Tag: Behaviourist turn

Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper

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I wrote an extensive critique of the recent government green paper on work, health and disability. I mentioned that a government advisor, who is a specialist in labour economics and econometrics, has proposed scrapping all Employment and Support Allowance (ESA) sickness and disability benefits.

Matthew Oakley, a senior researcher at the Social Market Foundation, recently published a report entitled Closing the gap: creating a framework for tackling the disability employment gap in the UK, in which he proposes abolishing the ESA Support Group.

I also said: “Oakely also suggests considering a “role that a form of privately run social insurance could play in both increasing benefit generosity and improving the support that individuals get to manage their conditions and move back to work.” 

And: “I’m sure the private company Unum (formerly UnumProvident) would jump at the opportunity. Steeped in controversy, with a wake of scandals that entailed the notorious company systematically denying people their disabilty insurance, in 2004, Unum entered into a regulatory settlement agreement (RSA) with insurance regulators in over 40 US states.

The settlement related to Unum’s “mishandling” of disability claims and required the company “to make significant changes in corporate governance, implement revisions to claim procedures and provide for a full re-examination of both reassessed claims and disability insurance claim decisions.”

The company is the top disability insurer in both the United States and United Kingdom. In the US, it has been regarded as one of the two most unscrupulous insurance companies. The rogue company was also accused of cheating thousands of people out of welfare payments in the US. By coincidence, the company has been involved in the design of the UK government’s controversial 2012 Welfare Reform Bill, advising the government on how to cut spending, particularly on disability support. What could possibly go right?

Of course the vulture capitalist company Unum continues to “mishandle” claims both in the US, in violation of the US Employee Retirement Income Security Act (ERISA) and here in the UK, denying people incapacity benefit, under employer’s group income protection policy (GIP).

The Reform think tank has also recently proposed scrapping what is left of the disability social security system, in their report Working welfare: a radically new approach to sickness and disability benefits, and has called for the government to set a single rate for all out-of-work benefits and to reform the way sick and disabled people are assessed.  

The members of the neoliberal think tank propose that the government should cut the weekly support paid to 1.3 million sick and disabled people in the ESA Support Group from £131 to £73. This is the same amount that people claiming Jobseeker’s Allowance receive. However, those people placed in the Support Group after assessment have been deemed by the state as unlikely to be able to work again in the foreseeable future. It would therefore be very difficult to justify this proposed cut, given the additional needs that disabled people have, which is historically recognised, and empirically verified by research.

Yet the authors of the report doggedly insist that having a higher rate of weekly benefit for extremely sick and disabled people encourages them “to stay on sickness benefits rather than move into work.” However, people on sickness benefits don’t move into work because they are too sick to work. Their own doctors and the state (via the work capability assessment) have already established that. Forcing them to work is outrageously tyrannical.

The report recommended savings which result from removing the disability-related additions to the standard allowance should be reinvested in support services and extra costs benefits – Personal Independence Payment (PIP). However the government have ensured that eligibility for that support is rapidly contracting, with the ever-shrinking political and economic re-interpretation of medically defined sickness and disability categories and a significant reduction in what the government deem to be a legitimate exemption from being “incentivised” into work.

Policy change can often be explained by reference to changes in background ideas about the state, society and the individual, held and promoted by influential individuals, groups, political parties and … multinational companies.  

It turns out that you can predict such a lot by simply watching the way the wind blows.

The crib sheet  

Theresa May’s new director of policy, John Godfrey, is a keen advocate of what, in his last job, at financial services giant Legal and General, he called “Beveridge 2.0”: using technology to introduce new forms of “social insurance”.

Godfrey told a campaigning group, the Financial Inclusion Commission last year that the systems used to deliver “auto-enrolment”, the scheme that ensures all low-income workers have a pension, could also be used to help the public insure themselves against “unexpected events”.

“There is a clear lesson from auto-enrolment that if you have a plumbing network or an infrastructure that works, that auto-enrolment infrastructure could be used for other things which would encourage financial inclusion: things like, for example, life cover, income protection and effective and very genuine personal contributory benefits for things like unemployment and sickness,” he said. 

“They can be delivered at good value if there is mass participation through either soft compulsion or good behavioural economics.”

Note the context shift in the use of the term “inclusion”, which was originally deemed a democratic right, now it’s being discussed narrowly in terms of soft compulsion and individual responsibility. And an exchange of money. Subtext: inclusion is only for those who can pay for it. 

report published by the Adam Smith Institute as far back as 1995 – The Fortune Account also sets out proposals to replace “state welfare” with an insurance system “operated by financial institutions within the private sector”. 

Mo Stewart has spent eight years researching the toxic and all-pervasive influence of the US insurance giant Unum over successive UK governments, and how it led to the introduction of the “totally bogus” and non-medical work capability assessment (WCA), which she says was designed to make it very much more difficult for sick and disabled people to claim out-of-work disability and sickness benefits.

Stewart’s excellent bookCash Not Care: The Planned Demolition Of The UK Welfare State, was published in September. She states that the assessment was modeled on methods used by the controversial company Unum to deny protection to sick and disabled people in the US who had taken out income protection policies.

She goes on to say that the WCA was “designed to remove as many as possible from access to [employment and support allowance] on route to the demolition of the welfare state”, with out-of-work disability benefits to be replaced by insurance policies provided by private companies like Unum.

Stewart warns us that the UK is now close to adopting a US-style model.

She’s absolutely right.

Our public services are being privately auctionedThe multinational corporations are queuing up for the sale of the century in the UK.

The public are picking up the tab.

 Rogue and antisocial corporations are writing public policies

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Corporate lobbyists are primarily interested in a tactical investment. Whether facing down a threat to profits from a corporate tax raise, or pushing for market opportunities – such as government privatisations – lobbying has become simply another way of making a lot of money for a few people. Lobbyist messages are very carefully crafted and spun, especially in the media. The ultimate corporate goal is sheer self-interested profit-making, but this will always be dressed up to appear synonymous with the wider, national interest. At the moment, that means a collective chanting of the “economic growth”, supply side “productivity”, implied trickle down, “jobs” and “personal responsibility” neoliberal mantra.

Corporations buy their credibility and utilise seemingly independent people such as academics with a mutual interest to carry their message for them. Some think tanks – especially free-market advocates like Reform or leading neoliberal think  tank, the Institute of Economic Affairs – will also provide companies with a lobbying package: a media-friendly report, a Westminster event, meetings with politicians. The extensive Public Relations (PR) industry are paid to brand, market, engineer a following, build trust and credibility and generally sell the practice of managing the spread of information between an individual or an organisation (such as a business, government agency, the media) and the public.

PR is concerned with selling products, persons, governments and policies, corporations, and other institutions. In addition to marketing products, PR has been variously used to attract investments, influence legislation, raise companies’ public profiles, put a positive spin on policies, disasters, undermine citizens’ campaigns, gain public support for conducting warfare, and to change the public perception of repressive regimes.

You can see how the revolving door of mutually exclusive political and corporate favour operates: it just keeps on spinning.

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Edelman Intelligence and Westbourne, for example, are engaged in rebuttal campaigns and multimedia astroturfing projects to protect corporate interests:

“Monitoring of opposition groups is common: one lobbyist from agency Edelman talks of the need for “360-degree monitoring” of the internet, complete with online “listening posts … so they can pick up the first warning signals” of activist activity. “The person making a lot of noise is probably not the influential one, you’ve got to find the influential one,” he says. Rebuttal campaigns are frequently employed: “exhausting, but crucial,” says Westbourne.” From The truth about lobbying: 10 ways big business controls government

Edelman Intelligence is the world’s largest PR company and have been quietly visiting my own WordPress site over this last year, the link shows they were referred to my site from their own social media monitoring command centre. I’ve contacted the company to ask why, but have yet to receive a response. I’m not a paying client so it’s highly unlikely that the visits are in connection with promoting my best interests. Paying clients include the likes of Rupert Murdoch. (See footnote).

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Unum’s long standing toxic influence on policy-making

In a recent press release, the delighted vulture capitalists at Unum say that they welcome the government’s recent Green Paper’s focus on Group Income Protection. The press release also says:

“Unum has welcomed the government’s recognition in a new Green Paper that “Group Income Protection policies have a much greater role to play in supporting employers” help people with health problems to stay in or return to work.

The proposals were set out in Improving Lives: the Work, Health and Disability Green Paper, launched by the Department for Work and Pensions and Department of Health, yesterday, 31 October 2016. As part of its efforts to enable “more people with long term conditions to reap the benefits of work and improve their health”, the Paper includes a number of proposals to prevent people falling out of work for health reasons and to make employers feel more confident about supporting disabled employees. In particular, it includes a number of specific policy ideas to increase the number of British workers with Group Income Protection (GIP).

Through GIP, Unum has enabled thousands of people to return to work after long term sickness absences caused by mental health and musculoskeletal problems and other serious health conditions, including cancer and multiple sclerosis. Unum also provides training, support and advice to employers and line managers on how to look after employees with health problems and help them stay in or return to work.

To increase the number of workers who benefit from GIP coverage, Unum is calling on the government to consider a temporary tax break for employers that buy GIP for their staff. This would reduce the number of people who fall out of work for health reasons, protect the finances of those who are unable to work and boost the productivity of UK businesses.”

In my critical analysis of the work, health and disability green paper, I said: 

“And apparently qualified doctors, the public and our entire health and welfare systems have ingrained “wrong” ideas about sickness and disability, especially doctors, who the government feels should not be responsible for issuing the Conservatives recent Orwellian “fit notes” any more, since they haven’t “worked” as intended and made every single citizen economically productive from their sick beds.

So, a new “independent” assessment and some multinational private company will most likely very soon have a lucrative role to ensure the government get the “right” results.”

The medical specialists are to be replaced by another profiteering corporate giant who will enforce a political agenda in return for big bucks from the public purse. Health care specialists are seeing their roles being incrementally and systematically de-professionalised. That means more atrocious and highly irrational attempts from an increasingly authoritarian government at imposing an ideological “cure” – entailing the withdrawal of any support and imposing punitive “behavioural incentives” – on people with medical conditions and disabilities.

Doctors, who are clever enough to recognise, diagnose and treat illness, are suddenly deemed by this government to be not clever enough to judge if patients are fit for work. It seems that the Conservatives don’t like competent witnesses who may challenge their droning ideologically driven neoliberal psychobabbling.

The political de-professionalisation of medicine, medical science and specialisms (consider, for example, the implications of permitting job coaches to update patient medical files), the merging of health and employment services and the recent absurd declaration that work is a clinical “health” outcome, are all carefully calculated strategies that serve as an ideological prop and add to the justification rhetoric regarding the intentional political process of dismantling publicly funded state provision, and the subsequent stealthy privatisation of Social Security and the National Health Service. 

De-medicalising illness is also a part of that process:

“Behavioural approaches try to extinguish observed illness behaviour by withdrawal of negative reinforcements such as medication, sympathetic attention, rest, and release from duties, and to encourage healthy behaviour by positive reinforcement: ‘operant-conditioning’ using strong feedback on progress.” Gordon Waddell and Kim Burton in Concepts of rehabilitation for the management of common health problems. The Corporate Medical Group, Department for Work and Pensions, UK. 

Medication, rest, release from duties, sympathetic understanding – remedies to illness – are being redefined as “perverse incentives” for “sickness behaviours”, yet the symptoms of an illness necessarily precede the prescription of medication, the Orwellian (and political rather than medical) “fit note” and exemption from work duties. Notions of “rehabilitation” and medicine are being redefined as behaviour modification: here it is proposed that operant conditioning in the form of negative reinforcement, which the authors seem to have confused with punishment, will “cure” ill health.

This is the same kind of thinking that lies behind welfare sanctions, which are state punishments entailing the cruel removal of lifeline income for “non-compliance” in narrowly and rigidly defined “job seeking behaviours.” Sanctions are also described as a “behavioural incentive” to “help” and “encourage”people into work. People who are ill, it is proposed, should be sanctioned, too, which would entail having their lifeline basic health care removed.

Many qualitative accounts from first hand witnesses, extensive research and empirical evidence has repeatedly demonstrated that welfare sanctions make it less likely that people will find employment: taking essential support from people with very limited resources profoundly demotivates, distresses and harms people, rather than “incentivising” them to find work. (See also: Benefits sanctions: a policy based on zeal, not evidence and The Nudge Unit’s u-turn on benefit sanctions indicates the need for even more lucrative nudge interventions, say nudge theorists.)

The darker meaning of David Cameron’s comment about “ending a culture of entitlement” back in 2010 has become clearer. He wasn’t only talking about perceived attitudes and referencing erroneous, unverified and unfounded notions of “welfare dependency”: his party’s aim was and still is about reducing public expectations of a supportive and rights-based relationship with the publicly-funded state – one that has evolved from the post-war settlement to ensure that everyone in the UK can meet their basic human needs.

Poor and ill people cannot be simply punished (or “nudged”) out of being poor or ill. 

Sanctions are a callous, profoundly antidemocratic, dysfunctional and extremely regressive form of economic terrorism, founded entirely on traditional Conservative prejudices about poor people and rigid ideological assumptions. It is absolutely unacceptable that a government treats some people, including some of the UK’s most vulnerable citizens, in such horrifically cruel and dispensable way, in a very wealthy, so-called civilised, first-world liberal democracy.

Unum also have a longstanding reputation for trying to reduce physical illness to “subjective states” and “faulty behaviours”, too. (See also: evidence submitted to the the select health committee by Professor Malcolm Hooper and Subjective symptom disability claims: Chronic Fatigue, Fibromyalgia and Multiple chemical sensitivity syndrome for example).

Even public policies that are supposed to address fundamental human needs arising from sickness and disability are tainted by a neoliberal idée fixe. The leitmotif is a total corporacratic commodification of human needs and relationships; building hierarchies of human worth within the closed and entropic context of a competitive market place, where resources are “scarce” and people are being herded; where the only holding principle that operates is profit over human need.

“In defiance of the substantial biomedical evidence submitted to its Guideline Development Group (GDG), NICE is recommending an inappropriate and potentially dangerous behavioural modification regime as the only management strategy for those with ME/CFS. NICE’s recommended management regime is promoted by a group (mainly psychiatrists) who have undeclared but undeniable competing financial interests.” Malcolm Hooper

It’s mind over matter and quids in

Behavioural medicine was partly influenced by Talcott Parsons’ The Social System, 1951, and his work regarding the sick role, which he analysed in a framework of citizen’s roles, social obligations, reciprocities and behaviours within a wider capitalist society, with an analysis of rights and obligations during sick leave. From this perspective, the sick role is considered to be sanctioned deviancewhich disturbs the function of society. (It’s worth comparing that the government are currently focused on economic function and enhancing the supply side of the labour market.)

Behavioural medicine more generally arose from a view of illness and sick role behaviours as characteristics of individuals, and these concepts were imported from sociological and sociopsychological theories.

However, it should be pointed out that there is a distinction between the academic social science disciplines, which include critical perspectives of conflict and power, for example, and the recent technocratic “behavioural insights” approach to public policy, which is a monologue that doesn’t include critical analysis, and serves as prop for neoliberalism, conflating citizen’s needs and interests with narrow, politically defined economic outcomes.

We have a government that has regularly misused concepts from psychology and sociology, distorting them to fit a distinct framework of ideology, and justification narratives for draconian policies. Parsons’ work has generally been defined as sociological functionalism, and functionalism tends to embody very conservative ideas. From this perspective, sick people are not productive members of society; therefore this deviation from the norm must be policed. This, according to Parsons, is the role of the medical profession. More recently we have witnessed the rapid extension of this role to include extensive State policing of sick and disabled people.

It seems many of the psychosocial advocates have ignored the rise of chronic illnesses and the increasing pathologisation of everyday behaviours in health promotion. Parson’s sick role came to be seen as a negative referent (Shilling, 2002: 625) rather than as a useful interpretative tool. Parsons’ starting point is his understanding of illness as deviance. Illness is the breakdown of the general “capacity for the effective performance of valued tasks” (Parsons, 1964: 262). Losing this capacity disrupts “loyalty” to particular commitments in specific contexts such as the workplace.

Theories of the social construction of disability also provide an example of the cultural meaning of certain health conditions. The roots of this anti-essentialist approach are found in Stigma by Erving Goffman (1963), in which he highlights the social meaning physical impairment comes to acquire via social interactions. The social model of disability tends to conceptually distinguish impairment (the attribute) from disability (the social experience and meaning of impairment). Disability cannot be reduced to a mere biological problem located in an individual’s body  (Barnes, Mercer, and Shakespeare, 1999). Rather than a “personal tragedy” that should be fixed to conform to medically determined standards of “normality” (Zola, 1982), disability becomes politicised. The issues we then need to confront are about the obstacles that may limit the opportunities for individuals with impairments, and about how those social barriers may be removed.

From a social constructionist perspective, emphasis is placed on how certain illnesses come to have cultural meanings that are not reducible to or determined by biology, and these cultural meanings further burden the afflicted (as opposed to burdening “the tax payer” , the health services, those with profit seeking motives, or the state.)

So to clarify, it is wider society and governments that need a shift in disabling attitudes, perceptions and behaviours, not disabled people.

The insights that arose from the social construction of disability approach are embodied in policies, which include the Disability Discrimination Act 1995, which included an employers’ duty to ensure reasonable adjustments/adaptations; the more recent Equality Act 2010 and the Human Rights Act 1998, which provides an important tool for disabled people to use to challenge discrimination, violations to their human rights and unacceptable treatment.

In contrast, Parsons invokes a social contract in which society’s “gift of life” is repaid by continued contributions and conformity to (apparently unchanging, non-progressive) social expectations. For Parsons, this is more than just a matter of symbolic interaction, it has far more concrete, material implications: “honour” (deserving) and “shame” (undeserving) which accompany conformity and deviance, have consequences for the allocation of resources, for notions of citizenship, civil rights and social status.

Parsons never managed to accommodate and reflect social change, suffering and distress, poverty, deprivation and conflict in his functionalist perspective. His view of citizens as oversocialised and subjugated in normative conformity was an essentially Conservative one. Furthermore, his systems theory was heavily positivistic, anti-voluntaristic and profoundly dehumanising. His mechanistic and unilinear evolutionary theory reads like an instruction manual for the capitalist state.

Parsons thought that social practices should be seen in terms of their function in maintaining order and social structure. You can see why his core ideas would appeal to Conservative neoliberals and rogue multinational companies. Conservatives have always been very attached to tautological explanations (insofar that they tend to present circular arguments. One question raised in this functional approach is how do we determine what is functional and what is not, and for whom each of these activities and institutions are functional. If there is no method to sort functional from non-functional aspects of society, the functional model is tautological – without any explanatory power to why any activity is regarded as “functional.” The causes are simply explained in terms of perceived effects, and conversely, the effects are explained in terms of perceived causes). 

Because of the highly gendered division of labour in the 1950s, the body in Parsons’ sick role is a male one, defined as controlled by a rational, purposive mind and oriented by it towards an income-generating performance. For Parsons, most illness could be considered to be psychosomatic.

The “mind over matter” dogma is not benign; there are billions of pounds and dollars at stake for the global insurance industry, which is set to profit massively to the detriment of sick and disabled people. The eulogised psychosocial approach is evident throughout the highly publicised UK PACE Trial on treatment regimes that entail Cognitive Behaviour Therapy (CBT) and graded exercise. By curious coincidence, that trial was also significantly about de-medicalising illnesses. Another curious coincidence is that Mansel Aylward sat on the PACE Trial steering group. 

Here is further evidence that government policy is not founded on empirical evidence, but rather, it is often founded on deceitful contrivance. A Department for Work and Pensions research document published back in 2011 – Routes onto Employment and Support Allowance – said that if people believed that work was good for them, they were less likely to claim or stay on disability benefits.

It was decided that people should be “encouraged” to believe that work was “good” for health. There is no empirical basis for the belief, and the purpose of encouraging it is simply to cut the numbers of disabled people claiming ESA by “encouraging” them into work. Some people’s work is undoubtedly a source of wellbeing and provides a sense of purpose. That is not the same thing as being “good for health”. For a government to use data regarding opinion rather than empirical evidence to claim that work is “good” for health indicates a ruthless mercenary approach to fulfill their broader aim of dismantling social security and to uphold their ideological commitment to supply-side policy.

From the document: “The belief that work improves health also positively influenced work entry rates; as such, encouraging people in this belief may also play a role in promoting return to work.”

The aim of the research was to “examine the characteristics of ESA claimants and to explore their employment trajectories over a period of approximately 18 months in order to provide information about the flow of claimants onto and off ESA.”

The document also says: “Work entry rates were highest among claimants whose claim was closed or withdrawn suggesting that recovery from short-term health conditions is a key trigger to moving into employment among this group.”

“The highest employment entry rates were among people flowing onto ESA from non-manual occupations. In comparison, only nine per cent of people from non-work backgrounds who were allowed ESA had returned to work by the time of the follow-up survey. People least likely to have moved into employment were from non-work backgrounds with a fragmented longer-term work history. Avoiding long-term unemployment and inactivity, especially among younger age groups, should, therefore, be a policy priority. ” 

“Given the importance of health status in influencing a return to work, measures to facilitate access to treatment, and prevent deterioration in health and the development of secondary conditions are likely to improve return to work rates”

Rather than make a link between manual work, lack of reasonable adjustments in the work place and the impact this may have on longer term ill health, the government chose instead to promote the cost-cutting and unverified, irrational belief that work is a “health” outcome. Furthermore, the research does conclude that health status itself is the greatest determinant in whether or not people return to work. That means that those not in work are not recovered and have longer term health problems that tend not to get better.

Work does not “cure” ill health. To mislead people in such a way is not only atrocious political expediency, it’s actually downright dangerous.

As neoliberals, the Conservatives see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined economic outcomes are politically stigmatised and outgrouped.

Nudging, Unum and the behaviourist turn in medicine. 

The history of medicine and definitions of illness and disability are being re-written for the insurance industry, by neoliberal “small state” ideologues and anti-welfarist governments.

Formally instituted by Cameron in September 2010, the Behavioural Insights Team, (otherwise known as the Nudge Unit), which is a part of the Cabinet Office, is made up of people such as David Halpern, who co-authored the Cabinet Office report: Mindspace: Influencing Behaviour Through Public Policy, which comes complete with a cover illustration of the human brain, with an accompanying psychobabble of decontextualised words such as “incentives”, “habit’, “priming” and “ego.” It’s all just a stock of  inane managementspeak. Neoliberal psychobabbling and strategies of psycho-complulsion.

The report addresses the needs of policy-makers.  Not the public. The behaviourist educational function made explicit through the Nudge Unit is now operating on many levels, including through policy programmes, forms of “expertise”, and through the State’s influence on citizens, the mass media, other cultural systems and at a subliminal level: it’s embedded in the very language that is being used in political narratives.

The increasing focus on social control and conformity in public policy design and governing has been dubbed “neuroliberalism”, reflecting something of a behaviourist turn. It draws on social marketing as a policy tool, in which principles from private marketing and advertising are applied to the definition and promotion of “good” behaviours. Deviance (“bad” behaviour) is defined politically through the intentional and systematic stigmatisation of already marginalised social groups, leading to the creation of folk devils and moral panic which is amplified and perpetuated by the media. 

Othering and outgrouping have become common political practices. 

This serves to desensitise the public to the circumstances of marginalised social groups and legitimises neoliberal “small state” policies, such as the systematic withdrawal of state support for those adversely affected by neoliberalism, and it also justifies inequality. By stigmatising the poorest citizens, a “default setting” is established regarding how the public ought to perceive and behave towards defined outgroups. 

Policies directed at the poorest and some of the most vulnerable citizens are being used to extend behaviour modification techniques, based on methodological behaviourism. This is a psychocratic approach to administration: the government are delivering public policies that have an expressed design and aim to act upon individuals, with an implicit set of instructions that inform citizens how they should be.  

Aversives and punishment protocols are being used on the public. Coercive and harshly conditional welfare policies are one example of this.

The origin of active welfare (the idea that the social security system should reflect that the habitually “idle poor” need coercing into work), founded on the idea that poor people are the cause of their own poverty because of their cognitive and behavioural flaws – they fail to take advantage of the opportunities “available” to them – lies with the US neoliberal right.

Charles Murray and Lawrence Mead clearly made an impact on the international policy debate in the 1980s, partly due to the legitimisation that they received from the support of the Reagan and Thatcher administrations for their central claims. They were particularly influential in the growth of work fare and a welfare system based on punishment and psycho-compulsion. Murray claimed the underclass of poor people avoid work because of the “overgenerous” nature of welfare benefits. Mead argued that a “culture of poverty” meant that workfare policies are required to “reintegrate” and “incentivise” the unemployed poor. 

In the UK, James Purnell, one of the work and pensions secretaries for New Labour, said: “For those who play by the rules, there is a world of opportunity. But for those who don’t, there will be clear consequences from their behaviour”.

He sounds rather like an authoritarian Victorian headmaster.

So what exactly are “the rules”, and who has made them?

Government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. In democratic societies, citizens’ accounts of the impacts of policies ought to matter. 
 
However, in the UK, the way that policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, and partly because the government employs the widespread use of linguistic strategies: euphemisms, superficial glittering generalities and techniques of persuasion to intentionally divert us from aims and consequences of ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly detached from public interests and needs. 

Neoliberal anti-welfarism, amplified by a corporate media, has aimed at reconstruction of society’s “common sense” assumptions, values and beliefs. Class, disability and race narratives in particular, associated with traditional prejudices and categories from the right wing, have been used to nudge the UK to re-imagine citizenship, human rights and democratic inclusion as highly conditional.  

Illness is all in the mind: conforming to roles and academically constructed stereotypes

“Diagnosis elicits the belief the patient has a serious disease, leading to symptom focusing that becomes self-validating and self-reinforcing and that renders worse outcomes, a self-fulfilling prophecy, especially if the label is a biomedical one like ME. Diagnosis leads to transgression into the sick role, the act of becoming a patient even if complaints do not call for it, the development of an illness identity and the experience of victimization”. Simon Wessely and Marcus S.J. Huibers: The act of diagnosis: pros and cons of labelling chronic fatigue syndrome. Psychological Medicine 2006: 36

In 1993, Mansel Aylward invited psychiatrist Simon Wessely to give a presentation on his biopsychosocial approach to Chronic Fatigue Syndrome before the then Minister for Social Security. Wessely claimed: “As regards benefits:- it is important to avoid anything that suggests that disability is permanent, progressive or unchanging. Benefits can often make patients worse.” 

Benefits can often make patients worse.” I think he meant the patient’s illness is made worse. Despite there being little empirical evidence for these claims, the Minister for Social Security was looking to cut spending, so self-styled “experts” were more useful to an expedient government than rigorous research. I think it would be true to say that without social security, many people who are disabled because of Chronic Fatigue Syndrome (CFS) would experience MUCH worse symptoms, as indeed people with other chronic illnesses would, and some would undoubtedly die without lifeline support to enable them to meet their basic survival needs. 

ME action UK say that on  May 17, 1995, Wessely was one of  the main speakers at a Unum-supported symposium held in London entitled “Occupational Health Issue for Employers” (where ME was described as “the malingerers’ charter”) at which they advised employers how to deal with employees who were on long-term sickness absence with “CFS”.  Moreover, in UNUM’s “Chronic Fatigue Syndrome Management Plan”, ME/CFS is described as “Neurosis with a new banner” and the same document states  “UNUM stands to lose millions if we do not move quickly to address this increasing problem”. 

Unum have been advising UK governments since at least 1994, when the  Conservative government hired John LoCascio, second vice-president of giant and scandalous US disability insurance company, Unum, to advise on reducing the numbers successfully claiming Incapacity Benefit (IB). He joined the “medical evaluation group”.

Another key figure in the group was Mansel Aylward. The group devised a stringent “all work test”. Approved doctors were trained in Unum’s approach to “claims management”. That’s basically  managing not to pay people what they are entitled to. The rise in IB claimants came to a halt. However, it did not reduce the rising numbers of claimants with mental health problems.

Supporters of the behaviourist “non-medical” model of disability and illness include Mansel Aylward, Dame Carol Black, Lord Freud and Lord Kirkwood of Kirkhope (the chairman of the Unum customer advisory panel, whilst he was also Chair of the UK parliament’s work and pensions select committee).

Of course there is the lowest common denominator for highest possible private profits in operation in the US and UK. Some names keep recurring, like the proverbial bad penny for bad thoughts. The controversial PACE trial is just another small variation of the leitmotif. Recently an information tribunal rejected a university’s £200,000 attempt to prevent release of data from the controversial medical trial, that was the first to receive Department for Work and Pensions (DWP) funding.

The PACE trial mirrors Unum’s previous systematic and wholly non scientific de-medicalisation and subsequent trivialisation of serious illnesses such as Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) and Fibromyalgia in the US, and has led to the growth and standardisation of “behavioural” medical treatment regimes, such as cognitive behaviour therapy (CBT), which is often used to reduce the use of pharmacological pain relief in a wide range of chronic illnesses, including connective tissue diseases such as rheumatoid arthritis and lupus.

The World Health Organisation classified these illnesses as physical diseases, now they are being reconstructed as “psychosocial” phenonena, with recovery supposedly being dependent on the sick person’s attitude and mindset, by greedy crony capitalists and ideologically expedient neoliberal “small state” anti-welfarist governments.

This current psychosocial approach to medical conditions is about addressing a perceived need for cognitive and behavioural change: it allegedly addresses patient’s “attitudes and perceptions” of their condition, their “coping mechanisms” or lack of them, and perceptions of pain and its “management”. None of this affects the underlying disease activity or the damage that disease processes cause to the body.  It’s speculative nonsense.

The trial assessed the value of “biopsychosocial” interventions at the same time as the DWP was using the biopsychosocial model of disability to help justify cuts to disability spending. 

The absurd consequences of permitting a vulture capitalist insurance multinational to write sickness and disability public policies

It’s an interesting observation that Mansel Aylward, who was a key architect of the last decade’s welfare “reforms”, had helped to secure funding for the PACE Trial and sat as an “observer” on the trial’s steering committee. The DWP co-funded the trial. The failure to release the results for the pre-specified analyses laid out in the PACE trial’s protocol is of concern as it had already been noted that there was a likely ideological bias of the trial’s three principal investigators.

All three investgators have invested in developing careers founded on the development of biopsychosocial interventions for CFS, and the two who had been part of the Chief Medical Officer’s CFS working group both resigned because the active biopsychosocial approaches of Cognitive Behaviour Therapy (CBT) and Graded Exercise Therapy (GET) were not endorsed over “pacing” in the way that they had wanted. (See Chronic fatigue report delayed as row breaks out over content. The British Medical Journal, 2002, and Power-sharing, not a take-over, 2002.)

All three principal investigators also reported conflicts of interest involving the insurance industry. There has long been concern about private insurance companies influencing changes to undermine the UK welfare state, a system of social insurance that they currently compete against. (See Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial, 2011 and “In the Expectation of Recovery” MISLEADING MEDICAL RESEARCH AND WELFARE REFORM, George Faulkner, 2016).

“Back in 1995 a Unum report on CFS stated that they could “lose millions if we do not move quickly to address this increasing problem”. It was argued that CFS claims should be managed “more aggressively and in a proactive rather than a reactive fashion” while attempting to present CFS as “neurosis with a new banner”. Emphasising the importance of psychosocial factors and classing CFS as a mental health problem could bring immediate financial benefits to insurance companies when policies limit payouts for mental health problems.

“One of the PACE trial’s principal investigators gave a presentation on the results of the PACE trial to Swiss Re insurance. Swiss Re’s report of his talk detailed the potential use of mental health exclusions to cut payments, while a 2013 Swiss Re presentation on their approaches to mental health problems describes their use of specific exclusions for CFS and ME.

“During the Swiss Re presentation on PACE no mention seems to have been made of the fact that PACE found neither CBT nor GET were associated with improved employment outcomes, and instead Swiss Re’s claims managers continued to be encouraged to believe that promoting these active rehabilitative approaches would assist return to work. There has been concern about insurance companies pushing some patients with CFS to take part in CBT and GET against their wishes.

“A response to the paper which published the PACE trial’s data on employment outcomes was titled Coercive practices by insurance companies and others should stop following the publication of these results, but has yet to receive a response from the PACE team.” George Faulkner, 2016

From 1996 to April 2005 Mansel Aylward was chief medical adviser, medical director and chief scientist of the UK Department for Work and Pensions and chief medical adviser and head of profession at the veteran’s agency, Ministry of Defence. He was involved in the establishment of the new Work Capability Assessment. When he left the department, he headed the UnumProvident Centre for Psychosocial and Disability Research, at Cardiff University. (The centre has since been renamed and Unum claim they no longer provides any funding – no doubt because of the claims that academic integrity could be called into question by its influence.)

The Scientific and Conceptual Basis of Incapacity Benefits by Gordon Waddell and Mansel Aylward, followed by the 2006 report: Is work good for your health and well-being by Gordon Waddell and Kim Burton, were both very influential reports that were commissioned by the DWP and so inclined towards ideologically biased outcomes from the start. Both reports were produced when Aylward and Waddell were sponsored by UnumProvident – Centre for Psychosocial and Disability Research ( at Cardiff  University) – with funding of course from Unum Provident, from 2004-2009.

In January 2003, an influential book, Malingering and illness deception was published as a very large hymn crib sheet that was to inform political rhetoric, media justification narratives and the subsequent welfare “reforms.” It was also funded by the DWP, with telltale dogma and schematic contributions from Gordon Waddell, John LoCascio of UNUM Provident Insurance Company, and of course there is this telling acknowledgment:

The meeting which formed the basis for this book would not have been possible had it not been for the enthusiastic support of Professor Mansel Aylward and funding from the Department for Work and Pensions.” 

The book has political agenda-setting chapter sub-headings such as: Investigating benefit fraud and illness deception in the United Kingdom, Malingering, insurance medicine, and the medicalization of fraud and Wilful deception as illness behaviour. 

Unum insidiously built up credibility and influence in Britain. The company appointed Mansel Aylward as director of their Centre for Psychosocial and Disability Research, following his retirement from the DWP. The launch event was attended by Archie Kirkwood, who was appointed chair of the House of Commons select committee on work and pensions. Malcolm Wicks, minister of state in the DWP, gave a speech praising the “partnership between industry and the university.”

The whole aim of the centre was to transform the ideological paradigm of welfare from one based on a rights-based post- war collectivism to one increasingly enclosed by a responsibility-based individualism and so help develop the market for Unum’s products. In 2005, the centre produced The Scientific and Conceptual Basis of Incapacity Benefits (TSO, 2005) written by Aylward and colleague Gordon Waddell. It provided the conceptual framework for the 2006 welfare reform bill.

Of course the more recent widespread criticism of “Atos” assessments in the UK has been beneficial to Unum as it undermines confidence in state provision of disability benefits. Such a profound loss of confidence makes it much easier to sell alternatives: private insurance. 

Its methodology is the same one that informs Unum’s approach. Is work good for your health and well-being by Gordon Waddell and Kim Burton was also a very influential report, both were also commissioned by the DWP and so inclined towards ideologically biased outcomes from the start. Just to be clear, both reports were produced when Aylward and Waddell were sponsored by UnumProvident – Centre for Psychosocial and Disability Research (the Centre) at Cardiff  University, with funding by Unum Provident, from 2004-2009.

Among the spurious ideas used to justify cutting lifeline social security support is that disabled and ill people are not working because of an “internalisation of the sick or “patient” role as the dominant feature of their lives,” and that “work is good for health.” 

In a memorandum submitted to the House of Commons select committee on work and pensions, Unum define their method of working: “Our extended experience […] has shown us that the correct model to apply when helping people to return to work is a biopsychosocial one.”

The emphasis, however, is on the “psychosocial”. This shifts the focus from the medical conditions that cause disability and illness to the behaviours and perceptions of patients and ultimately, to neoliberal notions of personal responsibility and self-sufficient citizenship in a context of a night watchman, non-welfare state. 

Waddell and Aylward adopted the same arguments in their monograph. Disease is the only form of objective, medically diagnosable pathology. Sickness is a temporary phenomenon. Illness is a behaviour. Incapacity Benefit trends are a social phenomenon rather than a health problem. The solution is not to cure the sick, but a “fundamental transformation in the way society deals with sickness and disabilities” (p123). The goal and outcome of treatment is work, because work is therapeutic.

Worklessness is a serious risk to life. It is “one of the greatest known risks to public health: the risk is equivalent to smoking 10 packets of cigarettes per day” (p17). And: “No-one who is ill should have a straightforward right to incapacity benefit.”

David Freud adopts the same spurious psychosocial approach in a report that formed a review of the government’s Welfare to Work strategy. He cites Waddell and Burton: “Work is good for health.” (From “Is Work Good for your Health and Well-Being”, 2006)

Aylward has been widely criticised for giving “academic” credibility to the biopsychosocial model which was said to be the basis of the Cameron government’s disability benefits “reforms”. Aylward prepared reports that were quoting “illness belief” as being a supposedly more likely cause for many “common mental health conditions” or “musculoskeletal conditions”. There were repeated references made in some of his and Gordon Waddell’s research to alleged “malingering” by patients.

“Obstacles to recovery and return to work are primarily personal, psychological and social rather than health-related “medical” problems.”

“Beliefs, perceptions and personal responses lie at the heart of the problem [of worklessness through ill health].”  Worklessness and Health: A Symposium – Mansel Aylward.

It’s worth noting that the “musculoskeletal conditions” include backache, pulled ligaments and muscles, injured tendons, prolapsed spinal discs, sciatica – all of which a person may fully recover from. This category of conditions also includes osteoarthritis, osteoporosis and more serious and chronic illnesses caused by connective tissue disease – most people do not recover from these, and the biological damage that this family of diseases cause is not just confined to the musculoskeletal system. By using such a broad category of wide-ranging conditions, this effectively trivialises the most serious and often progressive diseases in the category.

This is why I visit my doctor, and not the government or a “researcher” with a vested interest, when I am unwell. I don’t believe anyone was ever cured by ideology. Nor do I believe work is a “health” outcome. If the protestant work ethic is such an effective cure for disease, the Victorian era “trial” certainly didn’t provide any empirical evidence of that in the premature mortality rates. In fact both men and women were debilitated by the age of forty. Poor nutrition, long hours and premature full-time employment all contributed to a short life expectancy. (Daily Life in Victorian Britain, Sally Mitchell, 1996.)

Although life span slowly increased within the Victorian age, notably as treatment became more advanced, surgery more effective, and medical knowledge more extensive, the average life span in 1840, in the Whitechapel district of London, was 45 years for the upper class and 27 years for tradesman. Laborers and servants lived only 22 years on average. (Victorian Britain Encyclopedia, Sally Mitchell, 1988.)  

Aylward claims that the principal negative influences on return to work are: Personal / psychological: Catastrophising pain (even minor degrees). Low Self-Efficacy. Social: Lone parenthood / unstable relationships – being a “Victim” of modern society in rented or social housing. General Affect: Being sad or low most of the time: Pervasive thoughts about personal illness. Cognitive: Minimal health literacy. Self-monitoring (symptoms). False beliefs. Economic: Availability of alternative sources of income / support (such as the availability of health care and welfare. (Pages 15-16).

“Catastrophising pain” is a phrase that crops up in a lot of biopsychosocial texts. It’s another of those made up words and phrases, like “worklessness”, “making work pay” and “culture of dependency” which are just ideological signposts to neoliberal notions of competitive individualism, anti-welfarism and personal responsibility, without any reference to reality. And if you make a claim that sickness and pain are “subjective”, surely attempts to describe how other people subjectively experience sickness and pain is even more subjective.

And accusing someone else of holding false beliefs regarding their own state?  Really? You can’t get further away from empirically verifiable statements than that.

The UK government and the Reform think tank claim that the availability of social security serves as a “disincentive” for ill and disabled people to return to work. The cuts to essential lifeline support for people who are ill and disabled that have been embedded in the systemic welfare “reforms” are all about “promoting economic self-sufficiency.”  

However, that is precisely what public national insurance contributions are about. The idea originally was that social provision should be designed to protect people from the ravages of absolute poverty and capitalism – it was intended to support poor citizens  – and to speculate that such support actually makes people poor is simply incoherent pseudoscientific nonsense and derisory political posturing from the “private” state neoliberals.

Aylward highlights more than once on his writing a perceived tension between “disability rights” and state notions of “benefit dependency.” (for example, on Page 8 of  Worklessness and Health: A Symposium). 

Yet Unum say:  “And contrary to popular belief, if your employees are aware of benefits – such as private health insurance or Income Protection – they are not likely to take more time off sick. Cass’ research shows that communicating about a wide range of employee benefits actually builds employee engagement and a more loyal workforce that takes less time off sick.”  Unum: How to communicate your employee benefits package.

However, there are conflicting messages to employers on this issue: “Sick-pay provisions may also encourage or discourage absence, and it is important that an organisation monitors and analyses its absence recording systems in order to pick up any perverse behaviours being driven by the sick-pay schemes. For example, it is not uncommon to see spikes of return to work when an absent employee moves to half pay or no pay.”

The cure for sick leave is work and other gems of wishdom

The biopsychosocial model has become a disingenuous euphemism for psychosomatic illness, which has been exploited by medical insurance companies and by governments keen to limit or deny access to social security, medical and social care.

This approach to disability and ill health has been used to purposefully question the extent to which people claiming social security bear personal responsibility for their own health status, rehabilitation and prompt return to work. It also leads to the alleged concern that a welfare system which provides a livable income to those with disabling health problems may provide “perverse incentives” for perverse behaviours, entrenching “worklessness” and a “culture of dependency”. It’s worth pointing out at this point that there has never been any empirical evidence of welfare “dependency”.

Instead of being viewed as a way of diversifying risk and supporting those who have suffered misfortune, social and private insurance systems are to be understood as perverse incentives that pay people to remain ill and keep them from being economically productive.

The government have made it clear that there are plans to merge health and employment services. In a move that is both unethical and likely to present significant risk of harm to many patients, health professionals are being tasked to deliver benefit cuts for the DWP. This involves measures to support the imposition of work cures, including setting employment as a clinical outcome and allowing medically unqualified job coaches to directly update a patient’s medical record.

The Conservatives (and the Reform think tank) have proposed mandatory treatment for people with long term conditions (which was first flagged up in the Conservative Party Manifesto) and this is currently under review, including whether benefit entitlements should be linked to “accepting appropriate treatments or support/taking reasonable steps towards “rehabilitation”.  The work, health and disability green paper and consultation suggests that people with the most severe illnesses in the support group may be subjected to welfare conditionality and sanctions.

Such a move would have extremely serious implications. It would be extremely unethical and makes the issue of consent to medical treatment very problematic if it is linked to the loss of lifeline support or the fear of loss of benefits. However this is clearly the direction that government policy is moving in and represents a serious threat to the human rights of patients and the independence of health professionals.

Behavioural medicine is prevalent in the United States, where many health problems are primarily viewed as behavioural in nature, as opposed to medical. The biopsychosocial model of illness has encouraged unsubstantiated claims that “positive attitude” or “fighting spirit” can help slow cancer and other progressive diseases, which may be very harmful to the patients themselves. Patients may come to believe that a poor prognosis or their poor progress results from “not having the right attitude”, when in fact it is most likely through no fault of their own.

Increasingly, insurers, policy makers and employers are pressing for policies that would redistribute expenses resulting from what they regard to be “voluntary” health risks to those who “choose” to take such risks.

Of course the long term aim of the Conservatives is to dismantle social security and the National Health Service (NHS) – free health care provision – entirely. Access to health care in the UK is currently being rationed because of the government’s systematic cuts to the NHS budget, and payments for some treatments have been introduced by stealth.  

Unum say:The Green Paper also calls for proposals to overhaul sickness certification and GPs’ approach to Fit Note. Unum has been calling for reform of Fit Notes so more people are able to access the right support to return to work as soon as possible.”

By that phrase “the right support” the predatory private company are simply singing from the same crib sheet as the government. Lots of mutual back patting and private handshakes have sealed the deal of doom for the welfare state long ago. The “right support” simply entails removing any support at all for ill and disabled people so that they are forced to work or starve and become destitute.

Unum’s modus operandi in the US was based on the unscrupulous practice of putting profit over human health. A 2004 investigation determined the practice began as early as 1994, and a CBS 60 Minutes report revealed the company established a quota for denied claims and actually offered incentives to employees who denied valid claims from policyholders. The company also delayed claims to make profit.

Unum was forced by state regulators to re-open 290,000 disability insurance claims that had been rejected, including a case where “Unum insisted that a man who had quintuple bypass surgery was fit to go back to his job at a stock brokerage firm, even though his doctors said the stress might kill him” and also, where Unum “refused benefits to a man who had had multiple heart attacks”

An investigation in California found that Unum systematically violated state insurance regulations and fraudulently denied claims using phony medical reports, policy misrepresentations, and biased investigations. The rogue company admitted to only reviewing 10 percent of the eligible cases for reopening under the terms of their legal settlement reached three years earlier.

Unum’s callous profiteering and illegal behaviour led California Insurance Commissioner John Garamendi to state that “UnumProvident is an outlaw company. It is a company that for years has operated in an illegal fashion.” A Yale University research paper commented that, with regards to Employee Retirement Income Security Act (ERISA) and other cases, Unum was “engaged in a program of deliberate bad faith denial of meritorious claims.” 

Yet this is the company admired and unscrupulously hired by UK governments as a “leader” in dealing unscrupulously with disability claims, and violating the human rights of disabled people.

The cooperation between the UK government and Unum stems entirely from a community of mutually vested interests between them, with both the corporate vultures and their allies in government wishing to reduce the amount of people who are able to claim disability through sickness; the government so it can pay less and less of our money in social security to people who need to draw on their national insurance for support and the insurance company so it can profitably contest or refuse more insurance claims. 

So, after the systematic cuts to social security have been persistently justified by an alleged need to “change the behaviours” of poor people and to “incentivise” them into work, we now have behavioural change treatments becoming more prominent in health care and medicine. In the same way that poor people are held responsible for poverty, ill people are held responsible for illness. Just as ministers claim that poor people are a “burden” on public services and tax payers, now they are saying ill people are a burden on the NHS and tax payers… just take a moment think that through.

The Conservatives came up with an idea that will kill two birds with one stone, as it were. They decided to demand that poor people think work is good for health. They plan to combine the goals of job centres and GP surgeries. Job coaches are the new health care professionals, apparently. Of course that anti-welfare and anti-health care strategy won’t change a thing, except to make people who are ill and out of work even more miserable, poor and ill.

Political authoritarianism, neoliberalism and façade democracy present a tragicomedy that creates the ultimate experimental théâtre de l’absurde, transforming lucrative big business propositions of crony capitalism into Schadenfreude; groaning clichés and stereotypes, political scapegoats and outgroups. Irrational, anecdotal populist “common sense” soundbites become incoherent, cognitive dissonance-inducing justification narratives. For ordinary citizens this fanfares increasingly irrational and draconian policies – the “science” of imaginary solutions to fictitious citizen “behavioural” problems in a Théâtre de la Cruauté (cruelty) – because of a strong motivation to control, rule and empty the public purse into private bank accounts (usually offshore), rather than recognise public needs and interests, and include the masses in democratic decision-making and the economy.

The government think that social justice is actually about “incentivising” those at the wrong end of politically constructed socioeconomic problems with punishments. I’m surprised we haven’t seen the reintroduction of public thrashings, flogging and the ducking stool. Meanwhile the people responsible for hoarding all the wealth and causing poverty for others – and to a considerable degree, contributing to health inequalities too – well they get the deluxe package of privileged incentives – tax cuts, high esteem, status and a pat on the head just for being sanctimonious, greedy, grasping, antisocial money hoarders, enforcing the equivalent of an economic enclosure act. They also have a lot of power and freedom, and so get to write a lot of policies that help them make profits and thus hoard even more of what was once our public wealth.

It’s curious how ministers claim that throwing money at a problem doesn’t change it. They’re right: the very worst of the hoarding and wealthy elite remain the biggest socioeconomic problem with faulty behaviours that we face as a society.

But poor people are poor because of a lack of money. Taking more money from them that they don’t have won’t cure poverty. You can’t thrash wealth into someone. You can’t thrash poverty out of someone. I really should not have to explain that like a patient parent explains the way things work to a toddler. But the Conservatives have a form of arrested development, and cling to their reductionist rituals of ontological security. They refuse to learn. The government are too busy telling us how they think society ought to be, they never have time or an inclination to listen to mere citizens. Big businesses take up every shred of their attention.

We know from recent history that once the Conservatives start to hold people responsible for problems that are not their fault, the public institutions that support people facing social difficulties are in peril – usually through the increasing privatisation of services, and ultimately, through the dismantling and transformation of publicly funded social support mechanisms to purely private profit generating mechanisms for the crony vulture capitalists. The only people set to gain in the long term from all of this political destruction and mis-spending from the public purse are the big vulture capitalist insurance companies, who have also had a hand in the construction of narratives of “personal responsibility” economic self sufficiency, thrift and self help. Perhaps Neoliberal governments should develop a policy of providing invisible bootstraps for citizens to pull themselves up from the damage being inflicted on them from a great height. 

When you hear the same incoherent crib sheet responses over and over, and see the intentional political stigmatisation of social groups, you come to recognise the pattern of preemptive justificationism and the malicious and greedy intent behind the draconian policies.

It’s goodbye to the welfare state, the NHS and democracy, and hello to the new wealth care. 

The ministry of plenty say that private interest is public interest.

All hail the corporatocracy.

 

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Footnote

(Update: I shared this article in a few Facebook groups last night with no problem. Some 12 hours later, I just tried to share this article in one group on Facebook and received a ban from posting in groups immediately, with no reason provided for the restriction on my account. I can’t share posts for a week and suspect the content of the article is what has triggered the ban. I certainly haven’t violated any of Facebook’s community rules or posted this in a way that could have been construed as “spamming”.

I appealed Facebook’s seemingly random decision and have had no response at all. I posted this article and asked my friends to share it. After posting that request, my account restrictions have been extended by a further two hours, with no reason provided by Facebook.

Facebook are a client of Edelman Intelligence. Someone should tell both companies that if you insist on censoring information, such repressive action tends to ensure items are shared much more widely than they would have been ordinarily.)

Related

Unum welcomes Green Paper focus on Group Income Protection  Unum

MUTUAL BENEFITS  Private Eye

A Tale of two Models: Disabled People vs Unum, Atos, Government and Disability Charities – Debbie Jolly

Two Apparent Irregularities Involving UNUM, ATOS, And DWP – George K Berger

FROM THE BRITISH WELFARE STATE TO ANOTHER AMERICAN STATE – Mo Stewart

MAGICAL MEDICINE: HOW TO MAKE A DISEASE DISAPPEAR  ME Action UK

Health at work – an independent review of sickness absence  Carol Black and David Frost

Trust Law as Regulatory Law: The Unum/Provident Scandal and Judicial Review of Benefit Denials under ERISA  John H. Langbein 

TRIAL BY ERROR: The Troubling Case of the PACE Chronic Fatigue Syndrome Study – David Tuller

Major breakthrough on PACE trial – George Faulkner

Fit for Work: a quick guide for General Practitioners – The government: our armchair doctors and shrinks

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

Nudging conformity and benefit sanctions

 


 

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The Nudge Unit’s u-turn on benefit sanctions indicates the need for even more lucrative nudge interventions, say nudge theorists

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Some context: the new neuroliberalism and “behavioural insights”

The behaviourist turn in government administration – the use of targeted citizen behavioural conditionality in neoliberal policy making –  has expanded globally and is linked to the growth of behavioural economics theory (“nudge”) and a New Right brand of “libertarian paternalism.”  

Reconstructing citizenship as highly conditional stands in sharp contrast to democratic principles, rights-based policies and to those policies based on prior financial contribution, as underpinned in the social insurance and social security frameworks that arose from the post-war settlement.

The fact that the poorest citizens are being targeted with behavioural theory-based interventions also indicates discriminatory policy, which reflects traditional Conservative class-based prejudices. It’s an authoritarian approach to poverty which simply strengthens existing power hierarchies, rather than addressing the unequal distribution of power and wealth in the UK.

Some of us have dubbed this trend neuroliberalism because it serves as a justification for enforcing politically defined neoliberal outcomes. A hierarchical socioeconomic organisation is being shaped by increasingly authoritarian policies, placing the responsibility for growing inequality and poverty on individuals, side-stepping the traditional (and very real) political/structural explanations of social and economic problems.

Such a behavioural approach to poverty also adds a dimension of cognitive prejudice which serves to reinforce and established power relations and inequality. It is assumed that those with power and wealth have cognitive competence and know which specific behaviours and decisions are best for poor citizens, who are assumed to lack cognitive competence (because they are poor and therefore make “the wrong decisions”). Apparently the theories and insights of cognitive bias don’t apply to the theorists applying them to increasingly marginalised social groups. Policy has increasingly extended a neoliberal cognitive competence and decision-making hierarchy. 

It’s very interesting that the Behavioural Insights Team now claim that the state using the threat of benefit sanctions may be “counterproductive”. The idea of increasing welfare conditionality and enlarging the scope and increasing the frequency of benefit sanctions originated from the behavioural economics theories of the Nudge Unit in the first place. 

The increased use and rising severity of benefit sanctions became an integrated part of welfare conditionality in the Conservative’s Welfare “reform” Act, 2012. The current sanction regime is based on a principle borrowed from behavioural economics theory – an alleged cognitive bias we have called loss aversion.

It refers to the idea that people’s tendency is to strongly prefer avoiding losses to acquiring gains. The idea is embedded in the use of sanctions to “nudge” people towards compliance with welfare rules of conditionality, by using a threat of punitive financial loss, since the longstanding, underpinning Conservative assumption is that people are unemployed because of alleged behavioural deficits and poor decision-making. Hence the need for policies that “rectify” behaviour.

I’ve argued elsewhere, however, that benefit sanctions are more closely aligned with operant conditioning (behaviourism) than libertarian paternalism, since sanctions are a severe punishment intended to modify behaviour and restrict choices to that of compliance and conformity or destitution. At the very least this approach indicates a slippery slope from “arranging choice architecture” in order to support the “right” decisions that are felt to benefit people, to downright punitive and coercive policies that entail psycho-compulsion, such as sanctioning and mandatory workfare. 

Psychology is being misused by the government to explain unemployment (it’s claimed to happen because people have the “wrong attitude” for work) and as a means to achieve the “right” attitude for job readiness. Psycho-compulsion is the imposition of often pseudo-psychological explanations of unemployment and justifications of mandatory activities which are aimed at changing presumed beliefs, attitudes and dispositions. The Behavioural Insights Team have previously propped up this approach.

Welfare conditionality and its experimental approach to behavioural change doesn’t operate within an ethical framework, citizens cannot withdraw from behavioural experiments, nor is this framework based on informed consent. The impact of state directed psycho-compulsion and potential harm that it may cause citizens is not being monitored. 

The Behavioural Insights Team (BIT) is composed of mostly behavioural economists, who also claim the title of libertarian paternalists (and who have a clear and distinct ideological premise for their behavioural theories, while attempting to claim “objectivity”.)

They claim that while it is legitimate for government, private and public institutions to affect behaviour the aims should be to ensure that “people should be free to opt out of specified arrangements if they choose to do so.” Apparently, that proviso doesn’t apply to poor citizens.

The nudges favoured by libertarian paternalists are also supposed to be “unobtrusive.” That clearly is not the case with the application of extremely coercive and punitive Conservative welfare sanctions.

When it comes to technocratic fads like nudge, it’s worth bearing in mind that truth and ethics quite often have an inversely proportional relationship with the profit motive. It’s a cognitive bias, if you will.

And when one nudge theory fails, there are always lucrative and political opportunities to generate more.

Of course Dr Kizzy Gandy, a leading researcher at the policy unit says: “We are optimistic that behavioural science can help government departments to better design policies to help those who are ‘just managing’ in order to prevent and overcome poverty.”

In a new report released today from the Behavioural Insights Team, the authors say: “There is evidence that welfare conditionality in the UK – mandatory behavior requirements such as attending meetings with work coaches or providing repeated evidence of disability in order to receive benefits – is associated with anxiety and feelings of disempowerment.” 

“However, as far as we know no one has examined whether welfare conditionality has cognitive depleting effects.”

It’s particularly worrying that there is a proposal in the report for further experimental pseudo-psychological approaches to policies aimed at the poorest citizens. The researchers call on the Department for Work and Pensions to conduct experiments into whether welfare conditionality actually had any positive effects and suggested that “self-set” and “enforced goals” might be a better way of “helping people into work.” Although this allows for a little tokenist self-determination and permits a little autonomy, it is still an approach ultimately based on coercion and enforcement.

There is a clear distinction to be made between “behavioural science” – which is almost entirely about economic outcomes; what is politically deemed “best” for citizens and social conformity, and mainstream psychology – which embraces a much broader and deeper perspective of the complexities of human potential and wellbeing.

For anyone curious as to how such tyrannical behaviour modification techniques like benefit sanctions arose from the bland language, inane, managementspeak acronyms and pseudo-scientific framework of “paternal libertarianism” – nudge – here is an interesting read: Employing BELIEF: Applying behavioural economics to welfare to work, which is focused almost exclusively on New Right small state obsessions.

(Update 27/10/17 – the link to the original document no longer works. But I found a copy with the same page layout here, luckily: – https://www2.learningandwork.org.uk/sites/default/files/publications/CESI_employing_BELIEF.pdf).

Pay particular attention to the part about the alleged cognitive bias called loss aversion, on page 7.

And this on page 18: The most obvious policy implication arising from loss aversion is that if policy-makers can clearly convey the losses that certain behaviour will incur, it may encourage people not to do it,” and page 46: “Given that, for most people, losses are more important than comparable gains, it is important that potential losses are defined and made explicit to jobseekers (e.g.the sanctions regime).”

The recommendation on that page: We believe the regime is currently too complex and, despite people’s tendency towards loss aversion, the lack of clarity around the sanctions regime can make it ineffective. Complexity prevents claimants from fully appreciating the financial losses they face if they do not comply with the conditions of their benefit.”

The Conservatives duly “simplified” sanctions by extending them in terms of severity and increasing the frequency of use. Sanctions have also been extended to include previously protected social groups, such as lone parents, sick and disabled people. 

The paper was written in November 2010, prior to the Coalition policy of increased “conditionality” and the extended sanctions element of the Tory-led welfare “reforms” in 2012. I wrote about this at length earlier this year, here: Nudging conformity and benefit sanctions: a state experiment in behaviour modification.

The Behavioural Insights Team, (otherwise known as the Nudge Unit) was set up by David Cameron in 2010. In their most recent report called Poverty and decision-making: How behavioural science can improve opportunity in the UK, the nudge researchers now say that burdening unemployed people with responsibilities, using the threat of sanctions might actually be making it harder for them to get jobs.

According to the behavioural economist theorists authoring this highly jargonised report, government policies designed to help people are reducing and impairing people’s so-called cognitive scope and abilities.

However, it’s difficult to imagine how punitive sanctioning, which entails the removal of people’s lifeline income, originally calculated to meet the costs of only basic survival needs, such as for food, fuel and shelter, could ever be seen as “helping people.”

I don’t believe that Orwellian semantic shifts can ever provide a genuine and effective solution to poverty and inequality. 

Some major inconsistencies and incoherences in the report

In the latest BIT report, loss aversion is mentioned again:  “People dislike losses more than they like equivalent gains. Babcock, Congdon, Katz, and Mullainathan (2012) hypothesise that people may experience loss aversion if they consider taking a job paying below past earnings. Therefore, they may stay on unemployment benefits longer than they should. Unrealistic wage expectations may be reinforced when the social status and personal identities of workers are strongly tied to their previous job.” [My emphasis]

Note the phrase “unrealistic wage expectations” and later incoherent comments in the report about in-work poverty, which I will highlight.

The summary report states in the introduction: A third of the UK population spent at least one year in relative income poverty between 2011 and 2014.

Traditionally policymakers and anti-poverty organisations such as the Joseph Rowntree Foundation (JRF) have focused on boosting people’s economic capital (e.g., income) and human capital (e.g., educational attainment) to reduce poverty. While investments in these areas have led to important gains in opportunity for many Britons, emerging research from behavioural science shows that other less tangible resources, which derive from psychological, social and cultural processes, significantly influence people’s ability to overcome disadvantage.

BIT was commissioned by JRF to examine the role of individual decisions in shaping people’s experiences of poverty in the UK and to identify the drivers of these decisions. This reflects JRF’s interest in looking beyond traditional, structural drivers of poverty. Our findings, based on a review of the published literature, are presented in a new report, launched today.”

 

Let’s cut to the chase. The entire document is framed by the use of a distinct and established narrative; it’s composed of a pre-loaded ideological language, references and signposts, using comments and phrases like “[…] we explain some of the ways that cognitive, character and social capital influence social mobility, via decision-making.”  

And a sub-heading:Character capital: Self-efficacy and responsive parenting.” Apparently, “home visits by health workers have had positive effects in preventing intergenerational poverty.” That’s quite a remarkable claim, given that the document acknowledges poverty is actually increasing in the UK.

The whole concept of character capital is itself founded on the notion that people with an “internal locus of control” tend to perform tasks better than those with an “external locus of control.” This is about where people place the responsibility for what they achieve – either “inside” individuals, based solely on notions of merit, specific skills and talents, or external to individuals – “outside” of them, based on environmental conditions such as competition, chance, opportunities, socioeconomic, employment market context and so on. However, the cited evidence to support this theory was later contradicted in the report.

It’s also worrying that it is implied those who believe that achievement is linked with structural conditions are “under-performers.” It reads a little like a Samuel Smiles Victorian treatise on “thrift, character and self-help.”

It’s also an almost subliminal method of dismissing the impact of structural constraints on the opportunities available to individuals. It serves to make invisible what was once a key consideration in public discussions about poverty: the unequal distribution of power, wealth, resources and opportunity.

Also of note: “low levels of financial literacy” was conflated with notions of “human capital”, which “potentially exacerbate the effects of depleted cognitive capital among low income groups when choosing between credit options.”  Nothing to see here, then, regarding the behaviour of lenders. I mean whoever heard of a bank offering an overdraft to people who actually need one. Still, thank goodness there are generous companies like Wonga, always ready to step up to the mark, with eye-watering interest rates to offer those on low incomes.

The research authors seem to think that the only human potential worth recognising is that of our economic decision-making. Yet when people are materially poor, budgeting and decision-making are invariably constrained – that’s intrinsic to the very nature of poverty.

Limited decision-making and reduced available choices don’t cause poverty: they are the subsequent exclusion effects of poverty.

It’s telling that none of the recommendations made in this document actually address the structural and political causes of material poverty and growing inequality in the UK.

There is a substantial incoherence in some of the claims made, too. For example: “The world of work is possibly the single most important policy area for maximising individual and household resources to prevent and overcome poverty.”

Yet: “Just under half of those in poverty in the UK live in a workless household (Joseph Rowntree Foundation, 2014)”. So work clearly doesn’t pay for over half of those people in poverty. 

In fairness, it is later acknowledged that: “However, simply being in work is not sufficient to prevent or overcome poverty. Nearly two-thirds of children in poverty live in working families.” 

This heavily jargonised rhetoric is, on the whole, about looking for cheap individualist “solutions” to poverty that disregard the need for improving people’s material and financial situations, by extending on an existing neoliberal narrative of alleged individual fault, character deficits, cognitive bias and decision-making flaws.

None of this will raise the profile of crucial issues such as the conditions imposed by austerity and neoliberal policies, socioeconomic organisation and political decision-making, that are having a profound impact on growing inequality and increasing poverty in the UK. The persistent use of the word “workless” rather than “unemployed” is another linguistic signpost for neoliberal competitive individualism, too. 

Geographer David Harveydescribes neoliberalism as a process of accumulation by dispossession: predatory policies are used to centralise wealth and power in the hands of a few by dispossessing the public of their wealth and assets. The report does not refer to the mode of political-economic organisation of which growing inequality and poverty are an intrinsic and inevitable feature.

Proposed solutions: more of the same

Summary of recommendations:

MINIMISING COSTS

Consumer credit

1 Make it easier to access low cost credit through extending access to interest-free Budgeting Advances; assisting credit unions to expand online services; and providing tax relief to individuals taking out payroll loans.

2 Further restrict practices by high cost credit providers that play on consumer biases, and test remedies that will improve consumer credit decision-making.

3 Continue to evaluate financial capability programmes through initiatives like the Money Advice Service What Works Fund.

(Access to credit does not alleviate poverty in the long-term.)

Savings

1 Test ways of automating rainy day savings through employer enrolment, default savings accounts with banks, and Universal Credit payments.

2 Evaluate the effectiveness of financial apps for helping people save.

3 Optimise the Help to Save matching scheme, through testing auto-enrolment and prizes for regular saving, to encourage low-income groups to save.

(Poor citizens do not have sufficient funds to make savings. And research shows that absolute poverty is growing in the UK, which means that many people often don’t have sufficient funds for meeting even fundamental survival needs, such as for food and fuel.) 

MAXIMISING RESOURCES

Work

1 Use identity-building activities in Jobcentres to cultivate intrinsic motivation for work in order to improve the quality and sustainability of jobs that people find.

2 Collect longer-term and more holistic outcome measures of labour market interventions to understand their full impact on poverty.

3 Develop a simple tool for Jobcentres to identify capital deficits in order to match interventions to individual job seeker needs.

Entitlements

1 Develop a common “cognitive load stress test” that measures how easy it is for eligible groups to access government entitlements.

2 Use annual entitlement summaries to prompt existing welfare recipients to apply for other assistance they may be eligible for, and to help them budget.

3 Experiment with the design of welfare conditionality to boost cognitive capacity and self-efficacy, such as having claimants set their own payment conditions.

PREVENTING INTERGENERATIONAL POVERTY

Parenting

1 Provide families in or near poverty with free access to evidence-based online parenting programmes.

2 Develop community to strengthen social ties between parents from different backgrounds.

3 Conduct research into whether small and inexpensive adjustments to housing conditions can reduce cognitive load and improve parental decision-making.

Post secondary education

1 Make the application process for post-secondary education as simple as possible, for example, by pre-populating application forms.

2 Use personalised assistance and prompts to encourage students and parents to apply to post-secondary education.

3 Link formal information about returns to post-secondary education with informal information (from peers) about what post-secondary education will be like.

Every single intervention recommendation fails to address the structural causes of poverty, which lie outside of the control of people experiencing poverty. Yet most of these recommendations are aimed at prompting the state to act upon individuals.  

Proposals such as providing access to parenting programmes, “identity-building activities in Jobcentres to cultivate intrinsic motivation for work”, “rainy day savings”, and to “develop a simple tool for Jobcentres to identify capital deficits in order to match interventions to individual job seeker needs” all sound like a New Right blame-storming exercise. Again, the problem of poverty is regarded as being intrinsic to the individual, rather than one that is about material deprivation which arises in a wider political, economic, cultural and social context.

Post secondary education costs money and isn’t supported by the state. The Education Maintenance Award (EMA) was withdrawn by the Conservatives, and the cost of a university education is now far too much for many young people from poorer backgrounds because of the tripling of fees and reduction in maintenance support. It’s the government that need a nudge, here. This is a good example of how opportunities and choices are being limited for poorer citizens by cuts and constraints imposed by the neoliberal ideologues in office.  

The government never question the decision-making of the powerful and wealthy, yet it certainly wasn’t the poorest citizens that caused the global recession in 2007, nor was it the poorest citizens that imposed damaging austerity policies. The poorest people are burdened with a disproportionate weight of austerity cuts to their income and support. The wealthiest citizens have meanwhile been gifted with substantial tax cuts. 

Nudge is a state prop for neoliberalism, inequality and social control

Neoliberals argue that public services present moral hazards and perverse incentives. Providing lifeline support to meet basic survival requirements is seen as a barrier to the effort people put into searching for jobs. From this perspective, the social security system, which supports the inevitable casualties of neoliberal free markets, has somehow created those casualties. But we know that external, market competition-driven policies create a few “haves” and many “have-nots.” This is why the  welfare state came into being, after all – because when we allow such competitive economic dogmas to manifest without restraint, we must also concede that there are always ”winners and losers.”

Neoliberalism organises societies into hierarchies. Inequality is therefore an inevitable feature of the UK’s current mode of socioeconomic organisation. 

The UK currently ranks highly among the most unequal countries in the world.

Inequality and poverty are central features of neoliberalism and the causes therefore cannot be located within individuals.  

Neoliberals see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined outcomes are stigmatised, and outgrouped.

Shamefully, in a so-called first world, wealthy liberal democracy, othering and outgrouping have become common political practices.  

Replacing spent micro-managementspeak with more micro-managementspeak

The Nudge Unit, which was part-privatised in 2014, have now warned that some Government policies were reducing so-called “cognitive bandwidth” or “headspace” of the people they were designed to help. So more theoretical psychobabble to overwrite the previous psychobabble which didn’t work when applied via policy.

This is bland neoliberal managementspeak at its very worst. The policies are causing profound damage, harm and distress to those they were never actually designed to “help”. Let’s not permit an evading of accountability and techniques of neutralisation: the use of rhetoric to obscure the real intention behind policies, as well as the consequences of them. It’s nothing less than political gaslighting. 

Of course the report attempts to apply “the latest findings from behavioural science to improve government services.” In a neoliberal framework, there are many lucrative opportunities for private companies to experiment in the psychological management of populations who have become the casualties of political decision-making, for political ends. The ethical relativity, moral entrepreneurship and sheer financial opportunism on display here certainly reflect some fundamental neoliberal values and principles. The main one being profit over human need.

Dr Kizzy Gandy proposes that cost-effective “simple tweaks” to services could help improve the way services worked. “Government policies should help people to have less on their mind, not more,” she added. 

However, I propose that government policies in democratic societies should also be designed to meet the public’s needs, including alleviating poverty, rather than being about impoverishing targeted social groups and then undemocratically acting upon individuals, without their consent, directing them how to behave in order to accommodate government ideology and meet politically defined neoliberal outcomes.

Material poverty steals aspiration and motivation from any and every person that is reduced to struggling for basic survival. Abraham Maslow (a real social psychologist) explained that when people struggle to meet their basic physical needs, they cannot be “incentivised” to fulfil higher level psychosocial needs – that includes job seeking.

Further criticism 

Labour Shadow Work and Pensions Secretary, Debbie Abrahams, said: “Even the government’s own Behavioural Insights Team now recognise the mountains of evidence that the widespread use of sanctions is not leading to better outcomes for people seeking work. Indeed, this government team’s report suggests that sanctions may be operating as a barrier to finding a job.

“This government should be ashamed of their persistent failure to act on this issue over many years, after I, and other campaigners, have provided evidence of the devastating impacts of their sanctions policy.  I have committed to putting an end to Tories’ cruel and unnecessary sanctions regime, as part of our work to transform the social security system.” 

In fairness to the BIT, the report does say on page nine, among the listed areas of proposed future research: “A significant portion of behavioural science research focuses on improving the decisions of end-users – in this case people in poverty. But what about the decisions of service providers and policymakers? How can we improve the quality of their decisions to support people [to] escape poverty? And how can we build their empathy with those whose opportunities are at stake?”  

But who is nudging the nudgers?  I would think nudgers are “incentivised” by those providing the contracts that pay their salaries, on the whole. The government part-own the nudge unit.

Researchers from a variety of universities across the UK, using qualitative longitudinal interviews with nine groups of welfare service users from across England and Scotland, aim at determining longer-term effects of sanctions. The first wave findings from this collaborative ongoing study regarding the effects and ethics of welfare conditionality were released last year 

It was found that linking continued receipt of benefit and services to mandatory behavioural requirements has created widespread anxiety and feelings of disempowerment. The impacts of benefit sanctions are universally reported by service users as profoundly negative, having severely detrimental financial, material, emotional, psychological and health impacts. Some individuals disengaged from services, some were even pushed toward “survival crime”.  

The most surprising thing about these findings was the general lack of surprise they raised.

A recurring theme is that sanctions are grossly out of proportion to “offences”, such as being a few minutes late for an appointment. Many reported being sanctioned following administrative mistakes. The Claimant Commitment was criticised for not taking sufficient account of individuals’ capabilities, wider responsibilities and vulnerabilities. Many saw job centres as being primarily concerned with monitoring compliance, imposing discipline and enforcement, rather than providing any meaningful support. 

Power relations, class and economic organisation have now completely disappeared from public conversations about poverty. Neoliberal anti-welfarism, amplified by a corporate media, has aimed at reconstruction of society’s “common sense” assumptions, values and beliefs. Class, disability and race narratives in particular, associated with traditional prejudices and categories from the right wing, have been used to nudge the UK to re-imagine citizenship, human rights and democratic inclusion as highly conditional.  

This is not just about shifting public rational and moral boundaries to de-empathise the electorate to the circumstances of politically defined others. It also obscures the consequences more generally of increasingly non-inclusive, anti-democratic, prejudiced and extremely punitive policies.  

The bottom line is that government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. In democratic societies, citizens’ accounts of the impacts of policies ought to matter. 
 
However, in the UK, the way that policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, and partly because the government employs the widespread use of linguistic strategies: euphemisms, superficial glittering generalities and techniques of persuasion to intentionally divert us from aims and consequences of ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly detached from public interests and needs. 

For example, the state has depoliticised disadvantage, making it the private responsibility of citizens, whilst at the same time, justifying a psychopolitical approach that encodes a punitive Conservative moral framework. 

According to the behavioural economist theorists, in their highly jargonised and fairly meaningless report, government policies are reducing so-called “cognitive bandwidth” or “headspace” of the people they were designed to help.

That the government imposes additional “cognitive costs”, as well as material and financial ones, on low-income groups, is hardly a groundbreaking revelation. 

I can put it much more plainly, and strip it of neoliberal psychobabbling: imposing sanctions on people who already have very limited resources is not only irrational, it is absurdly unjust, damaging, distressing and spectacularly cruel. 

See also:

Benefit Sanctions Can’t Possibly ‘Incentivise’ People To Work – And Here’s Why

Two key studies show that punitive benefit sanctions don’t ‘incentivise’ people to work, as claimed by the government

Welfare, Conditional Citizenship and the Neuroliberal State – Conference Presentation