Tag: Workfare

The connection between Universal Credit, ordeals and experiments in electrocuting laboratory rats

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I’m currently writing an article about the intimacy between neoliberalism and behavioural economics, following Richard Thaler’s recent Nobel award. While I was researching, I came across an Institute for Fiscal Studies (IFS) document about Nudge from 2012Tax and benefit policy: insights from behavioural economics, which suggested the introduction of “ordeals” into the social security system. The authors claim it would “deter fraud”. Although the IFS didn’t quite commit to calling for the idea to be implemented formally via policy, they did present the idea as an incontrovertible fact. Yet it is a controversial opinion, which is not supported by empirical evidence.

Introducing ordeals to social security also deters our most vulnerable citizens from claiming the support they need in order to live. Because of this, it wouldn’t be possible to determine the number of people who were intending to make a fraudulent claim. Prior to the welfare “reforms”, social security fraud was estimated at around 0.7 %. However, this very low figure also included bureaucratic and administrative errors, which resulted in overpayments. 

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At the least, this comment reflected something of the mindset and taken-for-granted assumptions behind the Conservative welfare “reforms”, and the statement indicates that the “problems” with and subsequent hardships caused by Universal Credit and other forms of welfare support are intended.

The problems we are witnessing with Universal Credit, Employment Support and Allowance and Personal Independent Payment are arising, not because of unintended consequences, or bureaucratic ineptitude, but because of the governments’ “calculated cruelty”, rather than “gross incompetence”.

The idea of intentionally designed environmental “ordeals” indicates the political (misuse) of behaviourism a perspective that underpins libertarian paternalism  – which is the ideological basis of behavioural economics. The claim is that libertarian paternalism is designed to “help” people who behave irrationally and so are not advancing their own “interests” to behave in ways that self-appointed “choice architects” deem beneficial to themselves and society, while interfering only minimally with people who behave rationally.

Public policy over the last 7 years indicates that the poorest citizens are considered cognitively “faulty”, whereas wealthy people are seen as being cognitively competent precisely because they are wealthy. No-one seems to be challenging this fait accompli approach to public policy and ultimately, to altering public perceptions, experimenting on people without their consent, using armchair psychology and techniques of persuasion, and behavioural engineering on the basis of socioeconomic status.

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Richard Thaler once said that if everyone were rational, we would all invest in the stock market. That’s a pretty limited definition of “rational” behaviour. He also believes that poor people actually choose borrowing money and credit at the highest interest rates. This is the problem with having such a narrow ideological view and focus. It skews, limits and reduces perspective because you miss the impact of real and complex social interactions, of inequality; the influence of power relations on social outcomes; exploitation; the consequences of political decision-making and institutionalised class-based attitudes and prejudices on social behaviours, for example. There are structural constraints to consider, and a host of other crucial interconnections that shape outcomes in our highly complex social world.

Behavioural economics tends to focus on the quantification of human experiences, while framing social problems as simply arising due to incompetence of individuals’ decision making and behaviours. In doing so, it’s scope is so limited and it fails to generate meaningful explanations and promote understanding of those experiences. 

Thaler doesn’t discuss the irrational behaviours of very wealthy people who harm the economy by exploiting workers, by tax evasion or offshore banking. Or the finance industry, who never lend money to people who actually desperately need it. Banks and money lenders generally tend to consider any loan or credit for people with little money as “risky” investment and so, with impeccable logic, they hike up the interest rates. It’s not easy to see how that works out any better in terms of the risk of defaults on payments. Poor people pay much more for their credit because of the credit-scoring, profiteering and institutionalised discrimination and behaviours of the finance industry. 

Thaler doesn’t seem to provide much insight into the context and interdependencies of  behaviours. He simply believes that poverty happens because poor people make “poor choices”. However, being poor means having limited choices in a capitalist society, because it is wealth that creates choice and power, and because complex social and political barriers and institutionalised behaviours compound poverty by closing off possibilities for the poorest to gain an adequate income. It costs a lot more to poor than it costs to be wealthy.

Then of course there are the legal and exploitative loan sharks that are circling people who live in poverty. Provident is one of the largest companies in the UK unsecured lending market. This market targets people for whom banks and credit cards are out of reach – mainly the low paid and people with poor credit histories – and it offers them short-term credit, with a typical APR of 272%. These companies make money by locking people into cycles of debt, interest on debt, late payment charges and interest on late payment charges. The Conservatives talk about “cycles of poverty” as if it’s a matter of poor people’s lifestyle choice. It’s not poor people who create poverty and inequality. It’s the exploitative rich. 

Payday lenders such as Wonga, which sprang up during the financial crash of 2007-08, have more recently counted teachers, nurses and vets among their customers. Payday lenders ratchet up eye-watering interest the longer customers take to repay a loan.

Adrian Beecroft

Vulture capitalist Adrian Beecroft, a major investor in payday lender Wonga, and someone who likes to write draconian emloyment policy for the Conservatives, gave the Conservatives a £50,000 pre-election donation in the week to 6 June. Photograph: Catherine Benson/Reuters

However Thaler shows no interest in the social problems created by immoral greed, exploitation and profiteering of wealthy businesses, who rake in huge amounts of interest because a borrower happens to be poor. Instead he blames the poor for the consequences of those apparently normalised behaviours of the wealthy.

It’s easy to see why Thaler’s work made such an impact on the Conservatives. He’s an academic that provides a justification narrative for Conservative prejudices and draconian policies. He is a free market market advocate and so endorses neoliberalism.  This of course exposes the ideological basis of behavioural economics.

The finance industry’s collective risky behaviours caused a global economic crash, yet Thaler remains supremely unconcerned that his work is being used as a series of techniques of persuasion to enforce public conformity, to impose austerity on the poorest, making them pay for the sins of the wealthy; to politically micromanage and enforce social control within a socioeconomic system that is not only failing, but actually harming many citizens, while leaving the wealthy to continue as they were.

Behavioural economics is therefore a prop for a failing neoliberal system and the status quo. It’s just an extention of a totalising ideology. Neoliberal policies contributed to the global crash, and they are also the key reason why so many people’s standard of living is falling. 

It isn’t therefore in the majority’s best interests to have their “best interests” decided for them.

Conservative scroogenomics: punishing poor people by reducing their lifeline income will miraculously cure their poverty

One technique of persuasion used widely in behavioural economics is framing, which is based on the idea that how choices are presented to citizens affects both behavioural and economic outcomes. The environment in which decisions are made can be shaped to provide “cues” to favour particular choices – “nudges” towards [politically determined] “desirable” behavioural and economic outcomes.

Of course nudge is used disproportionately on poor people, and this asymmetry in the distribution of its use is based on an assumption that people who are poor and need social security support are cognitively “incompetent”, lack mental sophistication, all of which leads to “faulty” and politically undesirable non-neoliberal behaviours.

I’m irresistibly reminded of  B.F Skinner’s draconian laboratory-based rat experiments in operant conditioning, using behavioural reinforcement. We have Skinner to thank for the formal conclusion that punishment can be used to reduce “undesirable” behaviours, though despots and tyrants everywhere had always known this to be so.

All types of bullies, from politics to the playground, are crude behaviourists, after all.

Skinner demonstrated how negative reinforcement works by placing rats in his specially designed operant conditioning chamber, called theSkinner box and then subjected them to an electric shock. As the poor rat moved about the box it was trapped in, by chance it would eventually knock a lever that was purposefully placed. Immediately that it did so, the electric current would be switched off.

The rats quickly “learned” to go straight to the lever after being put in Skinner’s torture chamber a few times. The relief of “escaping” the electric current ensured that they would repeat the action again and again. Skinner subsequently added a reward of food when the lever was pressed.

The Skinner Box represents the environment created within our social security system. It’s enclosed. We don’t enter it by choice. Pressing the lever represents fulfilling welfare conditionality criteria and ultimately, it also represents “work”. The “reward”, once you have figured out what the randomly placed set of conditions are and escaped the ordeal of electrocution, is simply provision for one of your most essential and basic living requirements – food. 

In order to eat, the lab rats first have to navigate through the ordeal, designed by the experimenter. 

Punishment can work either by directly applying a painful or unpleasant stimulus like a shock after a response or by removing a potentially “rewarding” stimulus, for instance, such as food in the Skinner Box.

Or by deducting someone’s lifeline income to punish “undesirable behaviours” such as non-compliance with increasingly draconian and irrational welfare conditionality, aimed at “helping people into work”, by the imposition of hunger and the threat of destitution.

Which of course cannot possibly help anyone into work.  It’s not possible to look for work when you are struggling to meet your basic survival needs. Didn’t Abraham Maslow explain this clearly enough?

Food is essential to survival, surely it should never be provided conditionally, or seen as a reward for navigating an intentionally inflicted ordeal simply to elicit narrow political definitions of compliance and conformity. 

The privatisation of choice. No-one is nudging the choice architects

Of course the government’s explanation of the need for welfare sanctions (“making work pay”) doesn’t stand up to much scrutiny, especially once in-work sanctions were introduced. Those on the poorest wages are also punished financially for not “progressing” in work. Yet the fact that work isn’t paying for many people shows that this line of justification for the welfare cuts is utter nonsense.

In-work poverty is a much larger drain on the welfare system than unemployment or disability, and it is created by exploitative employers, executive decision-making and government labor-market deregulation. It not due to any failure of those being paid a pittance for their work. Most of the provision that helped disabled people get back to work has been cut, too. The government is not providing support for people to find work: they are withdrawing it.

The reason that the welfare “reforms” happened is purely about ideological preference, reflecting traditional Tory prejudices. The ultimate aim is to remove social security completely.

Welfare has nothing to do with “rewarding work”. It’s came about to ensure no-one is left unable to meet their basic needs for food, fuel and shelter. How work is rewarded tends to be decided discretely in boardrooms. 

Social security has been redesigned to deter anyone from actually accessing it, because needing such support is deemed “undesirable behaviour”. However, the national insurance scheme was put in place precisely because it was deemed inevitable that at some point in their lives, most citizens would need some support from public services to ensure their welfare, and that their basic survival needs are met.

International research over recent years has indicated that generous welfare systems tend to increase the numbers of people finding work, rather than “disincentivising” them. That a government in a first-world so called liberal democracy considers, and has framed, the provision for fulfilment of basic and essential human survival needs as a “perverse incentive” is frankly terrifying.

Social security was originally designed to ensure that everyone was protected from the worst ravages of unfettered capitalism. To say that we have regressed as a society since then is an understatement. 

Behavioural economics is a technocratic solution to essentially politically created problems. It addresses social problems by simply shifting the blame and responsibility from state to individual. Nudge is increasingly being used to ensure citizens behaviours are compatible with neoliberal ideology.

I also think that the punitive policies being directed at the poorest citizens reflect traditional class-based Conservative prejudices. Labour MP, Laura Pidcock, memorably pointed out the absurdities of the current system, and the relationship between those in power and those being stigmatised, held in contempt, punished and systematically disempowered. (See There Are Fines And Punishments Associated With Most Aspects Of Working Class Life.) 

There are many problems with using punishment as a political instrument of “behavioural change”, such as:

  • Punished behaviour is not forgotten or “unlearned”: it’s  simply suppressed – behaviour may simply revert when punishment is no longer present.
  • Ethical problems as punishments most often entail inflicting a psychological or physical violence on others, without their consent. 
  • There’s a difference between political “persuasion” and state coercion. The path from the former to the latter takes us down a rapidly descending, very slippery slope. Persuasion usually presents opportunity for some dialogue, coercion does not. 
  • No cognitive development or learning opportunities are presented, and so people may well be very confused about why they are being punished. Nudge works only when people are unaware they are being nudged. This requirement for subject naivety forecloses the possibility of informative or instructive dialogue, facilitating development, realising individual potential and of promoting even basic understanding.
  • Causes increased aggression – demonstrates that aggression towards individuals and social groups is an acceptable way to cope with societal problems. It reinforces political authoritarianism. (See Skinner’s frightfully dystopic book: Walden Two, which is a treatise for positivism as much as it is for authoritarianism).
  • It has unintended and harmful consequences. For example, it creates fear that can influence other generalised “undesirable” behaviours.
  • Does not guide toward desired behaviour – reinforcement tells you what to do, punishment only tells you what not to do.
  • Who defines what are deviant or “undesirable behaviours”? Who decides what is an appropriate action to take to discourage such behaviours?  How do we prevent unethical solutions? How do we prevent state actions from simply becoming expressions of political authoritarianism and manifestations of a gross abuse of power? Or expressions of eugenic ideologies and policies? 

We ought to have learned through the history of human atrocities that it’s never a good omen when an already politically marginalised social group is singled out for scapegoating, punishment and dehumanisation by a government. 

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Manipulating social behaviour with antisocial motives

Another key technique of persuasion in behavioural economics is the use of “social preferences”. Individuals are inclined to care not just about their own outcomes but also about those of others. The behavioural “insight” (ironically) is that people derive value from fairness, cooperation and/or from conforming to social norms. These motivations may be [and are] used to give intrinsic “incentives” to make particular choices that accommodate neoliberal outcomes.

So the irony is that people’s tendency towards collectivity, cooperation and fairness may be manipulated by choice architects in order to prop up a system that extends competitive individualism, unfairness and inequality from its very core, in order to ensure politically desirable behaviours that support specific socioeconomic outcomes. 

Social norms may be subjected to political “default setting” which manipulates people’s inclination towards social conformity. For example, it has become “common sense” that poor people are poor because of their own behaviours, rather than because of political decision-making and policy impacting on economic conditions and labour market conditions (deregulation, for example).

In the UK, social security recipients have been transformed into folk devils in order to generate moral panic, to legitimise harsh and punitive welfare cuts and to de-empathise and desensitise the public to the awful consequences of this process. This default has been reset using the bombardment of political and media “norm” narratives. To the point where those claiming any support are quite widely considered as deviant and psychologically pathological.

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“Ordeals” have been introduced to the social security system, and can be clearly identified. This isn’t “nudging”, it is a political clobbering. The endless re-assessments and withdrawals of support for disabled people; the introduction of heavily bureaucratic mandatory reviews, designed to deter appeals; the withdrawal of support and the long periods people are being left without any means of meeting even basic needs; the constant threat of and increased use of much harsher welfare sanctions and so on.

Then there are the unofficial, undeclared and non-legislative means that the Department for Work and Pensions (DWP) frequently use to try at every opportunity to end claims. For example, it’s fairly common for the DWP to try to end ESA claims because a disabled person has been awarded PIP – a non means-tested income to support day-to-day independence and meet the costs of the additional needs arising because of disabilities. The DWP often try to claim that this is “standard” process when someone has “another award.” But PIP does not affect your eligibility for ESA at all.

The tactic is designed to force disabled people to go through the thoroughly demoralisng, anxiety-provoking and punitive claim process all over again – which means a reduction in income because they will then only be eligible for the basic rate ESA. This also means there will be another long wait for another harrowing assessment, which presents a further opportunity for the withdrawal of disability support, and so on. This kind of tactic was probably also designed to ensure that people never feel secure while needing support – a kind of informal Poor Law-styled “deterrence”.

Such irrational and government-created ordeals are absolutely intentional. There are even targets for reducing the number of disability support awards built into the private service providers’ contracts for delivering the assessments.  (See also Government guidelines for PIP assessment: a political redefinition of the word ‘objective).

The Conservatives are all on the same page in the Orwellian handbook

I was forced to leave a profession I loved because I became too ill to continue working. My GP had to provide me with a “FIT” note explaining I was NOT fit for work. It’s worth noting the psycholinguistic framing being used here, as the word “fit” at the very least implies that a medical condition is trivial, it will be transient, and won’t be a long-term barrier to work. However, my illness is chronic, progressive and often life-threatening. 

It’s the Conservatves’ post-truth Orwellian approach to political narrative, a tactic that has emerged with the behaviourist turn. Punishment becomes “support”, social control becomes “welfare”, coercion becomes “behavioural economics”, authoritarianism becomes “nudge”, meeting basic survival needs becomes “incentivisation”.

“Employment and Support Allowance” is another example of state psycholinguistic framing and default setting. Despite the fact that ESA is only awarded to sick and disabled people whose doctors and the state (through the privately contracted assessments) have deemed not capable of work, the name suggests that the award is contingent upon people who are too ill to work nonetheless becoming employed.

I was eventually assessed by the state contracted private company Atos and found to be “fit for work”. By this time I was seriously ill. My doctor was outraged at this, and offered his support, so I appealed and won my case. I was placed in Work Related Activity Group (more psycholinguistics in that title, too).

The key message here is that work is the ONLY option for survival. Any work, regardless of whether or not the wage is sufficient to support your living needs. It does not matter if you are ill and disabled, because the government have pared back support and ultimately aim to remove it completely. 

The DWP said I couldn’t have the money I was owed in ESA back pay, following the Tribunal, because, they claimed, I owed them money. And of course I didn’t. It felt like some form of psychological manipulation, like a bullies’ projection technique. This was most definitely intentional, no explanation was ever given for the claim.

It’s almost as if there are some nudge measures in place to ensure that people lower their expectations in terms of the support that the state is obliged to provide with our taxes and national insurance contributions. Why, it’s as if nudge has become a part of a totalising neoliberal ideology. 

It’s as if the government ultimately aims to completely dismantle our social security system. One of the necessary stages along the way to fulfilling that aim is to make sure people no longer feel “secure” in their right to support. Part of that stage is to normalise the steady reduction in supportive provision, one cut at a time. Another prerequisite is the desensitisation of the public to the plight of those being abandoned by the state, by using norm setting and stigmatisation. Finally, it’s necessary to ensure that all routes of  challenge and redress are blocked by, say, coordinating the removal of public services with abolishing legal aid, restricting access to justice and simply ignoring protective legislations such as the Equality and Human Rights Act, dimissing them publicly as a “bureaucratic burden”.

 I did get the back pay soon after several phone calls and a demand for evidence of the “debt”. It was yet another pointless and designed “ordeal”. I was not provided with any explanation of the “error” regarding the non-existent debt.

However, just 3 months after winning the appeal, I received an appointment from the DWP for another ESA assessment. My illness is lifelong, chronic and progressive. The reassessment was of course another ordeal. This is a fairly standard tactic from the DWP, and I am far from alone in experiencing this particular ordeal.

I’m too ill to work, yet the government tell me that “work is the only route out of poverty”. They also tell me that the assessments and other barriers to my support are to ensure that “those most in need” are targeted, and to “protect the public purse”. The fact that there are people dying because they weren’t assessed as being in the “greatest need” of support illustrates very painfully that these politically expedient comments are untrue. 

The government is spending millions of pounds of our money on private profit-seeking companies to administer a system of “incentives” (punishments and ordeals) to coerce our most vulnerable citizens to somehow work or starve and face destitution.

My GP, my consultants, a Tribunal panel, and at the last assessment, Atos, have all said I am not well enough to work. The ordeals that the state has added to my “support” has exacerbated my illness, moving me further, not nearer, to any employment I may have found had I been supported rather than made to face state manufactured ordeal after ordeal.

There is no economic need or justification for welfare cuts. Nor does the systematic scaling back of the welfare state, and the Skinnerian punitive approach, come cheap. 

The political misuse of psychology costs a lot to plan, coordinate and administrate, in terms of costs for government advisors, willing academics, rogue multinationals and thinktanks, to create justification narratives, superficially feasible theoretical frameworks, and creating a technocratic lexicon that draws on pseudoscience, psychobabble, managementspeak and “common sense”. Those employed to do the administrative dirty work also require a salary. The motivation is entirely ideological.

The National Audit Office (NAO) has already indicated that the welfare “reforms” have cost far more money to implement than they have actually saved. (See Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.”)

For some of us, the Conservatives “long term economic plan” is the road to hell. “Economic competence” has come to mean simply stealing money from the poorest citizens, disdainful moralising about why people are poor and making sick and disabled people suffer. We have witnesed our public funds being handed out to a very wealthy minority in generous tax cuts, who take that money out of the economy and hoard it in private bank accounts.

The rich have their discrete creature comforts, a life of looking the other way, a culture of entitlement, offshore money trees, and a dialogue with the government. The poor have rent arrears, huge debts, eviction notices, hunger and a maximum of 3 visits a year to food banks, if they are referred by a professional. The government doesn’t engage with us, it simply acts upon us as if we were lab rats.

Handing out our public wealth to greedy vulture capitalists isn’t good economics, it’s corruption. It’s not good management of our resources or the economy. 

Being poor is itself an ordeal. 

Yet the government say they expect the use of financial deprivation (sanctions and austerity cuts) to work as a way of “incentivising” people not to be poor. If that actually worked, poor people would have already learned not to be poor. 

Taking money from poor people as a punishment for being poor will simply deepen their poverty and further limit their potential to increase their income, since struggling to survive is pretty time and effort consuming.  Meeting basic survival needs becomes the sole cognitive priority when people are deprived of the means of doing so.

So, you can’t simply punish someone into not being ill or poor. Yet the UK government continues to attempt to do so. This is a particularly irrational approach, reflecting a monstrous form of tyranny. 

Being poor, sick and disabled in the UK under a Conservative government is rather like being married to multiple abusive and gaslighting partners from whom there is absolutely no escape, ever.

It’s a relentless ordeal.

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How political ideology informs “science”. Graphic From Test, Learn, Adapt, a paper by the British government’s Behavioural Insights Team. Photo: Supplied

The simplistic, reductive design of a “behavioural” randomised controlled trial, shown with a test of a new “back to work” programme. There is no category that includes those who cannot work because they are too ill. Or any account of socioeconomic and political factors that may influence labor market conditions or individual circumstances. There is no scope for examining the quality, security and income that work provides (or doesn’t). It’s a very reductionist and deterministic “cause and effect” approach to public policy. Work fare is simply expected to somehow put people into work, and that is the only “route out of poverty”. Despite empirical evidence to the contrary.

The graphic illustrating the nudge “Intervention” and “Control” groups is itself a nudge – it also has a nudge built into it. There are more green “found work” graphics in the “intervention” – which implies that the “intervention” always works. In a genuine Randomised Control Trial (RCT) there is no guarantee that the experimental “intervention” will work – hence the need for a trial. 

There is no potential for dialogue, qualitative feedback, consideration or measure of citizens’ complexity, dignity or wellbeing. It is simply assumed that any work is the only possible outcome. The government work programme presents an imposing, rigid and restrictive choice architecture – there are just two options. Work or face severe, punitive sanctions. There is no opt out opportunity. There are significant ethical considerations raised because subjects are not participating on the basis of informed consent.

There are also implications for democracy. We don’t elect governments to change our perceptions and behaviours by stealth to suit their ideological agendas. In a first world democracy, it is expected that governments ensure all citizens can meet their basic survival needs. The Conservatives are failing to fulfil that function.

The government’s approach to social security for many has become random, controlling and an unremitting, Orwellian trial. 

 


 

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Mental Wealth Alliance response to the psy professional bodies’ statement on benefit sanctions and mental health

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The British Psychological Society (BPS) has responded jointly with other psychological bodies to call on the UK Government to suspend its cruel and degrading benefit sanctions regime.

The BPS say that the government should suspend its benefit sanctions system as it fails to get people back to work and damages their mental health. s

The professional bodies highlight evidence that sanctions, or the threat of sanctions (benefit cuts following a claimant’s failure to comply with jobcentre conditions, e.g. missing an appointment with their work coach) can result in destitution, hardship, widespread anxiety and feelings of disempowerment.

The call came in a joint response to the Government’s consultation, ‘Improving Lives’, from the British Psychological Society, the British Association of Counselling and Psychotherapy, the British Psychoanalytic Council, the British Association for Behavioural and Cognitive Psychotherapies and the UK Council for Psychotherapy.

Findings from the National Audit Office  show that there is limited evidence the sanctions system actually works, or is cost effective. The bodies argue that the Government needs to change focus from trying to make unemployment less attractive, to trying to make employment more attractive.

BPS President Professor Peter Kinderman said:

“We call for the benefits sanctions regime to be suspended until the completion of an independent review of their impact on people’s mental health and wellbeing

While there is evidence that the sanctions process is undermining mental health and wellbeing, there is no clear evidence that it leads to increased employment.  Vulnerable people with specific multiple and complex needs are being disproportionately affected by the increased use of sanctions.”

In order to improve mental health, the bodies have also called for:

  • Jobcentres to care about the quality of work they provide – citing evidence that bad jobs can be more damaging to mental health than unemployment.
  • The development of statutory support for creating psychologically healthy workplaces.
  • Increased mental health awareness training for jobcentre staff.
  • Review and reform of the work capability assessment (WCA), which may be psychologically damaging, and lacks clear evidence of reliability or effectiveness. 

The Mental Wealth Alliance have written a response to the collective statement on benefit sanctions and mental health:

Source: the free psychotherapy network

From:

Mental Wealth Alliance [1]

 Mental Health Resistance Network; Disabled People Against Cuts; Recovery in the Bin; Boycott Workfare; The Survivors Trust; Alliance for Counselling and Psychotherapy; College of Psychoanalysts; Psychotherapists and Counsellors for Social Responsibility; Psychologists Against Austerity; Free Psychotherapy Network; Psychotherapists and Counsellors Union; Social Work Action Network (Mental Health Charter); National Unemployed Workers Combine; Merseyside County Association of Trades Union Councils; Scottish Unemployed Workers’ Network; Critical Mental Health Nurses’ Network; National Health Action Party.

To:

British Association for Behavioural and Cognitive Psychotherapies

British Association for Counselling and Psychotherapy

British Psychoanalytic Council

British Psychological Society

United Kingdom Council for Psychotherapy

30th January 2017

MWA response to the psy professional bodies’ statement on benefit sanctions and mental health  30th November 2016

We welcome the call from the psychological therapy bodies for the government to suspend the use of sanctions by the DWP subject to the outcomes of an independent review of its welfare policies and their potential damage to the mental health of benefit claimants. Given the accumulation of evidence over many years of the material and psychological suffering inflicted on benefit claimants by workfare-based conditionality[2], it has been frankly shocking that the professional bodies directly concerned with the mental health of the nation have preferred to welcome and participate in workfare policies rather than publicly and vociferously dissociate themselves.

The timing of the statement is given to be the recent report on sanctions by the National Audit Office. Welcome as its report is, the NAO’s perspective on government policy is primarily monetary, not one of health, ethics and social justice. Its “vision is to help the nation spend wisely”.  The choice of this timing represents realpolitik on the part of the professional bodies no doubt, as perhaps is the intention of the conditional statement: “The sanctions process may be detrimental to people’s mental health and wellbeing”. But surely as psychotherapists and counsellors we can do better to represent the overwhelming evidence of personal suffering on such a scale than point to poor returns on expenditure and an ambivalent proposal that sanctions may be detrimental to people’s mental health.

Sanctions are only one dimension, albeit at the sharp end, of a welfare regime based on the political assertion that people need to be coerced off benefits and “nudged” into work. The psychological pressure of WCA and PIP assessments, job search rules, work programmes on “good employee” behaviours and the regular cuts to welfare benefits generally are part and parcel of the psycho-compulsion of the DWP benefits regime.[3]

We dispute the government’s premise that work is a therapeutic priority for people suffering from mental health difficulties. The marshalling of evidence for this modern-day workhouse mentality lacks both substance and integrity. Work has become the ideological mantra for neoliberal welfare policies.

Obviously where people want to work and where employment possibilities exist that will support and nourish people’s mental health, then encouragement, training and professional support should be available. But why is there no acknowledgement of the hundreds of thousands of claimants with mental health difficulties who cannot work, whether they want to or not?[4] Where is the evidence that people with mental health difficulties are actually benefiting from what is now two decades of workfare conditionality in the UK? Where is the evidence that in our current labour market decent jobs exist that will nourish people’s mental health? And where is the evidence that psychological therapy for benefit claimants with long-term mental health disabilities succeeds in supporting them into decent jobs they want, can survive and maintain?

When the professional bodies say, “an estimated 86-90% of people with mental health conditions that are not in employment want to work”, they are supporting the proposition that getting into work is an overwhelmingly important and efficacious goal for this group of benefit claimants. It is not clear where this figure comes from and what it means.

A similar figure is quoted by The Royal College of Psychiatrists’ report on Mental Health and Work (2013)[5], making use of a Sheffield study by J. Secker and others (2001)[6]. In fact, Secker finds that of their sample of 149 unemployed service users, when asked if they were interested in work of any kind – including voluntary and supported work –  “around half (47%) responded positively, and almost the same proportion (43%) had a tentative interest. Only 15 people (10%) had no interest in work”. At the same time, only 25% of respondents saw full-time employment as a long-term goal. 71% said that their preferred vocational assistance would be “help for mental health/keep current service”.[7]

This study does not translate into “86-90% of people with mental health conditions that are not in employment want to work”.[8] What it points to is the complex texture of attitudes, desires and fears around waged work that are the common experience of service users, alongside the harsh realities of the current labour market, the socio-economic environment generally, and the dire state of mental health services of all kinds more particularly.[9]

From our point of view, the professional bodies’ statement is a step in the right direction. It is a step that must now be followed through with active political pressure on the DWP and the Dept of Health to suspend sanctions and set up an independent review of their use, including the damage they inflict on people’s mental health.  Parliament has already called for such a review.[10]

But more than this, the remit of such a review should include all aspects of conditionality in a benefits system that deploy psycho-compulsion through mandatory rules or through the more subtle imposition of behavioural norms which aim to override the claimant’s voice.

We again suggest that the psy professional bodies would benefit by widening their own conversations to include service users and the rank and file of their membership. They would also win more credibility as organisations with ethical and social values independent of the government’s policies of dismantlement of social security and the welfare state if they were willing to make transparent their currently private conversations with DWP.

 


 

[1] Mental Wealth Alliance (MWA), formerly the Mental Wealth Foundation, is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

[2] Parliamentary committees, the national press, endless reports from charities, service user organisations, people with disabilities, claimants unions and workfare campaigners have been reporting the physical and psychological damage of ‘welfare reform’ and its tragic outcomes for a decade.

[3] On psycho-compulsion and the benefits system see Friedli and Stearn http://mh.bmj.com/content/41/1/40.full and https://vimeo.com/157125824

[4] In February 2015 over a million people claiming ESA under a MH diagnosis were in either the Support Group or WRAG. Over 70% of new applicants for ESA are found unfit for work

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/470545/3307-2015.pdf

[5]https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf p.17

[6] Secker, J., Grove, B. & Seebohm, P. (2001) Challenging barriers to employment, training and education for mental health service users. The service users’ perspective. London: Institute for Applied Health & Social Policy, King’s College London.

[7] Ibid, pp. 397-399

[8] Compare a DWP survey of disabled working age benefit claimants in 2013. 56% of 1,349 respondents agreed that they wanted to work. Only 15% agreed that they were currently able to work. Only 23% agreed that having a job would be beneficial for their health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf

[9] For example, some of this complexity is flagged by Blank, Harries and Reynolds (2012) The meaning and experience of work in the context of severe and enduring mental health problems: An interpretative phenomenological analysis Work: 47 45(3)    “Stigma, the disclosure of a mental health problem and the symptoms of the mental health problem are frequently described, as well as feelings of hopelessness, seeing recovery as uncertain, and feeling a lack of encouragement from services. Difficulties in accessing occupational health services, having a disjointed work history, lack of work experience, age, lack of motivation and fears about competency, as well as the social benefits system and caring commitments, are also experienced as barriers to accessing employment for people with mental health problems.”

[10] https://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/news/benefit-sanctions-report

 


 

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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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G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy”

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Background

Last April, more than 400 psychologists, counsellors and academics signed an open letter condemning the profoundly disturbing psychological implications of the government’s austerity and welfare reform measures. The group of professionals said that over the past five years the types of issues causing clients distress had shifted dramatically and now include increasing inequality, outright poverty and that people needing support because of structural problems, such as benefits claimants, are being subjected to a “new, intimidatory kind of disciplinary regime”.

The signatories of the letter, published in The Guardian, express concern over chancellor George Osborne’s plans, laid out in the latest budget, to embed psychological therapy in a coercive back-to-work agenda. Osborne said the government will aim to give online CBT to 40,000 recipients of Jobseeker’s Allowance, Employment and Support Allowance, people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.

The letter stated that the government’s proposed policy of linking social security benefits to the receipt of “state therapy” is utterly unacceptable. The measure, casually described as “get to work therapy,” was discussed by George Osborne during his last budget.

The letter’s signatories, all of whom are experts in the field of mental health, have said such a measure is counter-productive, “anti-therapeutic,” damaging and professionally unethical. The intimidatory disciplinary regime facing benefits claimants would be made even worse by further unacceptable proposals outlined in the budget.

I raised my own concerns about Osborne’s proposals in March last year. Amongst the groups represented by the signatories were Psychologists Against Austerity, Britain’s Alliance for Counselling and Psychotherapy, Psychotherapists and Counsellors for Social Responsibility, the Journal of Public Mental Health, and a range of academic institutions including Goldsmiths, Birkbeck, the University of London, the University of Amsterdam, Manchester Metropolitan University and the University of Brighton.

The proposals are widely held to be profoundly anti-therapeutic, potentially very damaging and professionally unethical. With such a narrow objective, the delivery will invariably be driven by an ideological agenda, politically motivated outcomes and meeting limited targets, rather than being focused on the wellbeing of individuals who need support and who may be vulnerable.

A major concern that many of us have raised is regarding consent to participation, as, if benefit conditionality is attached to what ought to be a voluntary engagement, that undermines the fundamental principles of the right to physical and mental care. Such an approach would reduce psychologists to simply acting as agents of state control, enforcing compliance and conformity. That is not therapy: it’s psychopolitics and policy-making founded on a blunt behaviourism, which is pro-status quo, imbued with Conservative values and prejudices. It’s an approach that does nothing whatsoever to improve public life or meet people’s needs.

The highly controversial security company G4S are currently advertising for Cognitive Behavioural Therapists to deliver “return-to-work” advise in Surrey, Sussex and Kent.

The Role Description:

  • Manage a caseload of Customers and provide return-to-work advice and guidance regarding health issues.
  • Targeted on the level, number and effectiveness of interventions in re-engaging Customers and Customer progression into work.
  • Focus on practical techniques that enable them to manage their conditions to enter and sustain employment.
  • Work with Customers on a one-to-one basis and in groups to provide support on a range of mental health conditions. Refer clients to relevant external health or specialist services as required
  • Conduct bio-psychosocial assessments via face-to-face and telephone-based interventions and produce tailored action plans to support Customers in line with contractual MSO.
  • Deliver specific health for employment workshops and input into delivery models to support achievement of MSO
  • Build relationships with key stakeholders including GP’s, employers and relevant NHS bodies
  • Identify and build relationships with other organisations that contribute to the successful delivery of the programme.
  • Expected to contribute substantially to the development of the service. Including the routine collection, review and feedback of activity/data, ensuring that activity targets are adhered to.

Basic Requirements

  • Experience of delivering CBT.
  • Evidence of understanding of Welfare to Work and the issues that unemployed people face.

This is yet another lucrative opportunity for private companies to radically reduce essential provision for those that really need support, nonetheless, costing the public purse far more to administer than such an arrangement could possibly save, despite the government’s dogged determination to rip every single penny from sick and disabled people and drive them into low paid, insecure jobs.

G4S priorities and the ideological context

“We are saving the taxpayer £120 million a year in benefit savings.” Sean Williams – Welfare to Work, Managing Director, G4S.

Welfare to work schemes exploit unemployed people desperately seeking work. Work programmes are mandatory, if people refuse to participate, they face sanctions, entailing the withdrawal of their lifeline benefit, which was originally calculated to meet basic physiological needs only. Workfare is unpaid labour provided as a handout to business, tax payers are subsidising the wage bill of the private sector. Workfare also serves to drive wages down, it is a disincentive for employers to create jobs that pay a fair wage. 

Anti-workfare group Boycott Workfare say that workfare replaces jobs and undermines working conditions and wages. A research report in 2012 found a Work Programme success rate of just 2.3%. Given that 5% of people who are unemployed in the long term would be expected to find employment if left to their own devices, the Work Programme is considered less successful than leaving people to make their own choices regarding their own work experiences.

Work as a “health” outcome

The Conservatives have come dangerously close to redefining unemployment as a psychological disorder, and employment is being redefined as a “health outcome.” The government’s Work and Health programme involves a plan to integrate health and employment services, aligning the outcome frameworks of health services, Improving Access To Psychological Therapies (IAPT), Jobcentre Plus and the Work Programme. 

But the government’s aim to prompt public services to “speak with one voice” is founded on questionable ethics. This proposed multi-agency approach is reductive, rather than being about formulating expansive, coherent, comprehensive and importantly, responsive provision.

Psychopolitics is not therapy. It’s all about (re)defining the experience and reality of a social group to justify dismantling public services (especially welfare), and that is form of gaslighting intended to extend oppressive political control and micromanagement. In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” will invariably make accessing support conditional, and further isolate already marginalised social groups. It will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

Conservatives really seem to believe that the only indication of a person’s functional capacity, value and potential is their economic productivity, and the only indication of their moral worth is their capability and degree of willingness to work. But unsatisfactory employment – low-paid, insecure and unfulfiling work – can result in a decline in health and wellbeing, indicating that it is poverty and growing inequality, rather than unemployment, that increases the risk of experiencing poor mental and physical health.

Moreover, in countries with an adequate social safety net, poor employment (low pay, short-term contracts), rather than unemployment, has the biggest detrimental impact on mental health.

There is ample medical evidence (rather than political dogma) to support this account. (See the Minnesota semistarvation experiment, for example. The understanding that food deprivation in particular dramatically alters cognitive capacity, emotions, motivation, personality, and that malnutrition directly and predictably affects the mind as well as the body is one of the legacies of the experiment.)

Systematically reducing social security, and increasing conditionality, particularly in the form of punitive benefit sanctions, doesn’t “incentivise” people to look for work. It simply means that people can no longer meet their basic physiological needs, as benefits are calculated to cover only the costs of food, fuel and shelter. Food deprivation is closely correlated with both physical and mental health deterioration. Maslow explained very well that if we cannot meet basic physical needs, we are highly unlikely to be able to meet higher level psychosocial needs. The government proposal that welfare sanctions will somehow “incentivise” people to look for work is pseudopsychology at its very worst and most dangerous.

In the UK, the government’s welfare “reforms” have further reduced social security support, originally calculated to meet only basic physiological needs, which has had an adverse impact on people who rely on what was once a social safety net. Poverty is linked with negative health outcomes, but it doesn’t follow that employment will ameliorate poverty sufficiently to improve health outcomes. In fact record numbers of working families are now in poverty, with two-thirds of people who found work in 2014 taking jobs for less than the living wage, according to the annual report from the Joseph Rowntree Foundation a year ago.

Essential supportive provision is being reduced by conditionally, by linking it to such a narrow outcome – getting a job – and this will reduce every service to nothing more than a political semaphore, and service provision to a behaviour modification programme based on punishment, with a range of professionals being politically co-opted as state enforcers. The Government is intending to “signpost the importance of employment as a health outcome in mandates, outcomes frameworks, and interactions with Clinical Commissioning Groups.”

The fact that the Conservatives also plan to make receipt of benefits contingent on participation in “treatment” worryingly takes away the fundamental right of consent. I submitted a Freedom of Information request to the Department for Work and Pensions last year to ask for details of their methods of gaining claimant consent, their ethical framework and safeguards regarding the trialing of the new Work and Health programme. My request was rather unreasonably refused on the grounds of cost. I also sent the same request to the Cabinet Office, since the Behavioural Insights Team are involved in the design of the trials. Worryingly, the Office did not have the information.

Therapy in job centres and employment advisors in GP surgeries will not address inequality, and the social conditions that are the consequence of political decision-making and imposed economic frameworks, so it permits society to look the other way, whilst the government continue to present mental illness as an individual weakness or vulnerability, and a consequence of “worklessness” rather than a fairly predictable result of living in a highly unequal, competitive society, and arising because of experiences of living stigmatised, marginalised lives because of politically expedient policy-directed material deprivation.

Private firms like G4s, awarded multimillion-pound contracts to run the Work Programme, advised that there should be many more cases where claimants have their benefits stripped as punishment for failing to seek work. G4S earned £183m to help unemployed people to find work through the Government’s Work Programme. During the first eight months of the programme G4S asked benefit offices to sanction 7,780 claimants. In fact the company has effectively sanctioned many more people than it has “helped” into work.

There really should not be a role for G4S in the health service. G4S has left a wake of atrocities committed against vulnerable people in the UK and in other countries, including human rights abuses: exploitation, torture, causing deaths and forcing anti-psychotic injections on vulnerable prisoners to ensure they are passive and compliant.

Here is little information about G4S’s track record of working with vulnerable individuals and marginalised social groups, though this list is by no means exhaustive:

Human rights abuse allegations

Disabled ex-serviceman Peter McCormack, aged 79, was chained to a prison officer employed by G4S for eight days while in Royal Liverpool University Hospital after a heart attack in March 2012. The restraint was removed only briefly for him to take off his upper clothing, and when he was under heavy sedation undergoing an heart procedure. But he remained chained even when using the toilet and shower. McCormack, who has a disability as a result of being shot through the knee while serving with the Royal Engineers during the 1956 Suez crisis, spent 14 days attached by his wrist to a 2.5 metre closet chain, despite having been described as a model prisoner. Judge Graham Wood QC ruled in September 2014 that “During this time he was humiliated and his dignity was affronted.” Mr McCormack was detained because he may have faced a modest criminal sentence at most for breach of a regulatory offence in relation to his business.

McCormack was awarded £6,000 compensation for breach of his human rights. The judge criticised the evidence given by G4S’s then head of security, saying it was “less than impressive … It is a reasonable conclusion that she simply ignored a recommendation from a security manager.”

Unacceptable use of force by UK Border Agency

In October 2012 the Chief Inspector of Prisons, Nick Hardwick published his inspection report into the G4S-managed Cedars Pre-Departure Accommodation UK Border Agency (UKBA). G4S were criticised for using “non-approved techniques” during one particular incident in which a pregnant woman’s wheelchair was tipped up whilst her feet were held. The incident used “non-approved techniques” causing significant risk to the baby and was a “simply not acceptable” use of substantial force. Hardwick said: “There is no safe way to use force against a pregnant woman and to initiate it for the purpose of removal is to take an unacceptable risk.”

Significant force was also used against six out of the 39 families, including two children, at the centre, which holds families for up to a week, the report said.

Judith Dennis, of the Refugee Council, called for UKBA to heed the report’s recommendations, which include that force should only ever be used against pregnant women and children to prevent harm.

Jerry Petherick, managing director of G4S custodial and detention services, said the welfare of people in its care was its top priority.

The unlawful killing of Jimmy Mubenga

In October 2010, three G4S-guards restrained and held down 46-year-old Angolan deportee  called Jimmy Mubenga on departing British Airways flight 77, at Heathrow Airport. Security guards kept him restrained in his seat as he began shouting and seeking to resist his deportation. Police and paramedics were called when Mubenga lost consciousness. The aircraft, which had been due to lift off,  returned to the terminal. Mubenga was pronounced dead later that evening at Hillingdon hospital. Passengers reported hearing cries of “don’t do this” and “they are trying to kill me.” Scotland Yard’s homicide unit began an investigation after the death became categorised as “unexplained”. Three private security guards, contracted to escort deportees for the Home Office, were released on bail, after having been interviewed about the incident.

In February 2011, The Guardian reported that G4S guards in the United Kingdom had been repeatedly warned about the use of potentially lethal force on detainees and asylum seekers. Confidential informants and several employees released the information to reporters after G4S’s practices allegedly led to the death of Jimmy Mubenga. An internal document urged management to “meet this problem head on before the worst happens” and that G4S was “playing Russian roulette with detainees’ lives.” The following autumn, the company once again faced allegations of abuse. G4S guards were accused of verbally harassing and intimidating detainees with offensive and racist language.

In July 2012, the Crown Prosecution Service (CPS) announced its conclusion that there was “insufficient evidence to bring any charges for Mr Mubenga’s death” against G4S or any of its former employees. On 9 July 2013 an inquest jury, in a nine-to-one decision, found that Mubenga’s death was caused by the G4S guards “using unreasonable force and acting in an unlawful manner.” 

Exploitation

In August 2014, G4S was again criticised for using immigrant detainees as cheap labour, with some being paid as little as £1 per hour. The Home Office defended the practice, and said: “The long-standing practice of offering paid work to detainees has been praised by Her Majesty’s inspectorate of prisons as it helps to keep them occupied whilst their removal is being arranged. Whether or not they wish to participate is entirely up to the detainees themselves. This practice is not intended to substitute the work of trained staff”

Abuse of vulnerable young people at Medway Secure Training Centre in Kent

A BBC Panorama investigation into abuse at a young offenders unit in Kent, run by security firm G4S, exposed child neglect and abuse. The Panorama programme provided shocking footage at Medway Secure Training Centre in Rochester following reports from a whistleblower. Shot by an undercover journalist who posed as a security officer, the footage shows staff using excessive force to restrain youngsters, bullying, lying when reporting incidents and boasting about hurting the inmates. The film shows a a senior officer restraining a 14-year-old boy by pressing his fingers on his throat.

One boy had injured himself by cutting his arm and staff piled on to restrain him, then left him in a cell crying, despite knowing that the boy’s mother had recently died and he was grieving. G4S employees boasted not only about harming children but also falsifying records so the company was not fined for losing control. Footage showed a vulnerable boy who was having his room cleared of anything he could harm himself with, was apparently choked and slammed on a bed. 

The programme also revealed officers lying about incidents to cover up their actions. 

G4S has been paid £140,000 per year per child held in Medway.

Among the allegations relating to ten boys aged 14 to 17, uncovered by Panorama and now subject to investigation are that Medway staff:

  • Slapped a teenager several times on the head
  • Pressed heavily on the necks and throats of young people
  • Used restraint techniques unnecessarily – and that included squeezing a teenager’s windpipe so he had problems breathing
  • Used foul language to frighten and intimidate – and boasted of mistreating young people, including using a fork to stab one on the leg and making another cry uncontrollably
  • Tried to conceal their behaviour by ensuring they were beneath CCTV cameras or in areas not covered by them

South Africa prison torture and abuse accusations

In October 2013, the BBC reported that there are allegations of prisoners being tortured at Mangaung Prison in South Africa. The security firm G4S was given the contract to run the prison in 2000. The BBC cites research from the Wits Justice Project at Wits University in Johannesburg, claiming that dozens of the nearly 3,000 inmates at the G4S prison have been tortured using electroshock and forced injections. As of October 2013, G4S said it was investigating the allegations.

Leaked footage revealed that complaints of forced injections – that is, involuntary medication with powerful anti-psychotic drugs, with serious side effects, we true.

Emergency security team warders have further said that they would assist in administering forced injections up to five times a week.

Human rights abuse and violence at Manus Island Asylum Centre

G4S provided security in the Manus Island asylum processing centre in Papua New Guinea, and failed to maintain basic human rights standards and protect asylum seekers from harm, the complaint lodged to the Organisation for Economic Co-Operation and Development (OECD) alleged.

In 2008, Aboriginal elder, Mr Ward, cooked to death while being transported by G4S, more than 220 miles across searing Goldfields in a badly maintained van with faulty air conditioning in January 2008. He had third degree burns from contact with the searing hot metal floor of the van. The guards driving the prison van did not stop to check his welfare or see if he needed a toilet break, food or water until, they say, they heard a thud from the back. Even then they didn’t unlock both the cell doors, and instead threw water on Mr Ward through the chained-up inner door. The Department of Corrective Services, the prisoner transport contractor – G4S, and the prison van driver Graham Powell were also prosecuted by WorkSafe. Corrective Services and G4S were each fined $285,000 for their role in Mr Ward’s death. Mr Powell was fined $9000. Prison officer Nina Mary Stokoe was fined $11,000 for her role in the death of Mr Ward.

The Australian government nonetheless contracted G4S to oversee management and security at the Manus Island centre from February 2013 to March 2014, despite this.

Rachel Ball, the director of advocacy at the Human Rights Law Centre, said under government-endorsed OECD guidelines, multinational companies were obliged to respect human rights and avoid contributing to human rights abuses.

“In February this year G4S guards at the detention facility on Manus Island went on what can only be described as a violent rampage,” she said.

“Reza Berati was killed, one man lost his eye, another had his throat slit, and 77 others were treated for serious injuries including head wounds, a gunshot wound, broken bones and lacerations.

“G4S was directly involved in this violence through its role in arbitrary detention and poor conditions that led to the unrest, and through the direct participation of its employees in the violence.”

Ball said the company had not been held to account for its role in the violence, prompting the joint complaint between her organisation and the British non-government organisation Rights and Accountability in Development.

Conditions in the camp have also been strongly criticised by UN agencies and human rights groups.

Fraud allegations

In July 2013, British Justice Secretary, Chris Grayling, asked the Serious Fraud Office to investigate G4S for overcharging for tagging criminals in England and Wales, claiming that it and rival company Serco charged the government for tagging people who were not actually being monitored, including tags for people in prison or out of the country, and a small number who had died. G4S was given an opportunity to take part in a forensic audit but initially refused.

Following the completion of a review by the Cabinet Office into major contracts across government, Francis Maude and the Cabinet Office announced in December 2013, that their review had “found no evidence of deliberate acts or omissions by either firm leading to errors or irregularities in the charging and billing arrangements on the 28 contracts investigated.”

In March 2014, G4S agreed to pay a settlement of £109 million to the government, incorporating a refund for “disputed” services and reimbursement of additional costs.

Scandal also followed G4S’s management of London Olympic security, back in 2012 when it failed to deliver enough guards to police the games. As a result 3,500 military troops were drafted in. 

Despite these issues, G4S won significant new work for the British government in 2014 including selection by the Department for Work and Pensions to manage community work placement contracts, a deal providing healthcare services for prisons in the north east, and patient transport for the NHS.

G4S’s involvement in the recruitment of cognitive behavioural therapists to work with vulnerable unemployed people is a very worrying development.

Mindful of the company’s failure to fully investigate its ethical practices, RT compiled a list of past instances G4S has broken standards.

The Guardian: Outsourced services fail the vulnerable – “Red front doors in Middlesbrough, red wristbands in Cardiff. Not long ago another group of vilified people were also made to mark their doors and wear a distinctive badge – the yellow star. Who is advising Clearsprings?” And G4S. Dr Jonathan Fluxman

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