Tag: Public Health England

Government plans to use your phone and online data to police your lifestyle and predict ‘threats’ to your health

“Artificial Intelligence in healthcare is currently geared towards improving patient outcomes, aligning the interests of various stakeholders, and reducing healthcare costs.” CB Insights.

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The Care.Data scandal

Back in 2014, public concerns rose because drug and insurance companies were able to buy information about patients – including mental health conditions and diseases such as cancer, as well as smoking and drinking habits – from a single English database of medical data that had been created.

Harvested from GP and hospital records, medical data covering the entire population was uploaded to the repository controlled by an arms-length NHS information centre. Never before had the entire medical history of the nation been digitised and stored in one place. Advocates said that sharing data will make medical advances easier and ultimately save lives because it will allow researchers to investigate drug side effects or the performance of hospital surgical units by tracking the impact of interventions on patients. 

However, data protection campaigners warned at the time that individuals were at risk of being identified and claimed notes were often inaccurate. The Department of Health was also criticised for failing to inform people they would be automatically opted into the scheme and would need to fill in a form if they wanted their medical records removed. 

All 26 million households in England were notified about the Care.data scheme, so that individuals could choose to opt out, but many didn’t know they had that choice. Those behind the £50million data-sharing plan said it would “improve healthcare and help medical research.”

Many doctors were so incensed about the failure to protect patients’ data that they opted out their entire surgeries from the database, and the roll-out was eventually aborted in 2014. Privacy experts warned there will be no way for the public to work out who has their medical records or to what use their data will be put. The extracted information contained NHS numbers, date of birth, postcode, ethnicity and gender.

The controversial £7.5 million NHS database (Care.data) was scrapped very quietly on same day as Chilcot Report was released.

Phil Booth of medConfidential – campaigning for medical data privacy – said: “The toxic brand may have ended, but government policy continues to be the widest sharing of every patient’s most private data.” 

Personal data is now used not only to deliver but to deny services, so it’s more important than ever to check what’s on your records.” 

He goes on to say: “Quite apart from the appalling mistreatment of generations of people, the Windrush scandal highlighted two deep problems about government’s handling of personal data. It confirms the government’s default position is one of disbelief – “guilty until proven innocent”, for some groups at least.

And it also confirms that – despite years of experience of the consequences, the government remains utterly cavalier in its stewardship of your data.

From the Home Office hunting people down through their NHS data and their children’s school records, to Google DeepMind’s secret deal intending to feed 1.6 million Royal Free Hospital patient records to its Artificial Intelligence project to Job Centre bosses interfering in medical records, and the Department for Education packaging up students’ personal data for private exploitation – as many have learned, “the power of data” is not always benign. Whether destroying the Windrush generation’s vital records or losing 25 million people’s records in the post, the consequences of poor information handling practices by Departments of the database state are always damaging to citizens.”

He’s right of course. The principle is one of private profits while the public carry the burden of risks every time. 

There is widespread concern over insurance and marketing companies getting access to our personal health data. The bottom line is that patients must have clear information about what happens to their data, how it may be used, and must be given a clearly stated opportunity to opt out.

The ‘business friendly’ government: deja Vu and AI

Theresa May has again pledged millions of pounds to use Artificial Intelligence (AI) to “improve early diagnosis of cancer and chronic disease.” In a speech delivered earlier this year, May also called for the industry and charities to “join the NHS in creating algorithms that can predict a patient’s care requirements based on their medical records and lifestyle information.” 

The government believes that early intervention would provide “less invasive, more affordable and more successful care than late intervention,” which they claim “often fails.”  

While the government has assumed that the unmatched size of the NHS’s collection of data makes it ideal for implementing AI, many are concerned about data privacy.

Importantly, May’s proposal would once again allow commercial firms to access NHS data for profit.

In April 2018, a £1bn AI sector deal between UK Government and industry was announced, including £300million towards AI research. AI is lauded as having the potential to help address important health challenges, such as meeting the care needs of an ageing population. 

Major technology companies – including Google, Microsoft, and IBM – are investing in the development of AI for healthcare and research. The number of AI start-up companies has also been steadily increasing. There are several UK based companies, some of which have been set up in collaboration with UK universities and hospitals.

Partnerships have been formed between NHS providers and AI developers such as IBM, DeepMind, Babylon Health, and Ultromics. Such partnerships have attracted controversy and wider concerns about AI have been the focus of several inquiries and initiatives within industry, and medical and policy communities. 

Last year, Sir John Bell, a professor of medicine at Oxford university, led a government-commissioned review. He said that NHS patient records are uniquely suited for driving the development of powerful algorithms that could “transform healthcare” and seed an “entirely new industry” in profitable AI-based diagnostics. 

Bell describes the recent controversy surrounding the Royal Free hospital in London granting Google DeepMind access to 1.6m patient records as the “canary in the coalmine”. “I heard that story and thought ‘Hang on a minute, who’s going to profit from that?’” he said.

Bell gave the hypothetical example of using an anonymised data for chest radiographs to develop an algorithm that eliminated the need for chest x-rays from the ‘analytical pathway’.

“That’s worth a fortune,” he said. “All the value is in the data and the data is owned by the UK taxpayer. There has to be really serious thought about protecting those interests as we go forward.”

However, Bell highlighted a “very urgent” need to review how private companies are given access to NHS data and the ownership of algorithms developed using these records.

Matt Hancock, the recently appointed health secretary, is now planning a “radical” and highly invasive system of “predictive prevention”, in which algorithms will use detailed data on citizens to send targeted “healthy living messages” to those flagged as having “propensities to health problems”, such as taking up smoking or becoming obese. 

Despite promises to safeguard data, the plans have already once again attracted privacy concerns among doctors and campaigners, who say that the project risks backfiring by scaring people or damaging public trust in NHS handling of sensitive information. People’s medical records will be combined with social and smartphone data to predict who will pick up bad habits and stop them getting ill, under radical government proposals. Of course this betrays a fundamnetal assumption of the government: that illness arises because of  bad “lifestyle choices.” 

Hancock said: “So far through history public health has essentially dealt with populations as a whole.

“The anti-smoking campaign on TV is targeted at everybody. But using data, both medical data — appropriately safeguarded, of course, for privacy reasons — and using other demographic data, you can work out that somebody might have a higher propensity to smoke and then you can target interventions much more closely.”

However, the historical evidence of the government “safeguarding” our data effectively isn’t particularly confidence-inspiring.

Public Health England is already looking at using demographic and smartphone health data to personalise messages on healthy living and plans to launch pilot projects next year.

Initially the data will be limited to broad categories, such as age or postcode. Ultimately, however, including detailed information on individual housing, employment and income or people’s internet use has not been ruled out. 

Hancock said: “We are now exploring digital services that will use information people choose to share, based on consent with only the highest standards on data privacy, to offer them precise and targeted health advice.”

Advice from whom? Unum and other private insurance companies? Businesses selling life style products? The pharma industry? Many campaigners are very concerned that the use of their data may lead to them being discriminated against by insurers or in the workplace.

Concerns

Another concern is how intrusive surveilance and data analytics is and how it may dehumanise patients. One NHS suicide prevention app, for example, that is currently in development, will monitor emails, texts and social media for signs that “people might be about to kill themselves.”

“Technology now allows us to offer people predictive prevention; tailored, intelligent advice on how to live longer, healthier lives,” Hancock said. 

“This used to happen within the brains of the GPs in the partnership when they really knew the community and had personal relationships with everyone in the community. As GPs’ practices have come under more pressure, that’s become harder and we can use data really effectively to target people who have propensities to health problems.”

Another danger is the ongoing demedicalisation of illness and the deprofessionalisation of trained doctors. Healthcare professionals may feel that their autonomy and authority is threatened if their expertise is challenged by AI. The ethical obligations of healthcare professionals towards individual patients might be affected by the use of AI decision support systems, given these might be guided by other priorities or interests, such as political ideology regarding cost efficiency or wider public health concerns.

AI systems could also have a negative impact on individual autonomy. For example, if they restrict choices based on calculations about risk or what is in the best interests of the user.

If AI systems are used to make a diagnosis or devise a treatment plan, but the healthcare professional is unable to explain how these were arrived at, this could also be seen as restricting the patient’s right to make free, informed decisions about their health. Applications that aim to imitate a human professional raise the possibility that the user will be unable to judge whether they are communicating with a real person or with technology.  

Although AI applications have the broad potential to reduce human bias and error, they can also reflect and reinforce biases in the data used to train them. Concerns have been raised about the potential of AI to lead to discrimination in ways that may be hidden or which may not align with legally protected characteristics, such as gender, ethnicity, disability, and age. 

The House of Lords Select Committee on AI has cautioned that datasets used to train AI systems are often poorly representative of the wider population and, as a result, could make unfair decisions that reflect wider prejudices in society. The Committee also found that biases can be embedded in the algorithms themselves, reflecting the beliefs and prejudices of AI developers.

Sam Smith, of the privacy group medconfidential, warned that a “ham-fisted” plan might backfire, given the government’s poor record on data-handing. He said: “Predictive intervention has to be done carefully and in the right context and with great empathy and care, as it’s easy to just look creepy and end up with a ‘Mark Zuckerberg problem’ [where a focus on the power of data leads to a neglect of the human problems it is trying to solve].”

Humans have attributes that AI systems might not be able to authentically possess, such as compassion and empathy. Clinical practice often involves very complex judgments and abilities that AI currently is unable to replicate, such as contexual knowledge (such as existing comorbidities) and and the ability to read social cues. There is also debate about whether some human knowledge is tacit and cannot be taught.

AI could also be used for malicious purposes. For example, there are fears that AI could be used for covert surveillance or screening by private companies and others. AI technologies that analyse motor behaviour, (such as the way someone types on a keyboard), and mobility patterns detected by tracking smartphones, could reveal information about a person’s health without their knowledge. 

Today it’s reported that NHS Digital is set to ignore the IT security recommendations of its own chief information officer, Will Smart, citing the estimated cost of between £800 million and £1 billion. It claims that the investment would not be “value for money”.

The recommendations were the result of a review, published in February, that was commissioned by government in response to the WannaCry ransomware attack, which affected one-fifth of all NHS trusts in the UK. The NHS was especially hard hit, not least due to a lack of up-to-date patching on Windows 7 workstations across the monolithic organisation, one of the biggest employers in the world.

The recommendations in Smart’s review had been endorsed by the National Cyber Security Centre (NCSC).

However, documents acquired under Freedom of Information by the Health Service Journal (HSJ), indicate that NHS Digital has opposed adoption of the recommendations on the grounds that they would not “be value for money”. 

NHS Digital’s response comes despite the organisation coming under sustained and continual cyber attacks, including one called Orangeworm that specifically targets sensitive healthcare data. HSJ adds that malicious phishing websites mimicking NHS trusts have also been found, while one NHS organisation was found to have exposed a sensitive database online.

A scan by NHS Digital, it adds, found 227 medical devices connected to the internet with a known vulnerability. And four out of five NHS trusts failed to even respond to a ‘high severity’ cyber alert issued in April.

The review of NHS IT security by CIO Will Smart came four months aftea damning report into the state of NHS IT security produced by the National Audit Office, which indicated that the NHS and Department of Health didn’t know how to respond to the outbreak.

With such a cavalier approach to basic IT security, it’s difficult to imagine how we can possibly trust the ‘business-friendly’ government and NHS with the stewardship of our personal health data. Personal data has become the currency by which society does business, but advances in technology should not mean organisations racing ahead of people’s basic rights. Individuals should be the ones in control and government and private organisations alike must do better to demonstrate their accountability to the public.

The use of AI in surgery

DA-VINCI-ROBOT

The Da Vinci surgicalrobot 

An inquest heard recently heard how a patient who underwent ”pioneering’ robotic heart valve surgery at the Freeman hospital in Newcastle died days later after the procedure went horribly wrong. 

Stephen Pettitt died because of multiple organ failure, yet it was expected that he was 98-99% chance of surviving the relatively low risk surgerical procedure.

Heart surgeon Sukumaran Nair had been offered training on the use of the robot with the hospital’s gynaecology department – but he refused.

He told a colleague later he could have done more “dry-run” training beforehand, the hearing heard.

The operation was planned to repair a mitral valve but damage was caused by the robot to the interatrial septum. The procedure had to be converted to an open heart operation where the chest was opened up to repair the tear.

Pathologist Nigel Cooper said: “By that time the operation had been going on for a considerable period of time. By the end of the surgery the heart was functioning very poorly.”

Medicines and a machine to help the heart function were brought in but Pettitt’s organs began to shut down and he didn’t recover.

The robot was so loud in use that the surgical team were shouting at one another and the same machine knocked a theatre nurse and destroyed the patient’s stitches, the Newcastle Coroner’s Court heard.

A leading heart surgeon, Professor David Anderson, told Newcastle Coroner’s Court the operation conducted by under-trained Sukumaran Nair, using the Da Vinci surgical robot, would not likely have ended that way had the robot not been used.

Anderson, a consultant cardiac surgeon at Guy’s and St Thomas’s Hospital, London, told the Newcastle hearing that Pettitt’s euroSCORE – the risk factor applied to heart surgery patients – was just 1-2% in normal circumstances.

Such was the concern at the completely botched six-hour-long procedure performed on Stephen Pettitt, that Northumbria police have launched a criminal inquiry.

Nair was fired from his job at Newcastle’s Freeman Hospital and their robotics heart programme ended. Newcastle coroner Karen Dilks recorded a narrative verdict into the retired music teacher’s death.

According to the US company behind the botched procedure, Intuitive Surgical Inc, “The surgeon is 100% in control of the da Vinci System at all times.”

However, there can be “serious complications and death” in any surgery, according to the business.

Risks during surgery include inadvertent cuts, tears, punctures, burns or injury to organs.

Don’t those stated risks negate the justification for using robotics to perform surgery – increased, not decreased, precision?

The company add: “It is advised the surgeon switch from minimally invasive surgery to open surgery (through a large incision) or hand-assisted surgery if problems occur.”

Related

Artificial intelligence (AI) in healthcare and research

GPrX – the company that sells NHS data to sales teams for pharma industry can market products and target the prescribers 

 


 

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The Government’s brutal cuts to disability support isn’t ‘increasing spending’, Chancellor, but handing out tax cuts to the rich is

Chancellor George Osborne

 

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Source: Hansard

Context

Many of us recognised in 2012, when the welfare “reforms” and other cuts to public services that support the poorest citizens were forced through parliament despite considerable opposition, using only the “financial privilege” of the Commons as a justification, that the Conservatives are on an ideological crusade, which flies in the face of public needs, democracy and sound economics, to shrink the welfare state and privatise our essential services.

In a wealth transfer from the poorest to the very rich, we have witnessed the profits of public services being privatised, but the losses have been socialised – entailing a process of economic enclosure for the wealthiest, whilst the burden of losses have been placed on the poorest social groups and our most vulnerable citizens – largely those who are ill, disabled and elderly. The Conservative’s justification narratives regarding their draconian policies, targeting the poorest social groups, have led to media scapegoating, social outgrouping, persistent political denial of the aims and consequences of policies and reflect a wider process of political disenfranchisement of the poorest citizens, especially sick and disabled people.

That the cuts are ideologically driven, and have nothing whatsoever to do with economic necessity, was demonstrated only too well by the National Audit Office (NAO) report earlier this year. The NAO scrutinises public spending for Parliament and is independent of government. The report indicates how public services are being appropriated for purely private benefit.

The audit report in January concluded that the Department for Work and Pension’s spending on contracts for disability benefit assessments is expected to double in 2016/17 compared with 2014/15. The government’s flagship welfare-cut scheme will be actually spending more money on the assessments conducted by private companies than it is saving in reductions to the benefits bill.

From the report:

£1.6 billion
Estimated cost of contracted-out health and disability assessments over three years, 2015 to 2018

£0.4 billion
Latest expected reduction in annual disability benefit spending.

This summary reflects staggering economic incompetence, a flagrant, politically motivated waste of tax payers money and even worse, the higher spending has not created a competent or ethical assessment framework, nor is it improving the lives of sick and disabled people. Some people are dying after being wrongly assessed as “fit for work” and having their lifeline benefits brutally withdrawn. Maximus is certainly not helping the government to serve even the most basic needs of sick and disabled people.

However, Maximus is serving the private needs of a “small state” doctrinaire neoliberal government, and making lots of private profit whilst it does so. The Conservatives are systematically dismantling the UK’s social security system, not because there is an empirically justifiable reason or economic need to do so, but because the government has purely ideological, anticollectivist, antidemocratic, profoundly uncivilising prescriptions and longstanding prejudices.

Last week I wrote about the £30 a week Employmen Support Allowance (ESA) work related activity group (WRAG) cuts, which the Government have forced through the legislative process, despite meeting with widespread opposition, the government claim that it is their financial privilege to do so. Yesterday I wrote about the brutal cuts that are planned for Personal Independence Payments (PIP) for sick and disabled people, which are aimed at saving money by reducing eligibility for the support. The cut, it is estimated, will affect at least 640,000 disabled people by 2020, who may lose up to £150 a week. This is money that provides essential support for people who need help to prepare food, use the toilet or dress themselves, amongst other things, and to maintain a degree of dignity and independence.

The cuts to ESA and Personal Independent Payments (PIP) take place in the context of a Tory manifesto that included a pledge not to cut disability benefits. In fact in March last year, the Prime Minister signalled that the Conservatives will protect disabled claimants from welfare cuts in the next parliament (this one). Cameron said the Conservatives would not “undermine” PIP, which was introduced under the Coalition to save money by “targeting those most in need.” Now it seems those most in need are not the ones originally defined as such.

At the time he told BBC Breakfast: “We’ve replaced one benefit – Disability Living Allowance – with a new benefit – Personal Independence Payment – it’s working well, it is also going to lead to some savings over time and we haven’t created that benefit in order to undermine it. We want to enhance it and safeguard it.”

Semantic thrifts: being Conservative with the truth

Only a Conservative minister would claim that taking money from sick and disabled people is somehow “fair,” or about “helping”, “supporting” or insultingly, “incentivising” sick and disabled people who have already been deemed unfit for work by their doctors and the state via the work capability assessment to work.

The Tories all too frequently employ such semantic shifts and euphemism – linguistic strategies – as an integral part of a wider range of techniques of neutralisation that are used, for example, to provide linguistic relief from conscience and to suspend moral constraint – to silence both “inner protest” and public objections – to the political violation of social and moral norms; to justify acts that cause harm to others whilst also denying there is any subsequent harm being inflicted; to deny the target’s and casualties’ accounts and experiences of political acts of harm, and to neutralise remorse felt by themselves or other witnesses.

Media discourse has often preempted the Conservative austerity cuts, resulting in the identification, stereotyping and scapegoating of the groups in advance of the targeted, discriminatory policies. Media discourse is being used as a vehicle for the government to push their ideological agenda forward without meeting legitimate criticism, public scrutiny and without due regard for essential democratic processes and safeguards.

The five neutralisation techniques identified by Gresham Sykes and David Matza are: denial of responsibility, denial of injury, denial of victims, appeal to higher loyalties, and condemnation of condemners.

The really critical part of Sykes and Matza’s argument is that rationalisations precede immoral, cruel or controversial acts and are a key factor in making deviant behaviour possible (amongst delinquents, the mafia or Conservative ministers). As such, the rationalisations betray intent.

The cuts of £120 a month to the disability benefit Employment Support Allowance  are also claimed to be “fair.” and “supportive.” Though I have yet to hear a coherent and rational  explanation of how this can possibly be the case. Ministers claimed that people subjected to the ESA Work Related Activity Group cuts could claim PIP if they required support with extra living costs, but now we are told that PIP is to be cut, too.

Osborne’s techniques of neutralisation: calling a cut “increased spending”

The chancellor has defended his decision to use the cuts in disability benefits to fund tax breaks for the wealthy. On the Andrew Marr show yesterday, he was questioned about his decision to cut PIP, currently made to over 640,000 disabled people in a bid to save at least £1.2 billion. Many severely disabled people are facing a cut of up to £150 a week under the new reduced eligibility assessment criteria.

Controversially, the cuts to disability benefits will fund tax cuts for the most affluent – the top 7% of earners. The Chancellor is set to raise the threshold at which people start paying 40p tax, in a move that will probably see  many wealthier people pulled out of the higher rate of income tax, in the coming budget. Mr Osborne says he wants to “accelerate progress” towards the Conservative’s manifesto pledge of raising the threshold for the 40p rate to £50,000 in 2020, it is understood. The average annual income in the UK is around £27,000. 

Andrew Marr said: You’re taking money out of the pockets of some of the most vulnerable people in this country, disabled people. These are the people who can least afford the sacrifice, the people with the weakest shoulders.

And you’re changing the rules to hit them. Is that really your priority?”

Osborne ludicrously claimed that the Conservative government was “increasing spending on disabled people”, he said: “Controlling welfare bills is part of what you need to do if you’re a secure country confronting the problems in the world.”

But as Marr pointed out, the cuts to ESA and PIP show an intended substantial reduction on government spending to essential support for disabled people.

From January 2017, the cut to PIP is likely to hit sick and disabled people who face fundamental barriers to health and essential basic care. The cut, it is estimated, will affect at least 640,000 disabled people by 2020.

Andrew Marr went on to say: “At the same time as you’re raising thresholds to help middle-class tax payers, it’s going to seem a very callous set of priorities.”

However, Mr Osborne maintained that the brutal and uncivilised cuts were “necessary to improve the economic conditions in the UK”. He said: “Yes, times are tough. The fiscal situation is a difficult one. All Western countries are not productive enough.”

You can see the interview here:


Austerity and premature mortality

Since 2011, a year after the government began their austerity programme, mortality rates have increased rapidly. Advisers to Public Health England (PHE) have warned that the 4-year trend may be the worst since World War II.

Data from the Office of National Statistics shows a 5.4% (27,000) increase in deaths in the past year alone, prompting calls for an urgent investigation. The year-on-year rise, to a total of 528,340 deaths, is the highest since 1968.

PHE said the elderly were bearing the worst of Tory austerity cuts, with women suffering disproportionately, though this is partly because they live longer, however, it is also due to a growing crisis in the NHS and cuts to social care. Professor Danny Dorling, from Oxford University, an advisor to PHE on older age life expectancy, said:

“When we look at 2015, we are not just looking at one bad year. We have seen excessive mortality – especially among women – since 2012.”

Figures show that the number of deaths had been falling steadily until 2011, a year after the government began their austerity programme, when deaths rates began to increase rapidly.

Professor Dorling cited Tory austerity as the biggest cause:

“I suspect the largest factor here is cuts to social services – to meals on wheels, to visits to the elderly.”

Empirical research published two years ago demonstrated the high a cost the country paid in terms of health and wellbeing for the Thatcher administration’s economic and social policies. The study, which looked at material from existing research and data from the Office for National Statistics, illustrates that Thatcherism resulted in the unnecessary and unjust premature deaths of British citizens, together with a substantial and continuing burden of suffering and a widespread degradation of wellbeing. Co-author and researcher Professor Clare Bambra from the Wolfson Research Institute of Health and Wellbeing said that deaths from violence and suicide all increased substantially during the Thatcher era in comparison with other countries. Regional inequalities in life expectancy between north and south were also exacerbated, as were health inequalities between the richest and poorest in British society.

Professor Bambra also says that the welfare cuts implemented by Thatcher’s governments led to a rise in poverty rates from 6.7% in 1975 to 12% by 1985; poverty is well known to be one of the major causes of ill health and mortality. Income inequality also increased in the Thatcher period, as the richest 0.01% of society had 28 times the mean national average income in 1978 but 70 times the average by 1990. Other research (The Spirit Level) indicates that income inequality is internationally associated with higher mortality and morbidity.

Welfare reform minister, Lord Freud, refused to monitor the number of people who take their own lives as a result of the £120-a-month cut planned for those people in the work related activity group (WRAG), claiming employment and support allowance from April 2017. Concerns were raised in the House of Lords last week, when Baroness Meacher, amongst others, warned that for the most vulnerable, the cut was “terrifying” and bound to lead to increased debt.

Condemning the truly callous and terrible actions of the Treasury, she urged ministers to monitor the number of suicides in the year after the change comes in, adding: “I am certain there will be people who cannot face the debt and the loss of their home, who will take their lives.”

Many people have died as a consequence of the welfare “reforms.”

Not only have the government failed to carry out an impact assessment regarding the cuts, Lord Freud said that the impact, potential increase in deaths and suicides won’t be monitored, apart from “privately” because individual details can’t be shared and because that isn’t a “useful approach”.

He went on to say “We have recently produced a large analysis on this, which I will send to the noble Baroness. That analysis makes it absolutely clear that you cannot make these causal links between the likelihood of dying – however you die – and the fact that someone is claiming benefit.”

Actually, a political refusal to investigate an established correlation between the welfare “reforms” and an increase in the mortality statistics of those hit the hardest by the cuts – sick and disabled people – is not the same thing as there being no causal link. Often, correlation implies causality and therefore such established links require further investigation. It is not possible to disprove a causal link without further investigation.

Whilst the government continue to deny there is a causal link between their welfare policies, austerity measures and an increase in premature deaths and suicides, they cannot deny there is a clear correlation establised, which warrants further research and political accountability.

Then they came for the ESA Support Group …

Despite the fact that this government face a UN inquiry into grave and systematic abuses of the human rights of disabled people, the blatant attacks on a social group with legally protected characteristics continues and the Conservatives continue to target disabled people for a disproportionately large and unfair burden of austerity cuts.

A government advisor, who is a specialist in labour economics and econometrics, has proposed scrapping all 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. To meet extra living costs because of disability, Oakley says that existing spending on PIP and the Support Group element of ESA should be brought together to finance a new extra costs benefit. Eligibility for this benefit should be determined on the basis of need, with an assessment replacing the WCA and PIP assessment. The Conservative definition of “the basis of need” seems to be an ever-shrinking category.

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.”

I’m sure the private company Unum would jump at the opportunity. Steeped in controversy, with a wake of scandals that entailed the company 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 handling 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. By coincidence, the  company has been involved with the UK’s controversial Welfare Reform Bill, advising the government on how to cut spending, particularly on disability support. What could possibly go right?

It’s difficult to see how someone with a serious, chronic and often progressive illness, (which most people in the ESA Support Group have) can actually “manage” their illness and “move back into work.” The use of the extremely misinformed, patronising and very misleading term manage implies that very ill people actually have some kind of choice in the matter. For people with Parkinson’s disease, rheumatoid arthritis, lupus and multiple sclerosis, cancer and kidney failure, for example, mind over matter doesn’t fix those problems, positive thinking and sheer will power cannot cure these illnesses sadly. Nor does benefit conditionality and being coerced into work by callously insensitive and medically ignorant assessors, advisors and ministers.

The Reform think tank has also recently proposed scrapping what is left of the disability benefit support 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 reform the way sick and disabled people are assessed. 

Reform says 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 Jobseeker’s Allowance claimants receive. However, those people placed in the Support Group after assessement have been deemed by the state as unlikely to be able to work again. It would therefore be very difficult to justify this proposed cut.

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.”

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 – PIP. However, as outlined, 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 hard work.

The current United Nations investigation into the systematic and gross violations of the rights of disabled people in the UK because of the Conservative welfare “reforms” is a clear indication that there is no longer any political commitment to supporting disabled people in this country, with the Independent Living Fund being scrapped by this government, ESA for the work related activiy group (WRAG) cut back, PIP is becoming increasingly very difficult to access, and now there are threats to the ESA Support Group. The Conservative’s actions have led to breaches in the CONVENTION on the RIGHTS of PERSONS with DISABILITIES – CRPD articles 4, 8, 9, 12, 13, 14, 15, 17, and especially 19, 20, 27 and 29 (at the very least.) There are also probable violations of articles 22, 23, 25, 30, 31.

The investigation began before the latest round of cuts to ESA and PIP were announced.

 

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Reverse the ESA disability benefit cut: sign the petition

Extend the PIP consultation & stop cuts to supporting terminally ill & disabled: sign the petition

 

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