerable, is through claims that his input into the development of this process has been minimal, and connected only vaguely to work on assessments he did while in previous service at the DSS.

Why then does he display the acronym ‘DDAM’ among his string of qualifications [13.], since ‘DDAM’ is the Diploma in Disability Assessment Medicine, a qualification specifically developed for HCPs administering the WCA – the training and accreditation for which is delivered solely by Atos Origin [14]. The primary academic reference for those studying for this qualification is the Disability Handbook [15], co-edited by Professor Aylward together with his ex-DSS colleague Peter Dewis [16.]

Both these doctors left government service to work for insurance firm UNUM, albeit for Professor Aylward it was under the umbrella of academic ‘funding’ provided by that company, though he must have necessarily been involved in negotiations with that company prior to leaving his government post in order to put that in place. Further, a third co-editor of that book, Dr Moira Henderson went on to hold the post of Chief Examiner for the DDAM from 2003 until 2012 [17.]

Dr Dewis’ involvement with the WCA is substantial. UNUM have described him as having “been instrumental in the setting up of the diploma of Disability Assessment Medicine of the Faculty of Occupational Medicine of the Royal College of Physicians” confirming that he “continues to work as an examiner for that diploma“. The 2005 UNUM page which attests to this has been removed, but Zoominfo has links to a cached version of it here: [18.]

A further reference on that page refers to the ‘leading role’ that Dr Dewis has played in the “development of disability assessment medicine”.

The ‘Disability Handbook’ is quite obviously the authoritative work on which the WCA was built and from which disability assessment has been sourced, and to which all who deal with disability in a general sense refer, bearing as it does the authoritative stamp of the UK government. Does Professor Aylward wish us to believe that although his co-editors of such an influential work have gone on to become further embedded within the Atos process, that despite being by far the most senior, influential, member of the group, and despite he himself holding the DDAM qualification, he has had nothing further to do with it?

This, while he has continued to work closely with his Unum employed colleague, Dr Dewis [19.], who now holds a Directorship with that company following an initial tenure as Chief Medical Officer ?[18] Is it really credible that he would be so uninformed about Atos and the WCA?

This information about Peter Dewis, by the way, is all the confirmation that anyone should need as proof of the direct connections between Unum and Atos, since he quite obviously works for both simultaneously. That, and the fact that Michael O’Donnell, now Chief Medical Officer since 2011 with Atos, held that exact same role for ten years with Unum. Though this is quite openly public knowledge, it is evidently not regarded as any conflict of interest by our government, despite Unum’s quite blatant attempt to capitalise on the increased precarity caused by these ‘reforms’ with their ‘Income Protection Insurance’.

Integrity – when one finds that the boot is on the other foot

Conscious perhaps of the emerging exposure of the profoundly influential role he has played in the WCA, and evidently experiencing a feeling of vulnerability concerning his reputation, Professor Aylward makes the plea of professing himself to be “a man of integrity”. Whether indeed he carries out his implied promise to ‘speak out’ if he ‘finds the WCA is not proper’ will demonstrate whether this is the case. What cannot be overlooked is the fact of the, now hundreds of thousands of sick and disabled people who have already had their integrity spuriously attacked via the  humiliating, fraudulent ordeal that is the WCA, the repercussions from which have damaged far, far more than their reputations. And the root of which is without any shadow of a doubt Professor Aylward’s work.

Gill Thorburn 18th September 2012.

 

References

As some of the material referred to is in the form of pdfs and powerpoints I have made them available through my dropbox account. The rest are weblinks.

[1.] Professor Mansel Aylward – The Interventionist https://dl.dropbox.com/u/32109159/Aylward/01.AylwardTheInterventionist-PostOnline2009.pdf

[2.] https://dl.dropboxusercontent.com/u/32109159/Illness%20as%20Deviance.pdf

[3.] https://dl.dropbox.com/u/32109159/Aylward/03.Waddell.WorkIsGood.ppt

[4.] http://www.amazon.co.uk/The-Power-Belief-Psychosocial-disability/dp/0198530110

[5] https://dl.dropbox.com/u/32109159/Aylward/05.Sept20BPSCardiff.pdf

[6] https://dl.dropbox.com/u/32109159/Aylward/06.AtosConference2004.pdf

[7] https://dl.dropbox.com/u/32109159/Aylward/07.DWPForDoctorsWorkIsGood.pdf

[8] https://dl.dropbox.com/u/32109159/Aylward/08.Aylward.GPs.pdf

[9] https://dl.dropbox.com/u/32109159/Aylward/09.RehabilitationWorkshopForInsurers.pdf

[10] http://www.healthyworkinguk.co.uk/uploads/decision_aid/resource/snorb/

[11] https://dl.dropbox.com/u/32109159/Aylward/11.Aylward.AssessmentOfWorkCapacity.ppt

[12] https://dl.dropbox.com/u/32109159/Aylward/12.Aylward.RealisingHealthBenefitsWork.pdf

[13] http://www.debretts.com/people/biographies/browse/a/25041/Mansel+AYLWARD.aspx

[14] http://www.fom.ac.uk/education/non-specialist-qualifications-and-training/diplomas/ddam

[15] http://www.fom.ac.uk/wp-content/uploads/ddamread1.pdf

[16] http://www.wharfside.org.uk/events/disability_handbook.pdf

[17] http://www.fom.ac.uk/general-news/new-chief-examiner-diploma-disability-assessment-medicine-ddam

[18] http://www.zoominfo.com/#!search/profile/person?personId=508408589&targetid=profile.

[19] https://dl.dropbox.com/u/32109159/Aylward/18.Aylward.Unum.Cardiff.Issue1.pdf

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

Peter Dewis: Steppin’ Sideways from Government to Unum

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This is Peter Dewis BSc MB ChB DDAM MRCP, UNUM’s UK Customer Care Director.

‘DDAM’ is the Diploma in Disability Assessment Medicine, a qualification whose training and accreditation is delivered by ATOS ORIGIN.

 

 

 

For sixteen years prior to taking up his current position at UNUM (which commenced in 2000) Dr Dewis held a post with the UK Government’s Department of Social Security (the precursor to today’s DWP). He seems to have worked his way through levels of the DSS, as UNUM describe him as having held ‘claims management, managerial and policy roles’ there. (I would link to the Unum web resource for this, but like quite a lot of their ‘old’ publicity material the hyperlink has disappeared, so the account only remains as an excerpt within a Nexis search result.)

In their (2008) description of his place in their  Executive Committee UNUM also position him as a ‘recognised expert in the developing discipline of Disability Assessment Medicine’. One would hope so, seeing as he co-authored, with Mansel Aylward, the DWP commissioned ‘Disability Handbook’ (2nd Ed) in 1998 – the book that tops the list of ‘Essential Reading’ for those taking the DDAM. As the string of letters after his name include DDAM I hope he really aced that course, considering that he himself helped provide its academic underpinnings!

I’m joking. I imagine its some kind of convention that when you devise a course you’re entitled to award yourself the qualification. Rather messes with your mind, though, that idea….

So, to sum it up: Here is a man who has extensive (one might say ‘insider’) experience of the way government works with respect to our Social Security/Welfare System, someone used to shaping policies. During his time as a public servant he laid the foundations for disability assessment through compilation of the Disability Handbook, following that up in 1999 by being ‘instrumental’ in setting up the training course designed to turn the medically qualified into Disability Analysts. Though working for UNUM since 2000 he has also been a practicing examiner for the DDMA (certainly as late as 2008 according to UNUM’s account), and therefore simultaneously in the pay of  ATOS who deliver the course (see link above).

Evidently the connections between UNUM and ATOS are much more symbiotic than either they or our government are willing to admit. The DWP constantly try to downplay the influence that UNUM have had on our welfare policies (positioning them as one among many holders of expertise that they have consulted), yet once again this is belied by the patterns of shared executive employment across the two companies.

 

 

 

 

 

Written by bigleyma

October 13, 2011 at 10:52 pm

Black Triangle Campaign: Are Unum all set to benefit from ‘insider’ knowledge of UK welfare?

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The Black Triangle Campaign today highlighted the conflict of interest that is at the heart of Big Insurance firm Unum’s relationship with our Government, illustrating how their knowledge of, and influence on, the benefits system has positioned at least some of their executive/ex-executives as ‘insiders’ with respect to the company’s commercial behaviour.

It is The Black Triangle Campaign’s understanding that it is illegal to use any influence that any individual or company has on Government policy and benefit financially from that policy so how come the totally discredited US insurance giant Unum, Government advisors on welfare reform for over a decade now are blatantly being allowed to push their Income Protection insurance policies, (that all past evidence shows they will do their best to wriggle out of paying out on when a claim is made), onto the British public with them even quoting the fact that the current welfare reforms, (that they have advised the government on), do not even meet the basic day to day needs of the disabled in the UK in what they describe as their Master Class to Financial Advisors, (their policy salesmen)

Written by bigleyma

October 1, 2011 at 11:20 am

Unum Influence Exposed in 2007 (yet still it goes on…)

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It’s quite difficult to comprehend that its four years since Jonathan Rutherford so completely detailed the process by which the disgraced Insurance company Unum had inveigled its way into a position from which it could determine the course of Welfare Reform in this country. How many sick and disabled people since then have been cheated out of their benefits for the profits Unum are anticipating from their playing of this ‘long game’? From the lack of action on this it would seem that no-one who matters cares.

And yet in the same year the BBC also cared  enough, as Rutherford notes, to run with this story on the Ten O’Clock news. What has happened in the meantime?  A recent Freedom of Information request to the BBC is attempting to find out whether, in light of even greater evidence of the corruption of our democratic process in service of private profit, the BBC are willing to revisit the subject. We all fund the BBC, let’s hope our trust in their stated independence and integrity is borne out by their response.

14.1

The BBC’s reputation, in the UK and around the world, is based on its editorial integrity and independence.  Our audiences must be able to trust the BBC and be confident that our editorial decisions are not influenced by outside interests, political or commercial pressures, or any personal interests.

The FOI deadline for their reply is next Wednesday, October 5th.

Its such a shame that the BBC’s initial exposure of this story, greeted as it was with such hope for change by those who were suffering then, did not manage to ignite a full enquiry into this scandal. Who can the vulnerable, sick and disabled in this country turn to for justice?

Written by bigleyma

September 25, 2011 at 11:48 am