Tag: Dennis Skinner

The DWP mortality statistics: facts, values and Conservative concept control

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I wrote
last week about the exchange in the Commons between Debbie Abrahams and Iain Duncan Smith regarding the Mortality Statistics Report released by Department of Work and Pensions. Debbie Abrahams asked a very reasonable question:

“The Government’s own data show that people in the work-related activity group are twice as likely to die than the general population. How can the Secretary of State justify £30-a-week cuts for people in that category?”

Duncan Smith gave a petty, vindictive and unqualified retort to avoid answering the question:

“The hon. Lady put out a series of blogs on the mortality stats last week that were fundamentally wrong. Her use of figures is therefore quite often incorrect. I simply say to her—[Interruption.] She has had an offer to meet the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for North Swindon (Justin Tomlinson), time and again, but she just wants to sit in the bitter corner screaming abuse.”

Adversarial style over meaningful content every time.

It’s certainly true that Conservatives advocate a limited ambition in politics, especially when it comes to maintaining the state support of even basic levels of human welfare. Small state fetishist Duncan Smith failed to provide a rational and evidenced response to a very reasonable question. He didn’t qualify why he thought that the blogs on the mortality statistics release last week were “fundamentally wrong,” either.

It has to be said that in light of the many official public rebukes that the Tories have faced for telling lies and using misrepresentations of statistics to justify their own value-laden, ideologically driven policies, and given the fact that the Government face a United Nations inquiry regarding the fact that their welfare “reforms” are incompatible with the Convention on the Rights of Persons with Disabilities, it’s truly remarkable that Priti Patel and Iain Duncan Smith have the cheek to call disability campaigners “thugs” and state that all other accounts of the mortality statistics are “wrong”, or to imply that opposition MPs are “liars”, when they are faced with valid concerns and founded criticisms regarding the consequences of their draconian policies.

Moreover, being civilised, values of decency and legitimate concerns about the welfare of sick and disabled citizens were depreciated as mere matters of “subjective interpretation” and not as worthy subjects of political, rational or objective discussion.

The Mortality Statistics release from Department of Work and Pension “provides further commentary on the appropriate use of this information” – in other words, it informs us what we may and may not do with the “data”, and carries this pre-emptive caution:

“Any causal effect between benefits and mortality cannot be assumed from these statistics.

Additionally, these isolated figures provide limited scope for analysis and nothing can be gained from this publication that would allow the reader to form any judgement as to the effects or impacts of the Work Capability Assessment.”

The way that the statistical data was intentionally presented without context, clarification or meaning, but with a warning that we may not draw any inferences from it lends a whole new layer of meaning to the phrase “the disappeared”.

The question we ought to ask is why? Firstly, why is it the case that we are being told that there is no reliable data regarding the impact of the Government’s policies, including their reformed Work Capability Assessment?

And of course, what is being hidden beneath the excessively  bureacratic management of information?

What kind of Government doesn’t concern itself with the well-being of citizens that it is meant to represent? A basic expectation surely ought to be that Governments monitor the effects of policy, especially the sort of policies that are, by their very design, likely to have a negative impact on sick and disabled people.

Cutting lifeline benefits, and using punishment in the form of sanctions to leave people without money to meet basic survival needs is never going to have a positive, or, to use a toryism, “incentivising” impact on people who are deemed medically unfit for work. The Government know this. And everyone who claims Employment Support Allowance may only do so because a qualified doctor has provided an evidenced statement that those people are unfit for work.

And what justification can there possibly be for a Government that is persistently refusing to carry out a cumulative impact assessment on such extensive, far-reaching welfare “reforms”?

When it comes to “knowledge” and “evidence,” the most significant struggle in what passes for Conservative epistemology is simply nothing more than wrestling with a grasping and malicious stranglehold over control of the terms of discourse. Those who can frame a controversial issue or concept in terms they prefer have the advantage in shaping and controlling public opinion.

There is existing empirical evidence (“data” if you prefer) of the correlation between the Government’s punitive policy regime and its negative effects, including increased mortality. As I argued with the Telegraph journalist Tom Chivers last year, the media have presented a record of evidence of tragic, individual cases where Government policy has clearly been correlated with deaths.

Though Chivers questioned the inferences and experiences of disabled people and disability campaigners back then, and though he stated how abysmally “unclear” the previous mortality statistics release was, remarkably, he didn’t once question that or investigate why.

Many studies have also clearly linked Tory policies with evidence of extremely adverse consequences of Tory policies. But Conservatives don’t take kindly to challenge, preferring to discredit those who criticise policy, and threaten them rather than stepping up to adopt a dialogic, democratic, transparent and accountable approach to Government.

Additionally, MPs, including Dennis Skinner, John McDonnell, Michael Meacher, Debbie Abrahams, Sheila Gilmore, Anne Begg, and Glenda Jackson, amongst many others, have raised concerns regarding people’s awful experiences of the negative impact of the Tory “reforms” as well as the mortality statistics, meticulously citing the evidence of case studies, often from their own constituencies. Those cited cases are recorded on the parliamentary Hansard site.

As well as via the use of early day motions (EDM) and adjournment debate, the many problems concerning the consequences of the welfare “reforms” are also addressed rigorously by the Work and Pensions Committee, through formal inquiries, (again, see Hansard record,) which are also informed by witnesses and empirical evidence.

I’ve also gathered some evidence here: Suicides reach a ten-year high and are linked with welfare “reforms” and here: Remembering the Victims of the Government’s Welfare “Reforms”

The Tories have dismissed such collective accounts of individual cases as “anecdotal evidence,” whilst also dismissing any attempt to cite quantitative data – statistics – as “wrong” simply to divert criticism of their policies and diminish public sympathy and concern.

I’m wondering where the empirical evidence is for Tory notions, such as a “culture of worklessness” or the “something for nothing culture”. Or for “making work pay”. The Tories tend to adopt a pseudo-positivist stance, claiming credibility via their ideological assumptions and by making invalid inferences from statistics when it suits them, and dismissing other accounts as merely “subjective”, yet no-one conflates the fact-value distinction more than the rigidly ideologically bound, staunchly neoliberal Conservatives, who produce every discussion as if there are no alternatives to Conservatism at all.

Statistics tend to dehumanise, and exclude people’s own validating  accounts of experiences of the social phenomena they measure. In a democratic society, qualitative accounts – “the people’s voice” – ought to matter to the Government. The impact of such draconian, punitive policies cannot be reduced to abstract speculation regarding what inferences may and may not be drawn from statistics: this is about very real experiences, real lives and real people being damaged and some, destroyed, in a real world of real and brutal Tory policies.

I’ve argued elsewhere that the point-blank refusal to enter into open debate and to allow an independent inquiry into the deaths that are most likely correlated with Tory policy reflects a callous, irrational and undemocratic government that draws on an underpinning toxic social Darwinist ideology and presents a distinctly anti-enlightenment, impervious epistemological fascism from which to formulate justification narratives for their draconian policies, in order to avoid democratic accountability and to deflect well-reasoned and justified criticism.

The lack of rational responses from Iain Duncan Smith, or concern about the welfare of the sick and disabled people that he tellingly differentiates from “normal” people, and the message from his Department, urging us not to make inferences about the deaths of sick and disabled people is an oblique reference to the fact/value distinction. It’s a method called “framing”. Such concept control is a way of rigging the debate: You must talk about this controversial issue using our categories, terms, and definitions only.

Or a way of avoiding debate altogether.

 The fact/value distinction is the alleged difference between descriptive statements (about what is) and prescriptive or normative statements (about what ought to be). Facts are one sort of thing, values another sort of thing, and the former never determine the latter. That’s the idea, anyway. But it isn’t considered to be very clear-cut when it comes to the “social sciences” such as politics and economics. I go further than the critics of logical positivism, and propose that it’s a false dichotomy anyway, especially where politics and policy-making are concerned, as these are invariably value-laden activities.

Whenever the Conservatives talk about “difficult decisions” or “tough choices”, they are in fact reflecting their own subjectivity and indulging Tory values, demonstrating their intentionality – and the capacity for a degree of free-will. Those “difficult decisions” have included the wilful handing out of £107,000 each per year to millionaires, in the form of a tax-break, and the intentional cutting of our social security down to the bone, the purposeful cutting of crucial public support services.

Sick and disabled people in this country have borne the brunt of the Tory directed austerity cuts. These cuts were the “tough choice” that the Tories freely made, ignoring less cruel and harmful alternative choices that could have been made. The Tories are masters at foreclosing possibilities.

Would you like to see some empirical data about Tory decision-making? Statistics? Facts and figures?  Here they are: Briefing on How Cuts Are Targeted – Dr Simon Duffy and here: Follow the Money: Tory Ideology is all about handouts to the wealthy that are funded by the poor.

tough choices

Government policies are expressed political intentions, regarding how our society is organised and governed. They have calculated social and economic aims and consequences.

How policies are justified is increasingly being 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 propaganda to intentionally divert us from their aims and the consequences of their ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly detached from public interests and needs.

Regardless of what kind of epistemology you may subscribe to, there are no “facts” that can ever justify the targeted political persecution of social groups in democratic societies. And the Tories know exactly what the impacts of their policies are likely to be. The level and extent of the stigmatisation and scapegoating of sick and disabled people in the media, coming from the Conservative camp to justify punitive cuts informs us of that.

Politics is invariably about values. That’s not a bad thing in itself. However, being open and honest about those values is crucial, and expected behaviour from a democratically elected government.

Human societies are not shaped by unchanging natural laws, despite what the Tories try and tell you. They are shaped by ideas of what ought to be. We make moral judgements about how to live and be. We have potential, intention and we make collective, cooperative decisions about how best to organise society. We progress, we change and evolve. 

Well, except during those times that we have regressive, authoritarian Right-wing Governments. 

Governments ought to face their moral obligations towards the well-being and interests of all citizens, to take responsibility for their ethical decisions and own their value-judgements. Rather than disguise them as shallow and meaningless “facts” to hide behind, as the pseudo-positivist Tories frequently do.

It’s truly remarkable that Tories loudly attribute the capacity for moral agency to people claiming benefits, for example, formulating punitive sanctions and “assessments” to both shape and question the morality of the poor constantly, yet stand outside of any obligation to morality and ethical behaviour themselves. It’s always someone else’s responsibility, never theirs.

Any claim to “value-freedom” in political decision-making does not and cannot exempt ministers from moral responsibility, or justify moral indifference.

A genuinely rational and morally responsible Government would hold an independent investigation into the reasons why people have died after being told they are “fit for work” when they clearly were not, and  commit to keeping data that effectively monitors and accurately reflects the impact of policy changes on citizens. A genuinely rational and morally responsible Government would be concerned about the possibility that their policies are harming people and causing deaths.

After all, this is a first-world liberal democracy, isn’t it?

430847_149933881824335_1645102229_n (1)Pictures courtesy of Robert Livingstone


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WORKING FOR PATIENTS OR NOT? – a guest post by Suzanne Kelsey

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A guest post by Suzanne Kelsey, who is a key campaigner for the NHS, amongst other things.

In 1988, when Margaret Thatcher had been in office for some 9 years, and the very foundations of our NHS had been shaken with more of the public encouraged to use private medical care,  there were serious concerns about capacity in the hospital services as waiting lists increased and wards closed.  The Conservative government appointed a group of people, without consulting the health professions, to look at this growing problem.

As a result of this the NHS experienced the most significant cultural shift since its inception with a White Paper entitled, ‘Working for Patients, ’ which proposed what we now  know as the ‘Internal Market’ and the development of the purchase provider split. GPs become the purchaser and the hospitals are the providers. This passed into law as the NHS and Community Care Act 1990. Understandably there was a great deal of opposition from trade unions, Labour and the general public but it went ahead as did the Private Finance Initiative in 1992 implemented for the first time in the UK by the Conservative government of John Major.

There is no doubt that further major problems were created for our NHS, although I would question if on the same scale as we are currently witnessing with the threat of complete privatisation and the sell-off of our publically funded service to huge private international companies, who have been waiting in the wings for quite some time and would have been rubbing their hands in glee some years ago if Thatcher and the Conservatives had continued in office.

The definition of ‘privatisation’ also needs to be acknowledged because with the downgrading of facilities and existing provision struggling to meet demands, more and more people will become anxious and tempted to pay for their treatment even if it is to ensure they have a hospital bed!

We must never let this practice become the ‘norm.’ Campaigners must ensure that the ‘free at point of use’ core principle is upheld or we will be taken back to pre-war years, removing freedom from fear that was fought long and hard for by our champions of social justice. At the same time we must remember the mantra, ‘public health not private wealth’ with numerous examples available to us of how private companies will always put profits before patients, but more of that later.

When Tony Blair became Prime Minister in 1997 he inherited a very impoverished NHS and although we expected him to abolish the internal market this did not happen, perhaps for a variety of justifiable reasons. How do you replace crumbling hospitals and inadequate resources without massively raising taxes, whilst also limiting the upheaval that had already been caused?

Alan Milburn was Minister of State at the Department of Health during this time and he stated that after years of the Tory’s gross underfunding, there was absolutely no money to fund the infrastructure, hence the use of John Major’s PFI initiative. Labour therefore it would seem had little choice but to implement this because of the historic neglect of the NHS under the Conservatives that led to understaffing and an NHS unable to manage with the rising expectations of the population, coupled with the costly advances in modern medicine and technology.

A global recession, which was not Labour’s fault, further compounded the challenges of meeting the complex needs of the nation’s health care. Dennis Skinner MP for Bolsover Derbyshire, passionately summarised this in parliament in 2014 when he stated; ‘Between 1997 and 2010 Labour dragged the NHS from the depths of degradation that the Tories had left it in and hoisted it back to the pinnacles of achievement.’

I would like to pose some questions to those experts of marketisation and competition. My knowledge is very limited on the economic implications but I am learning, slowly but surely, through my long involvement with local and national campaigning, speaking to key people in politics and campaign groups, who are also passionate about our NHS. I become increasingly frustrated when people continually blame Labour for the introduction of privatisation  Yes Blair did carry on certain aspects of it which was a disappointment for many, including me, but perhaps my arguments surely go some way to addressing why this was.

  •  My first question is in the title of this article; ‘IS THIS WORKNG FOR PATIENTS OR NOT?’
  •  If Labour had made such massive inroads into privatisation surely there would have been no need for the Coalition’s unwieldy and costly three billion pound reforms, so huge they were just about visible from outer space and the truth is many of those who voted for it would not have time to read it fully. The bill was a long time in the writing and despite the pause because of massive opposition it was nevertheless hastily introduced by the Coalition, despite all the election promises, notably, ‘there will be no top down reorganisation of the NHS.’ They have as predicted caused unprecedented chaos and in fact a major crisis in our NHS, with exhausted frontline workers propping up a system, becoming totally stressed, angry and demoralised.

Many of the population are afraid of becoming ill, because of worrying inadequacies not only at primary and secondary health care levels but also in social care. The frail and elderly feel a burden as they are constantly labelled as ‘bed blockers,’ Thus long queues have been created to see your GP and at A+E, the gateway to the hospital, all of which can result in a lack of timely care. In contrast however Labour ensured patient satisfaction was at its highest with waiting times were at their lowest and the NHS during their time was lauded as one of the best, if not the best health service in the world.

  • Were the massive and unprecedented reforms therefore unnecessary and unjustified?
  • What are the implications for binding private contracts that have taken place across large swathes of the country if hopefully there is a change of government?
  • What lesson have been learnt from the withdrawal of Circle, the private company that took over Hitchingbrooke hospital, with claims of managers installed by these private operators creating a ‘blame culture?’ Allegedly Circle were willing to ensure local GPs incurred financial losses as long as it meant corporations continued to make a profit and the damning report about the quality of care in this hospital is shocking. CQC inspecting the hospital felt obliged to intervene when they became fearful of a sickening child and Professor Mike Richards the chief inspector of hospitals said that the findings were the worst it had ever published.
  • Clive Efford Labour MP for Eltham, South East London,   presented a private members bill to parliament in November 2014,which in order to avoid further top down reorganisation, focussed on the most damaging aspects of the Health and Social Care Act 2012, that gave powers to competition regulators to interfere in decisions of local health care commissioners. The most significant change is that the Secretary of State is once again accountable to you and me through parliament. If the bill is passed he can no longer avoid answering parliamentary questions by saying that it is down to local decision making and not his responsibility. Efford’s Bill also provides that neither EU competition rules nor EU procurement rules will apply. That is an important change from the present because, at the moment, a disappointed private provider can sue an NHS commissioner for damages for failing to put a service out to tender or running a tender process wrongly. My thanks to Clive Efford for that explanation and for securing a vote of 241 for the bill to 18 against.
  • How is this Bill progressing and how it is being supported by NHS campaign groups and health professionals.
  • If the Conservatives are allowed to waltz back in by a public who have been influenced by the hype and propaganda through a biased media and/or have become disengaged, disenchanted or disillusioned , or indeed confused by the outrageous claims of some minor parties who seem to be making it up as they go along, what do we do next!?

I hear talk of a revolution being the only answer from those extremists who are likely to be the least affected by one. Perhaps we would do well to remember that our NHS has just seen the biggest revolution since its inception in 1948. Unfortunately we have seen a glimpse into our future and the outcomes are dire, if we do not use our votes wisely.

Suzanne Kelsey 1stFebruary 2015

http://www.nhshistory.net/shorthistory.htm#_ednref15

http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx

https://abetternhs.wordpress.com/2011/01/18/commissioning-and-the-purchaser-provider-split/

http://www.healthp.org/node/71

http://labourlist.org/2014/11/commons-pass-vote-on-clive-effords-nhs-bill/

http://www.telegraph.co.uk/news/politics/11333986/Damning-report-as-first-private-firm-to-run-NHS-hospital-pulls-out.html

Battle with GPs led to Circle’s retreat from Hinchingbrooke hospital,   The Guardian, January 9, 2015

Hinchingbrooke staff in CQC abuse concerns fear bosses BBC, September 29, 2014

http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html