Nov 132013
 

Dr Paul Litchfield, who has been asked by DWP to carry out the 4th Independent Review of the WCA is not as independent as he seems.

He was part of the Mental Health Technical Working Group commissioned by DWP in 2006, with, among others, Sue Godby from the College of Occupational Therapists and Unum Provident, and Dr Angela Graham from Atos Origin, to develop ‘proposals from transforming the Personal Capability Assessment (the forerunner to the WCA), from an incapacity-based tool for determining entitlment to Incapacity Benefit to a more positive assessment incorporating assessment of capability and of health related interventions which would contribute to overcoming health-related barriers preventing people with disabilities  from engaging with work’.  

With new emphasis on what disabled people were able to do rather than on their limitations or on the social barriers they may encounter, the new test was what effectively became the WCA, adopting the biopsychosocial model promoted by Unum.

 

The new descriptors are a mirror image of the old ones, which recognised that some actitives could not be performed at all by a disabled person, while the new ones only recognise different levels of ‘difficulties’  for the same activity.

But this new version of PCA also makes a clear break from the old one as its intention is not only to explore disabled people’s residual functional ability but also ‘their approach and attitude to returning to work’ which is one of the main feature of the biopsychosocial model, which sees disability or sickness as a  ’state of mind’.

 

Ultimately there is a very clear conflict of interest:  Dr Paul Litchfield will have to assess the effectiveness of the WCA, in particular ‘the way that mental health conditions are considered in the WCA’ and to consider the ‘biopsychosocial factors that influence capability for work’ as part of his review.

As part of the evidence one can speculate that he will certainly also receive, like Dr Harrington, strong calls for the WCA to be scrapped.

 

And as Dr Harrington did, he will certainly respond that the Independent Reviewer has not seen or heard any compelling arguments or evidence that the whole system should be scrapped.

 

How could he not say that about the WCA? After all, he designed it.

 

See the following document which now only seems to exist on the website WhyWaitforEver or as a hardcopy in the Parliament Deposited Papers: Transformation of the Personal Capability Assessment

 

 

 

Sep 252012
 

The United Kingdom Disabled Peoples Council Response to the Fulfilling Potential Disability Strategy issued by the DWP.
The United Kingdom Disabled Peoples Council (UKDPC) initially had welcomed the long awaited publication of the Government Disability Strategy, Fulfilling Potential.

This important document would have guided the implementation of the UN Convention on the Rights of Persons with Disabilities and been a public declaration of intent to support disabled people to exercise full participation in every aspect of society.

UKDPC was surprised and disappointed to find that the action plan, Fulfilling Potential Next Steps, has set out the intention of creating a Disability Action Alliance, convened by Disability Rights UK, (DRUK). This alliance is apparently intended to be a partnership of ‘organisations from the voluntary, public and private sector who have expertise and influence’.

UKDPC is unable to support this action based on the following:

  • The contracting of DRUK to convene such a group was not obviously opened to expressions of interest or tendering by any other organisation. Alongside the appointment of the CEO to lead an employment review commissioned by Lord Freud without public tender, this places DRUK in a position of preferred supplier to the ODI.
  • The continued contracting of DRUK by the ODI and the convening of an unaccountable group could be construed as the creation of a Quango, which is against the principals of co-partnership and accountability.
  • This is a ‘top down’ structure that excludes disabled people from setting the agenda or defining the terms of reference. The creation of this alliance by the government is antagonistic to the principals of the CRPD which advocates the value of consulting and full involvement of disabled people.
  • Without clear terms of reference there is the possibility that the service providers or corporate employers represented would have a potential conflict of interest, eg if participating in government backed schemes such as Workfare or if being awarded contracts determined by changes in the benefits system.
  • The use of the name, Disability Action Alliance, gives rise to potential confusion with Disability Awareness in Action, a human rights based disabled peoples organisation that closed last year, with a well earned respect not just within the sector but also internationally.
  • As UKDPC considers the convening of the alliance as a flawed process then it follows that the function of such a group would similarly be flawed.
  • UKDPC wishes to state these concerns publically, and calls for:
  1. The process of contracting DRUK as the convenors be questioned and an open response be sought from government.
  2. The potential for forming a Quango be questioned and an open response from government.
  3.  Any proposed alliance be guided by disabled people with agreed terms of reference drawn up by the participants.
  4. Any further move to implement this alliance be suspended pending the questioning and satisfactory response to these concerns.

DPAC says….

We’d also like to add some further concerns as the inclusion of corporate partners and private for profit partners is not something DPAC endorses due to the activities of ATOS, UNUM and CAPITA being involved in actions through government partnerships and contracts that have clearly led to devastating outcomes for many disabled people. These outcomes have impacted on the core principles of independent living, dignity, respect and equality for disabled people throughout theUK.

We also feel that involving those who will profit from their exploitation of disabled people is against the intentions of the UNCRPD and the involvement of disabled people in self-determination of their lives and may lead to a conflict of interests with DRUK’s ability to carry out their functions.

Jul 162012
 

The dangers of throwing several thousand people from paid work into unemployment should be obvious to anyone. The fact that a majority, although not all, of the Remploy workers are disabled people should signal a further problem: Disabled people who want to work, are more likely to be unemployed than non-disabled people in all official statistics since records began. For example in 2011 the employment rate was 48.8% for disabled people compared to 77.5% for non-disabled people[1].

It is dangerous, misguided and completely ludicrous to claim that all disability organisations and the disability movement have decided that a new perverse way of supporting disabled people is to make them unemployed and subject to the ravages that disabled people must endure under this government, as the Sayce report suggests. See for example https://www.dpac.uk.net/tag/guardian-newspaper/

For those of us that have spent years arguing for an equality agenda for disabled people the arguments put forward in the Sayce report are: dangerous, misguided and wrong.

Dangerous Partners

The Sayce report (‘Getting in, Staying in and Getting on’) and the Tory desire to seemingly make the poorest most excluded people further excluded and even poorer are a strange partnership, throw in Miller, Unum and ATOS and we have a list of known enemies of disabled people-some might wonder what Sayce is doing in such unpleasant company.

The Sayce/ Tory partnership produced a report rumoured to have cost over 2 million pounds to:

1. Explain how to save money

2 Improve disabled Remploy workers lives’ by closing their factories and seemingly removing their jobs.

3. Ensure that if factories are sold off to buyers at knock down prices, buyers have no enforcement in place to re-employ disabled workers

The basis of these ‘improvements’ are predicated on the notion that disabled people need to be included in society- who would disagree? However, inclusion for disabled people and many non-disabled people in society now often means being included in the growing army of the unemployed –for those disability organisations that sign up to this notion, unemployment prevents segregation- well that’s true, but maybe they should re-examine that particular version of inclusion vs segregation. Maybe we need examine the other partners in this game? Is it a surprise that Unum were involved in the Sayce report for example? See here for an explanation of why Unum have satisfied the status of an enemy of disabled people and co-conspirators in welfare reform or the cuts agenda. One organisation that needs no introduction is ATOS. ATOS own the company KPMG. KPMG were contracted by the Department of Works and Pensions too (cost currently unknown) – they produced a report of their own in March 2012. The report was titled: Analysis of Remploy Enterprise business and Employment Services’ A copy of the report summary can be found here

However, the validity of this report may be in doubt to the general reader as page two is filled with a list of disclaimers. These include:

●Nothing in this report constitutes a valuation or legal advice.

●We have not verified the reliability or accuracy of any information obtained in the course of our work.

●In preparing our report, our primary source has been Remploy’s internal management information and representations made to us by Remploy Senior Management during the project. We do not accept responsibility for such information which remains the responsibility of Management. Details of our principal information sources are set out on page 4 and we have satisfied ourselves, so far as possible, that the information presented in our report is consistent with other information which was made available to us in the course of our work in accordance with the terms of our Service Order. We have not, however, sought to establish the reliability of the sources by reference to other evidence.

Maybe Les Woodward’s analysis, which the DWP didn’t pay millions for, might be more credible

Closing Remploy factories will not save disabled workers from ‘Victorian-era segregation’. It will wreck lives[2]

An interesting postscript is that one of the directors of Remploy is also a director of RADAR: ‘all in it together’? Labour, (who incidentally closed a number of factories in 2008 so let’s not get too teary eyed), have urged the Government to start the whole consultation again, some claiming that it is a shambles. While Phil Davies, secretary of the GMB accused the Government of turning the consultation into a

good old-fashioned Klondyke gold rush”[3].

But there’s more, as argument after argument presented in the Sayce report is knocked down and proved to have a false or questionable basis.

 Misguided Arguments

The ‘Independent’ Sayce Report of June 2011 and the consultation that followed apparently showed that a group of  individuals, organisations, charities (and the insurance company Unum) felt that segregated workplaces were outdated and as a result disabled workers should be made redundant (see appendix for those involved in consultation).

 

 However, the process of redundancies was underway as early as January 2011 six months before the estimated 2 million pound plus Sayce report began. On 14 January 2011 Remploy HR Director, Sue Butcher phoned the GMB National Secretary and informed him that an announcement was to be made on 18 January 2011. No other information was given.

On 18 January 2011 the company met with the trade unions and informed them that they were opening up a voluntary redundancy programme and that consultation would start on 24 January 2011. The company had already informed the employees by letter that it was opening up a Voluntary Redundancy scheme. No consultation had taken place with the trade unions. Seems they were not important enough to be invited[4].

The Sayce report found people working at Remploy factories who were quoted as saying they wanted ‘real’ jobs and the report ‘team’ claimed to have consulted in-depth with workers

 

The GMB union cannot seem to find these quotees in the factories who wanted ‘real’ jobs, for some reason. It has, however found 4 people who took part in what was presented as an in-depth consultation with Remploy employees[5].

The closure of the Remploy factories is because they are segregated workplaces isn’t it?

 This is one simplistic argument popularised by the Sayce report, however the Remploy factories do not employ disabled people exclusively. In 2008, 29 factory sites geographically based from Scotland to Cornwall closed with over 2,500 Remploy employees becoming unemployed. Of these, 1,700 employees were disabled. The 2012 closures will affect around 80% of employees who are disabled.

Given the other players in the partnership –it all points to a ‘cuts agenda’ rather than any supposed moral high ground on inclusion.

The workers will find alternative jobs in the open workforce?

 

In 2008, 29 factory sites geographically based from Scotland to Cornwall closed with over 2,500 Remploy employees becoming unemployed. Nearly 1,700 of these employees were disabled and most of them have not worked since and remain on benefits.

From the last round of Remploy closures  85% of disabled ex-employees remain unemployed[6]. This was in a better economic climate than that of today. Some committed suicide, many threatened suicide and many experienced mental health issues, for those that already had mental health issues these were exacerbated.

The workers will be supported when the factories close

 

 During 2007 and the early part of 2008 the company gave promises of support for those leaving in the round of closures carried out under the Labour government but history has shown that very few of the 1,700 disabled people received even a phone call from Remploy let alone any practical support[7].

In 2012 there is a community pot of 1.5 million offered to charities and disabled peoples’ organisations (DPOs) to support the workers into jobs by the DWP. This may explain the keenness of the illogical ‘equality into unemployment arguments’ that some were producing but it is unlikely that DPOs and the usual list of disability charities or voluntary organisations can find jobs for ex-Remploy workers where they do not exist, despite taking their 30 pieces of silver. However, some are running the much maligned mandatory work programs-so maybe that will the grand plan, sanctions and all.

The full criteria for this fund has been laid out in a Freedom of Information Request on the purpose of the Community Support Fund (CSF)  [8]

The CSF will offer financial and non financial support to local disabled people’s user led organisations (DPULOs) and voluntary sector organisations to deliver support and services designed to meet the specific needs of
disabled Remploy employees affected by the announcements on the future of Remploy factories.

The intention is that the fund will help to support affected Remploy staff to re-engage with their local communities and help their transition from segregated sheltered employment to mainstream employment. It will be focussed around the geographical areas where affected Remploy employees live and used to build the capacity of local DPULOs, 3rd sector and voluntary organisations and to develop a range of activities and projects to help the move from sheltered to main stream employment.

As well as a modest amount of money being available to support projects to help ex-Remploy employees, and other local disabled people, get into work, training or volunteering funding will be made available to help create learning and development activities to improve employment
opportunities.

 Not really that impressive. But impressive enough for emails asking organisations to ‘put their applications in’ to go out to selected disability organisations and charities 24 hours after the closures were formally announced. These emails say nothing about jobs but give examples of film clubs and other types of support , none of which offer a paid job which is what the factories offered. One option is to offer support in ‘choice and control’ where was the choice and control for those workers that wanted to stay in their paid jobs in the Remploy factories?

The Remploy workers will be better supported by Access to Work Schemes- money will be better spent on Access to Work

 

First, to qualify for Access to Work you need to have a job or a documented firm offer of one: first hurdle. The problems with Access to Work, including cost cutting under this government are too numerous to go into here, but even the hallowed Access to Work cannot match the percentage of support that was already being provided at the Remploy factories. This is particularly the case with learning difficulties and mental health issues.

Another point made in the Sayce report is that access to work may be able to benefit disabled people with a mental health conditions.  Out of the 32,680 helped in the current year only 460 have a mental health conditions.  This is only 1.4% of all those helped.  Compare this to 131 employees in Remploy who have a mental health conditions out of 2,692 employees which is 5% or 4 times higher.

When you look at another major disability which is learning disability, out of the 32,680 helped by access to work only 1,680 with this particular disability have been helped into employment.  This is just over 5% compared to the 462 disabled people out of 2,692 who have a learning condition working in Remploy (17.2%) again over 3 times as high[9].

Never the less, its all been a useful exercise to set up an expert panel on Access to Work run by the CEO of Essex Coalition of Disabled People and to extend access to Work to young disabled people enduring workfare type schemes[10]

The workers in the factories cost too much

 

GMB argues that voluntary redundancies increased the cost of each worker by £1,000 per worker. Management has remained top heavy, apparently ineffectual and overpaid- and the continued use of consultants such as KMPG have added to costs. These costs were lumped together along with running costs to produce a misleading amount per worker[11].

Further: There are 3238 employees most of whom are disabled and who earn less than £16,000 per year. The cost of travel for all employees has escalated to £2m, the cost of company cars to £2.4m and the cost of car allowances to £1.1m; a total cost of £5.5m.

The figure of £138m losses for the factory network is not true. We believe that if all the measures outlined in the trade unions document are taken on board and implemented then the cost of the factory network would be approx £35m per year.

Put another way when the profit from sales is considered and taken into account the cost per disabled worker to the State could be as low as £7,000.

When you also take into account the fact that tax and insurance is being paid in and benefits are not being paid out this figure could be substantially lower[12]. Alternatively: the cost of unemployment which for a disabled person could be as much as £25,000 to £30,000 per year for each disabled person not working when you take into consideration the revenue lost in tax and national insurance contributions the cost could be higher. A disabled person who is not working will probably receive higher benefits than a non disabled person. Housing benefits and careers allowances are only the tip of the iceberg.

The unseen and unmonitored costs start to mount up when you consider that a large number of disabled people who were made redundant when Remploy closed 29 factory sites now have severe health problems and the use of the NHS has greatly increased. We would estimate that this cost could be as high as £20,000 for some disabled people.

Figures in the Sayce report show that factories never profit

 

 In May 2012 Profits were up -Sally Kosky said: “According to the management’s own figures, the cost to government is down by £16.5 million on the previous year – £2.5 million better than budget”[13].

Also from May: A letter sent to Remploy employees shows the business is doing well, Plaid Cymru has claimed. The letter congratulates workers on a 12.2 per cent growth in sales and a 17 per cent reduction in costs. The Remploy factory in Swansea is one of seven sites in Wales which has been earmarked for closure.

Plaid Cymru’s equalities spokeswoman, Lindsay Whittle AM, said: “These figures prove that the UK Government’s intention to close Remploy factories is a thinly veiled attack on the welfare state. It shows that there is absolutely no justification for the government’s plans, except as a continuation of its attack on welfare recipients.”[14] 

So it looks like they did profit! The Swansea factory will be closed along with the others despite 12.2% in growth and a 17% reduction in costs. It was never about profits or costs was it?

But Remploy wasn’t getting Contracts was it?

 

The more worrying aspect of the company’s strategy on sales is the outsourcing of work and the lack of tendering for public procurement contracts.

Letters from the NHS Forth Valley and Stirling Council to the Minister show it is clear that Remploy has not shown interest in tendering for large contracts that the company could have won.

It is also apparent that the senior managers work within a very nice comfort zone; no aggressive sales strategy exists and no stretching targets exist. The trade unions believe this is part of the conspiracy to fail and the failure of the sales team is the responsibility of the Chief Executive and the Board.

We understand that because of the previous reduction in manpower that large amounts of work is being turned away or outsourced. Birmingham factory and Healthcare are prime examples[15].

 

DPAC seems to be saying that disability Charities and some DPOs are involved in some way that is not in line with the principles of disability rights- this does not make sense

 

It depends on your idea of disability rights; the old chestnut that keeps being trotted out is that closing the factories is all about the right of disabled people to be included. We ask what are the ex-Remploy workers going to be included in exactly? Film clubs?

Where was their choice and their rights in where they wanted to work and in keeping their paid jobs in the worst recession since the 1930s?

So who Gains?

 

 Cleary not the Remploy workers, they are merely the collective sacrificial lamb on the altar of profit and gain by others or those with vested interests if you prefer.

These include:

The beneficiaries in the invited team that made up the Sayce report.

The director who was on the board of Remploy and RADAR (now DRUK: chief executive Liz Sayce) simultaneously–there’s got be some gain there.

Those disability charities and organisations who may gain from the community pot to support the Remploy workers in their unemployment

KPGM (and ATOS who own KPGM) whose report has so many disclaimers making it another gross waste of tax payers’ money

UNUM, but we are not sure how they gain yet-their inclusion in the Sayce consultation team must serve some purpose for them.

Remploy senior managers’ beneficiaries of a 1.2 million bonus payment in 2012 when it was clear that factories were earmarked for closure

Those companies and disability charities running work programs such as work for your benefits ‘work programs’ such as workfare.

Those that will further their careers (and income) by sitting on ‘expert’ panels discussing Access to Work (rather than paid jobs) in the wake of the closures

Remploy itself by winning contracts to deliver Access to Work for mental health users for every area tendered before the closure deal was complete[16]

Doesn’t all that show a conflict of Interests?

 

 Yes, but this is Tory Britain- who cares about other peoples’ lives anymore when they can make a few quid?

Debbie Jolly co-founder DPAC

twitter: @redjolly1


[1] Source: Labour Force Survey, Quarter 2, 2011

 [4] Written evidence submitted by the GMB May 2011

 [5] Sayce Report Analysis July 20th 2011 GMB,UNITE, Community

 [7] Written evidence submitted by the GMB May 2011

 [9] A new strategy for the employment of disabled people: a new concept in the field of employment – by Phil Davies, GMB National Secretary for Manufacturing Section on behalf of the Consortium of Trade Unions

 [11] Written evidence submitted by GMB May 2011

 [12] A new strategy for the employment of disabled people: a new concept in the field of employment – by Phil Davies, GMB National Secretary for Manufacturing Section on behalf of the Consortium of Trade Unions

 [15] Written evidence submitted by the GMB May 2011

 

Appendix

 List of those involved in Sayce Consultation NB we are still waiting for a list of those involved in the report itself.

The following organisations submitted evidence to the review. Source: appendix 3 of Sayce report

1. 104 films Limited
2. A4e
3. Acquired Brain Injury Forum for London
4. Action Group
5. Asperger’s Inc
6. Barnsley Metropolitan Borough Council
7. BASE
8. Birmingham City Council
9. British Assistive Technology Association
10. Bradford Council
11. Bristol and South Gloucestershire People First
12. Bristol City Council
13. British Psychological Society
14. Camden Society
15. Cardiff and Vale Coalition of Disabled People
16. Centre for Mental Health
17. Centre Point
18. Changing Faces
19. Cheshire East Council
20. Choices and Rights Disability Coalition
21. Elcena Jeffers Foundation
22. Employment Services at Westminster Centre for Independent Living
23. Enham College (RTC)
24. ERSA
25. Finchdale RTC
26. Foundation for People with Learning Disabilities
27. Hands Free Computing Ltd
28. Hao2.eu Ltd
29. Headway
30. Hertfordshire Action on Disability
31. Hillcrest Branch
32. Hudson Interpreting Services
33. Inclusion
34. Indigo Dyslexia
35. Ingeus
36. Kent County Council
37. Key Ring
38. KM Furniture Ltd
39. Lancashire County Council
40. Leicestershire Centre for Integrated Living
41. Low Incomes Tax Reform Group
42. Mencap
43. Mental Illness
44. Mind
45. Monmouth People First
46. National Association of Deafened People
47. NASUWT (teachers union)
48. Newco Employment and Training
49. North Bank Forum
50. Nottinghamshire Deaf Society
51. Papworth Trust
52. People First
53. Pluss
54. Queen Alexandra College (RTC)
55. Queen Elizabeth’s Foundation (RTC)
56. Reed in Partnership
57. Rethink
58. Royal British Legion Industries
59. Royal College of Nursing
60. Royal College of Psychiatrists
61. Royal National College for the Blind (RTC)
62. RNIB
63. RNID
64. Scope
65. Scottish Association for Mental Health
66. Scottish Autism Service
67. Scottish Independent Advocacy Alliance
68. Sense
69. Shout Out
70. Signature
71. Slough Council
72. Social Firms FRC Group
73. St. Annes (social firm)
74. St Loye’s (RTC)
75. St Mungo’s
76. Sustainable Hub of Innovative Employment for People with Complex Needs (SHIEC)
77. The Association of National Specialist Colleges
78. The Coalition of RTC Providers (covers all nine residential colleges)
79. The Small Business Consultancy
80. Transition Information Network
81. Travel Matters UK
82. UNITE
83. UNUM
84. Vangent
85. Visibility
86. Vocational Rehabilitation Association
87. Welsh Assembly Government
88. Woman at Wish
89. Work Fit

Liz and the review team met with people from a wide range of other organisations including, among others, People First, National Centre for Independent Living, Disability Wales, Inclusion Scotland, the Employers’ Forum on Disability, Remploy, the TUC, GMB, Social Policy Research Unit, Centre for Mental Health, Disability Alliance, Sense, UNITE, RNIB, Mencap, the Scottish Union for Supported Employment, a range of central government departments, Essex Coalition of Disabled People and many more.

N.B we do not suggest that those appearing on this list are all in favour of closure of the Remploy factories, but the list is telling, more so because DPAC also responded to this consultation and don’t seem to get a mention. The DPAC consultation response can be found here

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Apr 082012
 

One of the main advocates of the bio-psychosocial model, Lord Freud (Westminster’s Minister for welfare reform) claims that it is based on evidence. It is not. It is a right wing model led by profit and the market. It incorporates the worst aspects of neo-liberalism. It targets disabled people and ridiculously claims that we can think ourselves out of being disabled. Its underlying theme repeats the mantra that ‘work will set you free’. But this is not about work, despite the endless rhetoric; this model is an ideological cover for attacking disabled people and reducing every single right to financial support that has been achieved. Additional fringe benefits are provided to the insurance market of Unum, to the profits of Atos and to the big Disability Charities who all capitalise on the new notions of risk being imposed on disabled people. We can identify a clear pattern for the construction of the bio-psychosocial model, and its advocates. It features:

●‘Academics’ in the pay of the insurance company Unum

●The genesis of the Work Capability Assessment guided by Unum and Atos,

●Atos’ imposition of mass reassessments

● Successive governments

●Key players in the Department of Work and Pensions

● The big Disability Charities.

We can also identify a clear pattern for the construction and advocates of the social model of disability. The story features disabled activists some of whom  were institutionalised in a Leonard Cheshire home, disabled academics, disabled activists and disabled peoples’ organisations and groups run and controlled by disabled people who led the political challenges to individual models of disability and who continue to do so.  Which model seems better so far?

While successive governments were delivering a stream of white papers apparently dedicated to improving the life chances of disabled people the revenge of the bio-psychosocial model and welfare reform (read welfare destruction) was quietly being prepared behind our backs by the state and their market partners. The following explains why some disability campaigners were and are wrong to abandon the social model of disability and how the rhetoric behind the bio-psychosocial model is one of the keys to understanding the 21st century ideological attacks on disabled peoples’ lives.

Part One

The Social Model of Disability Basics: why it’s nothing to do with the bio-psychosocial model

The social model came into being through a letter to the Guardian from Paul Hunt[1], the early work of UPIAS (Union of Physically Impaired against Segregation) a document written by Vic Finkelstein[2] and other activists. They were institutionalised in a Leonard Cheshire institution. The UPIAS document and its premise were taken forward in the 1980s and 1990s by disabled activists and academics including Mike Oliver[3] and Colin Barnes[4]. Paul Abberley[5] also produced a seminal piece on  ‘The Concept of Oppression and the Development of a Social Theory of Disability’. The social model of disability was also taken forward by activists, campaigners and those who set up some of the first Centres of Independent Living (CILs).

The social model perspective has been used widely in the UK as answer to the sociological theories and common place mis-understandings on issues of disability being designated as entirely medical/individual attributes without reference to the environment, to the barriers that disabled people face, or the rights that they are being denied. Examples include: the American conservative sociologist Talcot Parsons who theorised the ‘Sick Role’ in the 1950s, and the International Classification of Impairments, Disabilities and Handicaps (ICIDH).  Parsons suggested that ‘the sick role’ gave individuals the opportunity to ‘opt out ‘of society, and elicit sympathy from others which brought them certain social benefits. However, this was perceived as a deviant role-according to Parsons the individual was at fault, merely exercising a form of deviance for particular rewards-they could quite easily change their attitude and function within society adequately. In addition, the first classification from the World Health Organisation (WHO) produced The International Classification of Impairments, Disabilities and Handicaps (ICIDH). This concentrated purely on medical factors and ‘handicaps’. It was later remodelled to include supposed interaction with social factors and renamed International Classification of Functioning, Disability and Health (ICF). Yet, it has never fully achieved the explanation of the interaction between impairment and disability.

In contrast, disability activists using the social model perspective argue it is how society treats disabled people that create the main problem. The experience of disability is not exclusively about the individual or the individual’s attitudes. The experience of disability is an interaction with actions of non disabled people, planners, governments, employers and others. People need educating on what it is really like to be disabled and the many barriers that disabled people face in their everyday lives. They need to understand those barriers which prevent disabled people having the same opportunities and life chances as their non disabled peers.

The social model does not focus on disabled people as victims of their physiology, whether physical, cognitive or otherwise, nor as vulnerable, helpless individuals but as people who are disabled by attitudes, the environment, design, working patterns and by those individuals who see disabled people as unworthy. The social model also offers a way to organise politically against the principles of social and economic exclusion, and oppression in a disabilist society.  It gives a critique of all that has gone before based on individualism and the market. It also argues that disabled people must be at the centre of voicing their own experiences. The social model was constructed by disabled people, not medical ‘experts’ , not policy makers, not social workers, not disability charities, not service providers, nor governments, nor private companies profiting from disability[6].

 

The Social Model: misunderstandings, misuse and other detractions

Disabled People against Cuts (DPAC) advocates the social model as do many others. Yet, DPAC has received criticism for insisting on working from the perspective of the social model. For example, the coalition governments’ use of the term social model in consultations regarding the proposed change from Disability Living Allowance to Personal Independence Payment (PIP) has caused some people to reject the social model: what’s the point of supporting something that is being used to limit our rights-but the coalition government don’t understand, care or really know what the social model is. This was evident to anyone that read through the questions in the first PIP consultation.

The social model has been rejected by some academics as being out dated or not quite fashionable enough: they claim it is better to write of discourse, and embrace the ‘subject’ (individual). From the ‘ivory towers’ it may be, but how can this version ever realistically contribute directly to social policy or to peoples’ lives? The social model is rejected because it is considered masculine, it talks about this thing called society, and it talks about ‘social oppression’-perceived as an outdated Marxist term. The social model is rejected because it talks about impairment, people don’t like to think of themselves as impaired, and anyway, some say: isn’t the social model all about physical impairments? What about mental health? What about learning difficulties? Disabled feminists also criticised the social model for what they suggested was the social model’s exclusion of the body, but it is in the body politic that this model has its greatest power. At times criticisms are academic (in both senses), overall it’s extremely damaging, as the criticisms are often based on misconceptions of the social model and miss what the perspective offers for changing disabled peoples’ lives (see Barnes[7]).

The Coalition and New Labour before them had some very fertile ground to make their attacks on a set of people who were divided on their own histories, who appeared to be against their own founding activists and their own collective political identity. At the same time, as noted, neither new Labour nor the Coalition understood, cared or really knew what the social model really meant. They did know that the social model was used as successful tool to establish rights for disabled people.

This is why recent governments and government departments have used the term without any notion of the motivation, history, or content nor any care for the outcomes. Governments claim they speak with some disabled peoples’ organisations, some disabled activists, but mainly governments’ speak with the multi million pound disability charities. The big disability charities also use the term social model to give the illusion that they understand disabled people and can speak on behalf of disabled people. They never could and they still can’t. It is for disabled people to speak for themselves individually, through their own user-led organisations and through their own grass root groups.

What the Social Model Perspective did for Disabled People

The social model perspective was used very successfully by campaigners, protesters, advocates, activists and Centres for Independent Living (CILs) to move disabled people in the UK to a position that was the envy of many European countries in terms of UK support for disabled people.

Was it this perspective and its promotion that brought us:

● The Independent Living Fund (ILF) –now closed to all new applicants since 2010 by the Coalition, while existing applicants are left wondering what will happen to their support

● Disability Living Allowance (DLA) to pay for the extra costs of being disabled -now being replaced by Personal Independence Payment and rounds of reassessment by the Coalition government

● Incapacity Benefit -now changed to Employment Support Allowance and rounds of reassessment by Atos put in place by New Labour and made more stringent by the Coalition government

● Access to Work to help with extra costs of working and to, in theory, provide extra support to those that needed it –recently we have seen cut-backs on Access to Work with the tightening of criteria and more costs transferred to the employer rather than the government under the Coalition.

● Direct Payments to pay for personal assistants to aid independent living through financial support from local authorities (L.A.s) -now cut back as L.A.s restrict access through more punitive eligibility criteria because of central government cuts of up to 40% to L.A. budgets

●The Disability Discrimination Act (DDA) –now we have a diluted replacement including all discriminated groups called the Equality Act (2010) put in place by New Labour and further diluted by the Coalition government.

These things originally opened up independent living for disabled people; social model arguments affected social policy, housing, information, education, transport, design, peer support, advocacy and attitudes towards disabled people. Few would claim that the social model was a panacea for all the problems that disabled people faced, disabled people were still fighting for better rights, improvements on what we had, and better access before the current onslaught from the Coalition. However, to say that the social model and the social model perspective did nothing to change the lives of disabled people is an insult to the generations of disabled activists before us that fought for change. All those that pushed those extra rights forward were social model advocates who wanted more independence for themselves and for disabled people, they wanted to educate on a better understanding of the social and economic oppression that disabled people faced. Yet, New Labour, the Conservatives and a host of other actors were working on removing those gains and more from disabled people and disabled children from as early as 1992.

Those disabled people that now have a public platform and criticise or dismiss the social model are disparaging the very thing that gave them that platform in the first instance. We can identify a clear pattern for the advocates and history of the social model: disabled people, some of whom were institutionalised, disabled academics, disabled activists and disabled peoples’ organisations run and controlled by disabled people.  We can also identify a clear pattern for the bio-psychosocial model rhetoric and its advocates.

Part two

The Bio-psychosocial Model Basics: why it’s nothing to do with the social model

There are a few references explaining where the original version of the bio-psychosocial model came from. Some cite George Engel[8] others claim that it is an outcome of the International Classification of Functioning and Disability (ICF) [9] Gill Thorton[10] describes the model from a medical approach, while clearly identifying the vulgarisation of its later use as a tool in getting disabled people back to work

Briefly put, it is a theory that seeks to broaden the perspective on illness, by taking into account not only the biological, but also psychological and social factors which may have an influence on sickness, and consequently on the course that healing takes. The acknowledged value of this approach, when used for the benefit of the patient, is that it allows for the identification of non-biological influences which may interfere with an individual’s capacity to heal.

However, it seems that Parsons’ ‘sick role’ and of the disabled person as deviant comes closest to the rhetoric of the Coalition government. So rather than identify who or what the original source of the bio-psychosocial model might be, we need to look at its promotion and how it has been used to justify the rhetoric that ‘work makes you well’ and that ‘work is good for you’. A DWP Press release from October 2011[11] shows the ways in which Freud (Minister for welfare reform) justifies the new era of the bio-psychosocial. He is speaking from the perversely titled ‘Health and Well- Being’ conference.

Key speakers at the conference included Dr Catherine Hannaway trained in the U.S. in ‘improvement methodologies’ by the Institute for Healthcare Improvement whose former President and Chief Executive Officer was Donald M. Berwick administrator for the Centers for Medicare and Medicaid Services insurance. Dr Bill Gunnyeon CBE, Director for Health, Work and Wellbeing and Chief Medical Advisor DWP:a regular ‘expert’ in House of Commons groups, and like Freud an apologist for Atos testing and the change from DLA to PIP. Also Samantha Wortley, Health and Safety Advisor at the University of Derby: a university running accredited courses for Atos health practitioners, and Disability Charity RNIB’s Philip Connolly, Employment Campaigns Officer to name just a few.

Freud’s rendition was surely a case of ‘preaching to the converted’ as it was delivered to those connected to insurance, disability accreditation, disability charities (who are still using the language of rehabilitation) and various apologists for the current regime. He also uses academics Waddle and Burton who, like many others supporting this rhetorical model are connected with the Centre for Psychosocial and Disability Research directed by Mansel Aylward, (former Chief Medical Officer at the DWP) at the University of Cardiff: a department bankrolled by Unum. Freud happily declares:

Not so long ago employers were frightened of ill health. Good employers were concerned that being in work would cause some harm. Responsible employers acted to protect people, keeping them off work until they were fully recovered. But perversely they may have been doing more harm than good. We now understand that work is not necessarily bad for you.

People with physical or mental health conditions do not need to be protected from work and sometimes maintaining some form of working life can aid recovery. This understanding was first put forward by Aaron Antonovsky. It was expanded upon by Waddell and Burton. And helpfully formed an evidence base upon which I developed my welfare reform report.

Work provides more than just an income. Employment can also give people a sense of purpose, some structure to their lives. It can also be an important part of people’s social lives.

Quite simply good work is good for you.

Quite simply ‘good work’ is in short supply under the Coalition. Their promotion of the deeply unpopular workfair and the limited supply of temporary (including contract work), part-time, precarious jobs, and job insecurity for those in work have all been found to have adverse affects on mental and physical health. In addition, poor quality work can affect mental health in the same way as no work. The growing gap in inequality between the richest and the poorest affects the nation’s health and remains intergenerational.

The Construction and Deconstruction of a model for Private Profit

Aaron Antonovsky, one of the academics mentioned, put forward the idea of the concept of sense of coherence (SOC) in 1979[12]. It is not related to the bio-psychosocial model but ironically identifies one of the reasons why the current coalition regime imposed on disabled people will make them more susceptible to stress, anxiety and individual deterioration.

Collingwood claims[13]: The SOC is defined as: “The extent to which one has a pervasive enduring though a dynamic feeling of confidence that one’s environment is predictable and that things will work out as well as can reasonably be expected.” It has three components – comprehensibility, manageability, and meaningfulness. Comprehensibility is the extent to which events are perceived as making logical sense, that they are ordered, consistent, and structured. Manageability is the extent to which a person feels they can cope. Meaningfulness is how much one feels that life makes sense, and challenges are worthy of commitment. All these things are based on financial security, upbringing, social networks and natural ‘coping’ styles. Unremarkably, those in higher social classes who are more financially secure are deemed to have higher SOC levels, yet it also likely that they have better health outcomes too, as they are more likely to come from financially secure backgrounds.

As Antonovsky died in 1994 he will be unable to sue Freud for what seems to be a complete misinterpretation of SOC. Later we’ll compare the Antonovsky theory to the Waddell and Burton (Unum) scenario which exhibits a ‘blame the individual’ approach developing individualistic themes on illness and disability in which the social is completely erased.

Of course, the Health and Well- Being conference is just one in a long line of such conferences. In 2001 a conference with the charming title of ‘Malingering and Illness Deception’ was held at Woodstock near Oxford. It covered old ground for the insurance industries. Amongst the participants were Malcolm Wicks, then Parliamentary under Secretary of State for Work, and Mansel Aylward: Chief Medical Officer at the Department of Work and Pensions (DWP) and a number of academics like Waddell and Burton who would come to add academic credibility to Unum’s and government protestations on disability and illness.

What linked many of them together, including Aylward, was their association with the giant US insurance company UnumProvident (later Unum), represented at the conference by John Lo Cascio. The goal of the conference was the transformation of the welfare system[14] in particular the reduction of payments to disabled people which was perceived to be a key problem for successive governments. Unum were perfect for such a project as they had a very useful track record of reorganising exactly what health problems were in order to avoid insurance payouts. John Lo Casio was no stranger to such events or to working with Westminster governments. As second Vice chair of Unum he had been brought in by Conservative Peter Lilley (Secretary of State for Social Security 1992-1997) to ‘manage claims’ of incapacity benefit. Both Lo Casio and Alyward joined the government medical advisory group to devise the All Work Test, a forerunner of the Personal Capability Assessment (PCA) and a forerunner to the more recent Work Capability Assessment (WCA) used by Atos. The All Work Test awarded points for different descriptors and ignored GP evidence-Instead a set of adjudication officers who were trained in a theory set out by Mr Lo Cascio were employed to aid the management of claims – sounds familiar doesn’t it? Unum Provident was at the centre of UK welfare reform as early as 1992 under the Thatcher government, but they worked with New Labour too.

Unum Provident continued to build its sphere of power and influence, in 2001 launching: New Beginnings, a public private partnership between charities, including Disability Charities, NGO’s and government ministers with the express intention of furthering the company’s power in policy making. The New Beginnings advisory group included some of the academics from the Woodstock conference as well as major disability charities such as the Shaw Trust, Disability Alliance, and the Employers Forum for Disability[15] Unum went further stretching their tentacles into the university sector with the help of Mansel Alyward formally of the DWP.

Mansel Aylward, began directing the Centre for Psychosocial and Disability Research at Cardiff University in 2004:a department that Unum Provident paid 1.6 million pounds for. A  department set up to provide an academic credibility and a new political slant to the bio-psychosocial model[16]  allowing Freud to claim that welfare reform for disability benefits was backed up by evidence that ‘work was good for you’. The department included Alyward, Professor Peter Halligan and Gordon Waddell. One year later Alyward and Waddell produced The Scientific & Conceptual Basis of Incapacity Benefits published by the DWP. As Rutherford[17] notes:

In their declarations of interest at the beginning of the text neither man cites their association with UnumProvident. This matters, because the monograph provides the unacknowledged intellectual framework for the 2006 Welfare Reform Bill [originally passed by New Labour]. And the methodology used by Waddell and Aylward is the same one that informs the work of UnumProvident. In a memorandum submitted to the House of Commons Select Committee on Work and Pensions, UnumProvident 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 bio-psychosocial one’.

Peter Halligan, and Derek Wade of Oxford University (another Woodstock academic) explained the model in the British Medical Journal as something that needed to make a break from old understandings of the bio-psychosocial. ‘The old biomedical model of illness, which has dominated health care for the past century, cannot fully explain many forms of illness.’ What they really meant was that it was not helping reduce the number of applicants for incapacity benefit.

The old model ‘assumes a causal relation between disease and illness, (?) and fails to take into account how cultural attitudes and psychological and social factors shape illness behaviour. In other words it allows someone to report symptoms of illness, and for society to accept him or her as sick, without their having pathology’-a throwback to Parsons’ ‘sick role’ theory. They add that: ‘Personal choice plays an important part in the genesis or maintenance of illness’.

Alyward and Wadell moved this rhetoric up several gears: Arguing that adopting this new version of the model would lead to a ‘fundamental transformation in the way society deals with sickness and disabilities’ (p123). The goal and outcome of treatment is work: ‘work itself is therapeutic, aids recovery and is the best form of rehabilitation’. Work can set you free, in fact worklessness now transforms into a bizarre serious risk to life. It is announced as:

one of the greatest known risks to public health: the risk is equivalent to smoking 10 packets of cigarettes per day’ (p17).

Halligan and Wade also tap into theories of Talcot Parsons to argue: ‘Our model suggests that illness is a dysfunction of the person in his (or her) physical and social environment’. Like Parsons, they suggest that the ‘sick role’ is no more than an individual deviance: a choice. The solution is to change people’s behaviour by transforming the language and culture of welfare, and by using incentives as a ‘motivational tool’ to prise people out of their sick role (p166). The motivation tools were later renamed sanctions. That is sanctions to those people refusing to work for their benefits on programs such as ‘workfare[18]’, sanctions through which their benefits can be removed from weeks up to three years leaving them without income if they dare indulge in any ‘wrong thinking’.

 Influence and Profit: Unum, ATOS and complicit Disability CharitiesIn July 2007 The Personal Capability Assessment (PCA) was redesigned by two technical working groups, one for ‘physical impairment and another for mental health issues. Representatives from Unum and Atos were present in both groups[19]. The redesign would be one step closer to the hated and much maligned Work Capability Assessment to be delivered by AtosTechnical working groups on the WCA also hosted the views and input of some of the big Disability Charities including: MENCAP, MIND, the National Autistic Society, Parkinson ’s Disease Society, RNIB, RNID and the Disability Benefits Consortium including some of those already mentioned, as well as Leonard Cheshire Disability, Sense, RADAR, SCOPE, Sue Rider and the Papworth Trust[20].No doubt this was good preparation for the Disability Works UK launch in 2011 another charity consortium exercising their muscle as ‘experts in disability employment’ involving SCOPE, MENCAP, MIND, Leonard Cheshire, and Action for Blind People (a part of RNIB) with a healthy turnover value of 654.4 million and a cumulative surplus of 15.6 million[21] All corporate disability charities were more than prepared to take maximum advantage of workfare type schemes recently announced as having unlimited time scales for disabled people[22].We should note that so far we do not see any user-led disabled peoples groups involved in any positions of power or profit in this wholesale transformation of welfare or in partnership with the government. The charities were speaking for us because there were profits to be made from lucrative government contracts designed to get disabled people back to work- they are in the disability business too after all. They continue to ‘help’ by advising on mental health issues and producing publicity against the WCA that they were involved in and publicity against Atos, who they sat at the table with-I guess that’s part of the social model bit they adopted, plus of course their partnership with user-led groups in the Hardest Hit protests which protested against the WCA and welfare reform-oh the irony or is it duplicity?Atos were also on board the welfare transformation gravy train before the WCA.  Atos bought out SchlumbergerSema in 2003 for 1.3 billion Euros. Through this, they gained access to key SchlumbergerSema public sector contracts in the UK, including one with the Metropolitan Police, a deal with the Department for Work and Pensions, and the Government Gateway project[23]. This was a significant move as DWP contracts included the Personal Capability Assessment and the buyout gave Atos (renamed as Atos Origin in 2004) access to the Logical Integrated Medical Assessment (LIMA) and 100 million per year from the DWP for delivering it with the proviso that they speed up claim and processing times. Another Disability Charity: Shaw Trust announced their pleasure at future work in partnership with Atos in 2010. Shaw Trust would also profit through the misery of disabled people by delivering the euphemistically titled ‘work programs’ for disabled people. Sally Burton, CEO[24] at Shaw Trust gushed:

“Shaw Trust is delighted the consortium has qualified to bid for the opportunity to supply seven Lots of the Government’s Work Programme. As the UK’s largest   third sector provider of employment services, our partnership with Atos Origin and Pinnacle People can ensure the charity sector remains at the heart of welfare-to-work.” [My emphasis]

But lets move from income driven Disability Charities to failed bankers (apparently they do exist). In 2006 New Labour chose David Freud, a senior banker at UBS AG to conduct a review of New Labour’s welfare to work policies. Freud later defected to the Conservatives on a promise of a peerage. Invest in ME[25] expose Freud’s mistakes in banking and other areas explaining his own incapacities in some detail:

The “To Banker from Bankies” 2009 report (which was supported and funded by Oxfam) states, in 2007 Freud was appointed as the key Government advisor on welfare reform by Labour’s John Hutton and was commissioned to produce a report “Reducing Dependency, Increasing Opportunity” on the “Welfare to Work” programme.  This was despite the fact that, in his own words, Freud “didn’t know anything about welfare at all” (Daily Telegraph, 4th February 2008). Despite the great complexity of the welfare system, Freud researched and wrote his welfare “shake-up” plan in just three weeks (Daily Telegraph, 1st May 2006). It recommended that the existing role of private firms (such as UNUM and Atos) in the Government’s “Welfare to Work” programme be dramatically increased; he acknowledged that there was no evidence to suggest that private contractors were any better than the Department for Work and Pensions, but he still concluded that it would be “economically rational” to pay them tens of thousands of pounds for every person they removed from benefits.

In his report Freud constantly misquotes studies and uses over 170 references to ‘models’ citing the zsars of the Unum financed Centre for Psychosocial and Disability Research at Cardiff University consistently. While Freud openly acknowledges a useful partnership between of two of the most hated private companies and their involvement in welfare to work issues, the company’s themselves have been much more unwilling to acknowledge any links between them.

Links between Unum and Atos

In the 2004 Atos report, Atos appears to use the language of Unum and the academics of Centre for Psychosocial and Disability Research unreservedly, with sex thrown in for good measure:

Psychosocial factors…are at least as important as physical factors in the onset and maintenance of these conditions.  Patients can make a number of ‘secondary gains’ with these unexplained illnesses, such as…turning a socially unacceptable disability into a more acceptable ‘organic’ disability caused by injury or disease beyond their control. They can blame their failures on the illness; elicit care, sympathy and concern from family and friends; avoid work or even sex; and there are financial rewards associated with disability.

 …if a patient believes their illness was caused by a virus and there’s nothing they can do about it, their prognosis is not likely to be positive.  But if the patient believes…that the symptoms won’t last long and they have control over them, then the prognosis will be better….We need patients to understand their situation, so they are more likely to go back to work

(Except from the powerful letter from Douglas Frazer to the House of Lords reproduced on the Invest in ME web site)

Despite being linked in the chain of the key players at the DWP, successive government ministers, a string of conferences, the Centre for Psychosocial and Disability Research and involved together in the PCA and WCA. Atos and Unum continue to deny that they have any links with each other. However, they appear to swop CEOs and often share the same platforms at conferences and on government groups as noted. As DPAC’s sister campaign group Black Triangle posts show: MP Norman Lamb, (special political advisor to Nick Clegg) also seems to have trouble recollecting links with Unum. He denied any knowledge of a company named Unum going as far as to write to our very own minister Maria Miller. Lamb wrote:

xxxx xxxxxxxx informs me that a company called Unum Provident “has been convicted of major fraud and banned from trading in many States in the US” up until 2008. He states that this company has been advising the DWP on welfare reform since the early 1990s. He also states that the current Atos Chief Medical Officer, Mike O’Donnell, had been Chief Medical Officer of Unum from March 2000 to September 2010.  Is all this true?  Can you let me know exactly what the Government knows about the position relating to Unum Provident and its relationship with Atos healthcare?

The post on the Black triangle site continues:

Imagine my surprise and shock then considering the above to discover this morning while doing some research online about connections between Atos & Unum, particularly the relationship between Mike O’Donnell – Chief Medical Officer – Atos Healthcare and Peter O’Donnell – Executive Director, Chief Financial Officer – Unum Insurance, (brothers perhaps? Anybody know?), to find out that good old Norman last Tuesday was a guest speaker at a Unum hosted fringe meeting at the LibDem Conference speaking alongside Peter O’Donnell, the Chief Financial Officer of Unum Insurance –

Speaker/Artist(s) Info: Norman Lamb MP; Teresa Perchard, Director of Public Policy, Citizens Advice; Nick Pearce, Director, IPPR; Peter O’Donnell, Chief Financial Officer, Unum. Chair: Patrick Hennessy, Sunday Telegraph.

Time: Tuesday September 20, 2011 6:15pm – 7:30pm

Venue: Hyatt Regency: Fortissimo2 Bridge Street, BirminghamB1 2JZ

Type: LibDem → Panel

Host Organization(s): IPPR, Unum

It’s also worth recognising the media representation at this too. As noted Unum continue to deny any involvement with Atos and vice versa, yet Unum was providing insurance for Atos workers up until 2009. On Unum’s rather amusing ‘Ask Unum’ site, clearly set up so that they can continue denying what is a matter of record in many instances, they state: “Unum UK currently has no relationship with ATOS Ltd. Until September 2009, it provided Income Protection to ATOS Ltd for ATOS’s staff” .Should they also add that the previous chief medical officer of Unum installed at Atos in 2011 had nothing to do with Unum before that time too?

Additional information on Atos partners has been requested through a Freedom of Information request to the DWP by P. Wilkinson (2011)[26] this asks which third parties Atos works with. The response states:

Atos Healthcare have advised that to release the name of the private company they have appointed to investigate the handling of complaints would affect the basis of the contract between Atos Healthcare and that company and would have contractual and commercial implications for Atos Healthcare.

As part of their preparation for Independent Tier (IT) arrangements under the new Contract, Atos Healthcare proposed and DWP agreed that details of the private company they have appointed to investigate the handling of complaints be withheld to ensure independence. This proposal and agreement took the form of an entry in the contract as follows: “The name of this firm will not be divulged to any third party to ensure continued
independence”.  

Can we guess who it is yet? The phrase ‘all in it together’ comes to mind –maybe this is what Cameron was actually talking about. But, what of Unum’s own useful criminal record to the Coalition?

Disability Denial: an alliance between Unum and the State

When the links between the profiteers in the misery of disabled people and the ideologies of denial are exposed what we are left with? First this is not about getting people into work, whatever the Tories and previous governments claim  they don’t care if you work or not. Media rhetoric[27] on scroungers, workshy and other protestations of undeserving poor were part of the strategy to change public opinion helped along by misleading DWP press releases. This is about denying benefits, denying illness and denying incapacity. It is not about even about ‘thinking yourself well’ or tortured nonsensical models shored up by dubious academics: It’s about something Unum have a successful history of: it’s about denying pay outs and capitalising on fear and risk.

The denial of pay outs may be through Unum’s insurance policies or it may be through denying pay outs after an individual has paid a life-time of national insurance contributions to the state-but is put on time limited Employment and Support Allowance- the outcome will be same. Who better to work with ex-banker Freud and MP’s in denying people their rightful entitlements than a company which has been publically named as: “an outlaw company- It is a company that for years has operated in an illegal fashion[28]” by California Insurance Commissioner John Garamendi in 2005, where Unum were charged with more than 25 violations of state law and fined $8 million. Among the charges were:

 ….that the company knowingly applied the wrong legal definition of disability in denying claims or ruling claimants were able to go back to work, targeted high-cost claims for denials to save the firm money, misused claimants’ medical records and even the opinions of in-house medical personnel to deny benefits and wrongly sought to file cases under a federal benefits law that severely limits claimants’ ability to successfully sue their insurers.

Reads like the work theory of Atos doesn’t it? These charges followed a financial settlement in the previous year in which 48 other U.S states raised critical issues on Unum’s working methods.

Rutherford argues:

in the 1980s Unum, and insurance companies Provident and Paul Revere were in trouble in the U. S. They had increased profits by sharing similar policies on disability and sickness insurance and selling to professionals. A combination of falling interest rates and the growth of diagnosed illnesses which were not subject to the insurance sector’s tests appeared to be increasing, affecting the professionals who had taken out policies with the companies, and in turn affecting company profits. These illnesses included: Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS), Fibromyalgia, Chronic Pain, Multiple Sclerosis, Lyme disease.

An aggressive ‘Chronic Fatigue Syndrome plan followed, with claims being managed in a way that continued to maximise profits. The insurance industry called on the academics, Professor Simon Wessely of King’s College and Professor Michael Sharpe of Edinburgh University (both participants in the Woodstock conference) in an attempt to reclassify those conditions that were costing money, and lobby the medical profession on such conditions so they fell outside the remit of ‘pay outs’. It meant that specific illnesses were targeted in order to discredit the legitimacy of claims.

This ‘strategy’ was to prove useful in dealing with the UK’s welfare reform and in overriding the basis of medical opinion on a whole set of conditions. As the state joined in the denial with its set of private companies and supporting academics Unum achieved more market returns while disabled people began to see their own welfare support rapidly diminishing.

Capitalising on Fear: how the denial of state support improves Unum’s profit margin

Unum couldn’t lose, as early as 1997 with the roll out of the All work Test, in which Lo Casio had had played a major part, Unum launched an expensive advertising campaign. One ad ran:

April 13, unlucky for some. Because tomorrow the new rules on state incapacity benefit announced in the 1993 autumn budget come into effect. Which means that if you fall ill and have to rely on state incapacity benefit, you could be in serious trouble[29].

Lo Cascio replied in the negative when Private Eye asked if he was concerned about the conflict of interest involved in his company’s advertising campaign, which sought to gain from benefit cuts that he had helped to initiate. However Unum Chairman Ward E. Graffam did acknowledge the ‘exciting developments’ in Britain. Unum’s influence in government was helping to boost the private insurance market:

The impending changes to the State ill-health benefits system will create unique sales opportunities across the entire disability market and we will be launching a concerted effort to harness the potential in these.’[30]

In 2012 the worst aspects of welfare reform were pushed through by multi-millionaire ex-banker Freud: including over a million disabled people expected to be completely removed from Incapacity benefits and unable to qualify for Employment Support Allowance (ESA) through more stringent testing by Atos, 12 month time limits on ESA to include those with terminal illness, and an additional half a million set to lose Disability Living Allowance and be ineligible for Personal Independence Payments amongst the regime. The fraud of the government rhetoric claiming to be supporting ‘those in most need’ was almost complete with the closure to new applicants for the Independent Living Fund (ILF) in 2010 and ILF’s expected closure in 2015. To celebrate Unum happily launched another set of advertising campaigns in 2012 advising people that the state wouldn’t support them and that they should take out insurance against sickness and disability.

A Tale of two Models: Disabled People vs Unum, Atos, Governments and Disability Charities

The social model and the bio-psychosocial model have each had powerful affects on disabled peoples’ lives. However they are two completely different animals and we must never succumb to the government’s attempts to conflate them. It’s quite clear which model gives most to disabled people and which is being used to take away disabled peoples’ rights and their right to dignity . It is quite clear why we should continue to rage against the current imposition of the market regime of misery. It is quite clear why we should continue to support and use the social model of disability: a model with its rooted in the experiences of those incarcerated in a Leonard Cheshire Disability Charity institution: One of the disability charities that continue to profit from disabled peoples’ misery by sitting at the table with governments, Atos and Unum ‘helping’ the progress of the WCA and gaining from lucrative government contracts for work programs- with their and other charity support disabled people don’t need enemies.

The increases in the recorded suicides of disabled people brought about by the fear and misery imposed on disabled people through the current neo-liberal regime is likely to grow. Yet, the worsening situation of the many being denied support to which they are entitled to through national insurance contributions, through the most basic notion of human rights, the UN Convention on the Rights of Disabled Persons, and the European Convention on Human Rights will not affect the income or profits of the private companies or the disability charities involved .

This is not about getting people into work- there are no jobs, much less jobs for disabled people. It is not about even about ‘thinking yourself well’ or tortured nonsensical models shored up by dubious academics in the pay of Unum. This is about denying benefits, denying illness and denying disability: It’s about something Unum have a successful history of:  denying pay outs for disabled people while capitalising on fear and risk. It’s about an ideological regime of misery and austerity in the twelfth richest country in the world.

It amounts to the biggest government benefit fraud in social welfare and human rights in contemporary history.

twitter: @redjolly1

Acknowledgements

With thanks to Ann Whitehurst for sending me Jonathan Rutherford’s excellent piece in Soundings (on which some of this is based) and other pieces explaining how poverty and disability were being remade as an individual attributes rather than a societal failings by the right wing. Thanks to Bob Williams Findlay for his helpful comments. Thanks also to Julia Cameron for her comments, sending numerous links and information and urging that this (or something like this) should be written, and to all those activists past and present who will continue to fight for the rights of disabled people using the social model and who usually also say Rights not Charity! You know who you are…..

For online texts on the social model and disability issues see: https://www.leeds.ac.uk/disability-studies/archiveuk/



[3] Oliver, Mike The Politics of Disablement

 

https://www.leeds.ac.uk/disability-studies/archiveuk/archframe.htm

[4] DISABLED PEOPLE IN BRITAIN AND DISCRIMINATION A

Case for Anti-Discrimination Legislation https://www.leeds.ac.uk/disability-studies/archiveuk/archframe.htm

 

[5] https://www.leeds.ac.uk/disability-studies/archiveuk/Abberley/chapter10.pdf

[6] https://www.leeds.ac.uk/disability-studies/archiveuk/Oliver/in%20soc%20dis.pdf

[7] The Social Model of Disability: Myths and Misconceptions https://www.leeds.ac.uk/disability-studies/archiveuk/archframe.htm

 

Dec 182011
 

DWP Atos Healthcare Business

source: https://www.whywaitforever.com/dwpatosbusiness.html

Abstract

Information on how Atos Origin and Unum run their businesses and their impact on the DWP ESA and Atos Healthcare medical examinations and assessments.

 

For an excellent overview I commend: ATOS HEALTHCARE OR DISABILITY DENIAL FACTORIES: RESEARCH SUMMARY (https://blacktrianglecampaign.org/2011/08/23/important-read-circulate/).

This page is published in the public domain and is uncopyrighted. Feel free to copy. See Copyleft (https://www.gnu.org/copyleft/)

 

This website provides information on how Atos runs its business, extracts from the Contract between the DWP and Atos including the MEDICAL CONDITIONS that mean a face to face medical assessment is not always necessary, ASSESSMENTS AND POINTS, the breaches of Contract that occurred in my case, my unsound medical report and the correspondence showing how difficult it is to obtain justice or advice.

 

The Government is inviting the public to submit petitions. Search epetitions.direct.gov.uk for “DWP” or “Atos” or “disabled” to list relevant petitions including Stop and review the cuts to benefits and services which are falling disproportionately on disabled people, their carers and families (https://epetitions.direct.gov.uk/petitions/20968).

Other ongoing petitions are Petition against constant vilification of sick and disabled claimants and Petition to “Sack Atos Immediately” .

The DWP occasionally consults the public https://www.dwp.gov.uk/consultations/.

Atos Origin IT Services UK Limited (Atos Healthcare)

Atos Origin appears to have followed the approach of the discredited Unum company in the US. Unum in the US describes the fines in the US for operating “disability denial factories”. Unum in Wales describes Unum’s funding of the activities of Professor Mansel Aylward, the former Chief Medical Adviser at the DWP and head of the UnumProvident Centre, Cardiff University. Unum in the UK describes their activities in the UK including their contributions to creating the regulations that implemented the Welfare Reform Act.

In 2001 Schlumberger bought SEMA for $5bn. In 2003 Atos Origin bought Schlumberger SEMA, an IT Services company. At that time the Atos Origin had 50,000 staff and annual revenues of €5bn.

Reuters reported in February 2010 on KPMG. It mentioned that KPMG sold its original consulting practice to IT services group ATOS Origin in the wake of the Enron scandal (https://en.wikipedia.org/wiki/Enron_scandal). Many executives at Enron were indicted for a variety of charges and were later sentenced to prison.

Atos Origin has such a poor track record. The examples below are just a few of those that highlight the way this company is managed and operates after the DWP hired Atos Origin.

Atos Origin claim on their website in September 2010.

DWP Disability Assessments:

Atos Healthcare conducts DWP disability assessments for people claiming a range of disability benefits including Employment Support Allowance, Incapacity Benefit, Disability Living Allowance, and Industrial Injuries Disablement Benefit. Each year we process over 1.2 million referrals for medical advice and provide over 800,000 face-to-face medical assessments via our nationwide network of over 140 medical examination centres.

Atos Origin IT Services UK Limited are on the Goverment’s preferred supplier list. Why? If you feel strongly, please write to or email your MP to ask why Atos Origin is still able to compete for Goverment contracts. (MP email addresses: https://www.parliament.uk/mpslordsandoffices/mps_and_lords/alms.cfm)

Cancer patients threatened – December 2009

 

The Telegraph on 6 December 2009

https://www.telegraph.co.uk/health/healthnews/6743920/Cancer-patients-forced-to-undergo-cruel-interviews.html

Seriously ill cancer patients are being forced to undergo “cruel” back-to-work interviews despite the fact they should be exempt, charities warned today.

Those who are terminally ill or undergoing chemotherapy or radiotherapy are being threatened with benefit cuts if they do not attend the meetings, according to Macmillan Cancer Support and Citizens Advice.

The “fit for work” interviews are for people seeking the employment and support allowance (ESA), which replaced incapacity benefit and income support in October 2008.

De Beers sue Atos – April 2009

 

The Daily Mail on 13 April 2009

https://www.dailymail.co.uk/money/article-1169753/Diamond-giant-De-Beers-sues-IT-firm-8-6million-row.html

Diamond company De Beers has launched an £8.6m compensation claim in the High Court following a row with software group Atos Origin.

…But as work progressed, De Beers became concerned about progress and slippages in the timetable for delivery of software….

Loss of confidential data – November 2008

 

Inquiry into loss of confidential data on 12 million website users.

The Independent on 3 November 2008 by Kim Sengupta.

https://www.independent.co.uk/news/uk/home-news/inquiry-into-loss-of-confidential-data-on-12-million-website-users-986837.html

An investigation is underway after a memory stick with user names and passwords for a government computer system was found in a pub car park, leading to the shutting down of the website as a security precaution.

With critics lambasting the latest security breach, the Prime Minister intervened in the affair to say that the Department for Work and Pensions would be taking action and the company which lost the information, Atos Origin, could face changes to its five year contract worth 46m.

The memory stick lost in the latest incident was found in the car park of the Orbital pub in Cannock, Staffordshire, where Atos Origin is based.

Patients recalled for scans – April 2007

 

900 patients to be recalled for scans

Manchester Evening News on 5 April 2007 by Amanda Crook

https://www.manchestereveningnews.co.uk/news/s/1003/1003729_900_patients_to_be_recalled_for_scans.html

UP TO 900 people are to be recalled for medical scans after a series of blunders by a private company.

NHS bosses last month suspended tests being carried out by Atos Origin at centres in Manchester, Salford, Bolton, Stockport, Oldham, Wigan and Liverpool, after discovering technical and administrative problems.

Now regional health bosses are set to write to the 900 patients who had ultrasound tests to investigate conditions like kidney, prostate and abdominal problems at Atos centres to offer them the chance to be re-scanned at NHS hospitals or private companies.

Clinic faces second investigation – November 2006

 

Following complaints by a former GP at the privately-run NHS Walk-in Centre at Canary Wharf, the Nursing and Midwifery Council has started an investigation.

…nurses at the centre were expected to do work for which they were unqualified and were consequently putting patients at risk.

https://www.bbc.co.uk/print/london/content/articles/2006/11/24/walkin_clinic_feature.shtml

Errors block benefits – May 2006

 

Errors block benefits to disabled

BBC on Saturday on 20 May 2006 by Geoff Adams-Spink, BBC News website age & disability correspondent

https://news.bbc.co.uk/1/hi/programmes/4995078.stm

Almost 80,000 sick and disabled people a year are being wrongly denied benefits, according to a BBC investigation for Radio Five Live.

It has emerged that medical reports on people claiming some benefits are unreliable or inaccurate.

As a result, thousands claiming Incapacity Benefit or Disability Living Allowance have had to appeal.

The government says that it is “responding positively” when criticisms are made.

The investigation found that some handwritten medical reports were altered so that the meaning was completely changed, while in other cases a computer-based medical questionnaire produced misleading or nonsensical information.

Atos Origin doctors send their reports to civil servants who make a final decision about a person’s entitlement.

DWP hires Atos Origin – March 2005

 

DWP hires Atos Origin to provide medical assessments.

Personnel Today on 18 March 2005 by Dan Thomas

https://www.personneltoday.com/articles/2005/03/18/28715/dwp-hires-atos-origin-to-provide-medical-assessments.html

The Department for Work and Pensions (DWP) has awarded services company Atos Origin a £500m seven-year contract for the delivery of medical advice and assessment services.

The Department for Work and Pensions (DWP) has awarded services company Atos Origin a £500m seven-year contract for the delivery of medical advice and assessment services.

Under the contract, Atos Origin will manage the provision of medical advice and assessments on behalf of the DWP for benefits including Incapacity Benefit, Disability Living Allowance, Industrial Injuries Disablement Benefits, and others.

In addition, services will also be provided to the Ministry of Defence Veterans Agency.

Revenue

The highlights that relate to the financial information published on the Atos Origin (https://www.atosorigin.com/) website.

2010 Quarter 1 Revenues

  • First quarter 2010 revenue: EUR 1,231 million
  • Order entries up: +17 per cent
  • Book to bill ratio: 128 per cent
  • Further reduction of net debt: down to EUR 130 million

…reported revenue of EUR 1,231 million for the first quarter of 2010 representing a decline of -5.5 per cent at same scope and exchange rates….

…Several new contracts were signed during quarter one including …Vehicle and Operator Services Agency (VOSA) (https://www.dft.gov.uk/vosa/) in the United Kingdom for Managed Services….

…In Medical BPO, the revenue was EUR 40 million, representing 3 per cent of the Group and was up +7 per cent thanks to an increase in the number of medical assessments processed in the United Kingdom….

Revenue by Global Business Unit

In EUR Million Q1 2010 Q1 2009 proforma % organic growth
UK 211 216 -2.4%

In the United Kingdom, revenue totalled EUR 211 million down -2.4 per cent organically. In Managed Services, the revenue increased +2 per cent thanks to the growth in the Public Sector and Financial Services markets. Systems Integration was down in the Private Sector while it remained strong and growing in the Public Sector. In Consulting, revenue decreased by EUR -3 million due to lower revenue in Health while the Financial Services market started to recover. In HTTS, the revenue grew +8 per cent with the ramp-up of the contract with Capita and an increase in payment transactions. Finally, Medical BPO reported a +7 per cent growth mainly thanks to the increase of transaction volumes.

… including the acquisition of the company Shere (https://www.shere.com/) in the United Kingdom …

Forthcoming events

  • 27 May 2010 – Annual General Meeting
  • 28 July 2010 – First Half 2010 results
  • 14 October 2010 – Third quarter 2010 revenue

2009 Results

  • Operating Margin: 5.7 per cent up by more than +80 basis points
  • Group net debt reduced by EUR 165 million
  • Revenue: EUR 5,127 million down organically -3.7 per cent

Thierry Breton, Chairman and CEO of Atos Origin declared: …I am proud of our clients’ trust in Atos Origin …

…Representing 3% of the Group, Medical BPO revenue was EUR 153 million, up +3.5 per cent at constant scope and exchange rates. This business is fully operated in the United Kingdom only with increasing volumes with all the major clients, particularly for occupational health services….

…The United Kingdom reported organic growth of +7.4 per cent thanks to the contribution of Managed Services;…

Operating Margin

…In the United Kingdom in all business lines with a profitability at 9.1 per cent representing an increase of +180 basis points compared to 2008;…

…In France where the profitability improved by almost +180 basis points at 3.9 per cent essentially thanks to Systems Integration which reported a margin rate at 3.0 per cent compared to 0.6 per cent in 2008;

In the Rest of the World where operating margin increased from 3.9 per cent to 6.5 per cent of revenue.

The main signatures of the fourth quarter were: in the United Kingdom, in Managed Services with Brakes in manufacturing, in finance with Capita Life & Pensions; in the public sector with Skills Development Scotland (https://www.skillsdevelopmentscotland.co.uk/) and with UK Government Gateway (https://www.gateway.gov.uk/) in High Tech Transactional Services (HTTS) .

…The full qualified pipeline as of 31 December 2009 was EUR 3 billion up +14 per cent compared to 2008, mainly thanks to HTTS and Medical BPO; Systems Integration showed a slight increase.

OPERATING PERFORMANCE BY SERVICE LINE

  Revenue Operating Margin Operating Margin %
In EUR Million FY 2009 FY 2008 % growth FY 2009 FY 2008 FY 2009 FY 2008
Medical BPO 153 148 +3.5% 19.6 12.6 12.8% 8.5%
OPERATING PERFORMANCE BY GLOBAL BUSINESS UNIT

  Revenue Operating Margin Operating Margin %
In EUR Million FY 2009 FY 2008 % growth FY 2009 FY 2008 FY 2009 FY 2008
UK 902 840 +7.4% 82.1 61.3 9.1% 7.3%

Academia

Governments, like companies, like to pick and choose those elements of research that best fits the short term objectives of the time. There are rigorous scientific and engineering disciplines and there are those which are less so. Academics are asking the following questions and similar.

  • Is eugenics scientifically credible even if socially unacceptable?
  • How did eugenics relate to “Survival-of-the-fittest” Social Darwinism?
  • How does “welfare-to-work” and “fit-for-work” relate to Social Darwinism?

Prior to World War 2, there was a widely held view that there was some evidence of correlation between social behaviour and the physical characteristics of individuals. It was suggested that individuals with particular features were more likely be “criminal” types and so, to protect society, should be placed in locations where their activities can be closely monitored. Politicians can influence scientific opinion.

The rational scientific world has seemed to have moved on from the primitive and barbarous view of many religions, widely held until recent times, that sickness is a punishment by a deity and as such is just if prayers or votive offerings fail to cure the sickness. Irrational delusions can influence politicians.

Welfare to Work

Here is an extract from some of the information published on the London School of Economics (LSE) (https://www.lse.ac.uk/) website. Document locations change frequently so it is best to use the search facility.

The research of Lord Richard Layard and Stephen J Nickell has strongly influenced labour market reforms in Europe.

Lord Richard Layard is emeritus professor of economics at LSE and a Labour life peer in the House of Lords. Stephen Nickell is Warden of Nuffield College, University of Oxford, and was previously a professor of economics at LSE and a member of the Bank of England Monetary Policy Committee.

They have produced ground-breaking work on the relationship between labour market institutions and unemployment. Their research provided a theoretical and empirical framework for the analysis of equilibrium unemployment and the impact of labour market institutions on economic performance.

The “welfare-to-work” approach now adopted by many nations draws on their finding that generous unemployment benefits need not be detrimental if they are granted only for a limited time and are accompanied by adequate instruments that require (and assist) unemployed individuals who are able to work to actively search for a new job.

Other work by Layard and Nickell provides evidence that stricter employment protection regulations do not generally increase the level of unemployment, but increase the persistence of unemployment by reducing short-term unemployment at the cost of raising long-term unemployment.

They have also shed light on the interaction between wage setting institutions and unemployment. In particular, they were able to show that higher union coverage tends to increase unemployment, but these negative effects of collective wage bargaining can be offset if unions and employers coordinate their wage bargaining activities effectively.

Individuals and the state have a duty of care to the less fortunate. Concepts such as “welfare to work” and “fit to work” may or may not be appropriate for the able but it is clear that these concepts can and do place more pressure on the unemployed dying, sick, disabled and their carers.

Social Darwinism, if it means anything, it means weeding out the less strong in society. If this is the intent of Parliament it should be clearly stated. The Welfare Reform Act is not clear in this respect. However the implementation of the Welfare Reform Act by Atos Healthcare appears to conform to the spirit and practice of Social Darwinism.

Civilisation allows man to rise above a “survival of the fittest” world. The judgements handed down at the Economists, Lawyers and Doctors Nurnberg Trials are as appropriate today as they were in 1945.

Fit For Work and Fit Notes

Even as a medical layman, there seems to be some minor medical conditions where “fit to work” assessed though a medical examination undertaken by someone without access to the patient’s medical history or without specialist knowledge might be possible. If my leg was broken and there were no complications and it was taking longer than the time allowed before an ESA form needed to be completed, then a “few simple physical tests” might be sufficient for a “fit to work” assessment.

Atos Healthcare has confirmed in writing to the Health and Safety Executive that their medical assessment comprises only a “few simple physical tests”.

In the real world, the Secretary of State does not give a breakdown of the medical conditions of those denied allowances. If she said what these medical conditions were and she put forward medical experts who agreed with her that a “few simple physical tests” was sufficient to deny allowances, then concerns would lessen. Instead we hear of dying cancer patients and people with autism denied allowances, this is a concern.

https://www.personneltoday.com/articles/2008/03/17/44952/dame-carol-black-calls-for-urgent-reform-to-workplace-health.html

Dame Carol Black has called for a new approach to work-related health services, after her review found that ill health was costing the country £100bn annually.

Dame Black has been commissioned by the Department for Work and Pensions (DWP) to advise on how to improve the health of those in work and reduce the number claiming sickness benefits.

Black questioned the current sick note system, which she said concentrated on what people cannot do instead of what they can. She recommended that doctors’ written sick notes should be replaced with an electronic “fit note”, explaining what people were able to do even if they were ill.

Business Influences

At times it seems the UK Government have been influenced more by financial considerations rather than by medical considerations.

UnumProvident in the US

My case suggests that there are similarities between the approach taken by Atos Healthcare and that of UnumProvident.

In 2007 the American Association for Justice named Unum in the top 2 of worst insurers. In 2005 the California Insurance Commissioner described Unum (formerly Unum Provident) as an outlaw company and it is a company that has operated for years in an illegal fashion. BBC Scotland on the 6 November 2007 produced a documentary on Unum. https://www.youtube.com/watch?v=VVqCSmHnIPE

https://www.lawyersandsettlements.com/articles/10429/first-unum.html

Back in 2002, a class action lawsuit charged UnumProvident (now First Unum or Unum) with operating “disability denial factories”. The company also faced thousands of lawsuits filed by individuals who were denied disability claims. Despite jury verdicts against the insurer (in January 2003, a California jury reached a US$31.7 million against UnumProvident and two years later, the California Department of Insurance fined the company US$8 million because it “misinterpreted job classifications, improperly overruled doctors’ opinions and knowingly used incorrect insurance definitions to avoid paying benefits”), Unum continues bad faith insurance practices.

Unum Group (formerly UnumProvident) holds about one quarter of the disability insurance market in the US, making it one of the largest providers of group disability insurance in the country.

In 2004 and 2005, regulators ordered Unum to re-evaluate thousands of denied claims. According to the LA Times (April 12, 2007), the company reviewed less than 10 percent of the 290,000 claims eligible for review and potentially, re-instatement of benefits.

The Unum view is published on the Unum (https://www.unum.com/) website. Document locations change frequently so it is best to use the search facility.

Unum press release: (https://www.investors.unum.com/phoenix.zhtml?c=112190&p=irol-newsArticle&ID=763320&highlight=)

UnumProvident Reaches Settlement with California Department of Insurance; ‘Changing Landscape’ May Impact Cost, Availability of Disability Insurance in State

CHATTANOOGA, Tenn.–(BUSINESS WIRE)–Oct. 3, 2005–UnumProvident Corporation (NYSE: UNM) today announced that three of its insurance subsidiaries have entered into a settlement agreement with the California Department of Insurance, concluding a market conduct examination and investigation of the subsidiaries’ disability claims handling practices. As part of the settlement, UnumProvident has agreed to change certain practices and policy provisions related to its California business and consistent with California case law. The settlement also incorporates claims handling practices previously covered by the multistate agreement reached last year with 48 other states, and includes certain additional claim handling changes. Additionally, UnumProvident has agreed to pay a fine of US$8 million to the Department as part of the settlement.

Added Watjen, “Over the past two years, our company has undertaken broad changes designed to improve the quality of claims decisions and our service levels to policyholders. We made many changes during this time to improve in these areas, and added to those through the multistate settlement that was previously approved by 48 other states. Because of this, we do not believe that California’s allegations or the market conduct exam report, which is essentially a snapshot from a prior period, provide an accurate portrayal of our claim practices today.

Psychosocial and Disability Research (UnumProvident Centre) Cardiff University

UnumProvident Centre provides funding for Psychosocial and Disability Research based at Cardiff University. The Director of the Centre is Professor Mansel Aylward. He is the former Chief Medical Adviser at the DWP and was instrumental in the DWP accepting the UnumProvident concepts applied in the US and was influential in how the Welfare Reform Act should be implemented.

It is bellieved that the UnumProvident Centre has been one of the leading forces in trying to make it harder for allowances to be paid to the dying, the sick, the disabled and their carers. Staff from UnumProvident were important in the design of the Personal Capability Assessment and of the new, much harsher Work Capability Assessment required if an Employment and Support Allowance is to be paid.

Professor Aylward continues to be involved in research for the DWP. He has provided support for Dame Carol Black, proponent of the replacement of sick-notes with “well-notes”.

The UnumProvident Centre carries out research into “presenteeism”. “Presenteeism” is the culture of working ridiculously long hours and not taking time off when sick. Professor Aylward has been quoted that “presenteeism” costs the country ten times more than sickness absence. It seems ironic that in addition he has been quoted as saying, “The problems come from people who are ill, those who are not up to the mark, who are continuing to work.”

The allowance paid for ESA(C) is just under £90 per week. The current “National Minimum Wage”, set in October 2009, is £5.80 per hour. If a 40 hour week is worked, the weekly pay, before tax and NI, would be £232. The unemployed dying, the sick, the disabled and their carers have to live on just under £90 per week and for this amount have to attend repeated assessments and “pathways” meetings.

Professor Aylward and Cardiff University appear to be distancing themselves from Unum. Here is an image from the Cardiff University research spotlight page taken on November 2011 (https://www.cardiff.ac.uk/research/spotlight/publichealth/).

Unun

UnumProvident in the UK

The key phrase is “The U.K. market is still in many respects underdeveloped…”. In the USA, individual states have a Department of Insurance to protect people from unfair business practices. Perhaps the UK needs a similar body to protect people from similar unfair business practices.

https://www.fundinguniverse.com/company-histories/UnumProvident-Corporation-Company-History.html

1990: Unum acquires National Employers Life Assurance Co. Ltd., the largest disability provider in the United Kingdom.

UnumProvident CEO Watjen Says Company Poised to Capitalize on Emerging Trends in Employee Benefits

PORTLAND, Maine (May 17, 2006) – In his comments to stockholders at the company’s annual meeting today, Thomas R. Watjen, UnumProvident Corporation (UNM) president and chief executive officer, outlined the progress the company has made over the past two years and said that, while challenges lie ahead, the future holds great promise.

Watjen added that the company is also poised to capitalize on opportunities in the United Kingdom, where UnumProvident is the largest provider of group disability insurance. “The U.K. market is still in many respects underdeveloped, with less than 10 percent of employers offering group disability coverage. As the market leader, UnumProvident is in a unique position to help educate buyers to the need for this coverage.”

Please note that The Regulations in July 2008 were created with the assistance of the following UnumProvident staff.

  • Sue Godby, College of Occupational Therapists and Unum Provident
  • Dr Peter Dewis, Disability Analyst and Customer Care Director, Unum Provident

Why would such a discredited company be involved?

Share and Stock Ownership

Private equity funds interested in the healthcare services market are likely to have significant Atos Origin and Unum holdings.

28 September 2008, Centaurus Cap Sells Half of Atos Origin Stake to PAI Partners.

Parliament

A number of Honourable MPs have asked questions in Parliament to draw attention to the abuse of the dying, the sick, the disabled and their carers. See DWP Atos Politics for more details on press comment and extracts from Hansard.

The National Audit Office (https://www.nao.org.uk/) should review the accounts and check the audit records and see how Atos Healthcare delivers the contracted for service at the cost levels that have been reported to Parliament.

Transformation of the Personal Capability Assessment

The relationship between the DWP, Unum and Atos Origin is very close. The Technical Working Groups were chaired by Dr. Moira Henderson, Head of DWP Health and Benefits Division.

Report of the Physical Function and Mental Health Technical Working Groups (https://www.dwp.gov.uk/docs/tpca.pdf)

Commissioned by the Department for Work and Pensions – September 2006

As part of implementation of the Government’s proposals for welfare reform, the Department for Work amd Pensions’ Health, Work and Wellbeing Directorate was commissioned to develop proposals for transforming the Personal Capability Assessment(PCA) from an incapacity-based tool for determining entitlement to Incapacity Benefit, to a more positive assessment incorporating assessment of capability and of health related interventions which would contribute to overcoming health-related barriers preventing people with disabilities from engaging in work.

Annex C – working group and consultative group members

Mental Health Technical Working Group

  • Sue Godby, College of Occupational Therapists and Unum Provident
  • Dr Angela Graham, Atos Origin

Physical Function Technical Working Group

  • Dr Peter Dewis, Disability Analyst and Customer Care Director, Unum Provident
  • Dr Angela Graham, Atos Origin Medical Services

The DWP engaged Unum in September 2006 despite, as described above, in 2005 the California Insurance Commissioner described Unum (formerly Unum Provident) as an outlaw company and it is a company that has operated for years in an illegal fashion.

DWP and Atos Healthcare Mutual Appreciation

A mutual appreciation society.

Atos Healthcare wins customer delivery supplier of the year at the Department for Work and Pensions Supplier Excellence Awards London, 14 June 2010

The Atos Healthcare occupational healthcare programme was key in cutting the number of working days lost across the Department by 20% while improving employee wellbeing

London, 14 June 2010, Atos Healthcare, the number one occupational healthcare provider in the UK and a business division of Atos Origin, today announced that it won customer delivery supplier of the year at the Department for Work and Pensions (DWP) Supplier Excellence Awards held in London last week. The award recognises the contribution that the occupational healthcare programme delivered by Atos Healthcare has made in cutting the number of working days lost across the Department by 20%.

“Many congratulations to Atos Healthcare on their success at winning DWP’s inaugural Award for Excellence in Customer Delivery,” said Colin Herring, Programme Manager for Occupational health and Attendance Management at the DWP. “The service improvements that Atos Healthcare has delivered over the past 18 months have been key to our success at reducing sickness absence and improving employee wellbeing. As a result of this shared success, we have had the confidence to promote our joint approach as best practice across Government.”

Atos Healthcare took over management of the occupational healthcare service for the Department’s 120,000 employees in 2008. Working in partnership with the Department for Work and Pensions, Atos Healthcare has made significant improvements to processes and services. The benefits include returning employees back to work quicker, increasing employee productivity and providing more support to managers to deal with absence issues in a timely and effective manner.

The Occupational Health Service helped DWP reduce its current sick pay bill by around £13m annually and increase staff resource by the equivalent of nearly 1,000 full-time posts. Assessments can now be scheduled within 4 days and customer satisfaction has increased to 91%.

Improvements implemented by Atos Healthcare include the launch of a new web portal to make it easier, faster and more convenient to make an appointment and track cases; and new standards and an audit regime to ensure the quality of clinical advice.

“We are delighted that our occupational healthcare service has been recognised at the Department for Work and Pensions Supplier Excellence Awards,” said Gary Gear from Atos Healthcare. “The award is testament to our team of clinical and administrative experts who are committed to delivering a professional, high quality service that supports both the Department’s employees and the wider organisation. It also shows what we can achieve working in partnership with an engaged and proactive customer.”

DWP payments to Atos Origin

The DWP paid Atos Origin £80.6 million for the year March 2008 to February 2009.

Hansard Written Answer

https://services.parliament.uk/hansard/Commons/ByDate/20090714/writtenanswers/part015.html

The Department for Work and Pensions re-awarded Atos Origin IT Services Ltd., trading as Atos Healthcare, a new contract to perform medical services on behalf of the Department from 1 September 2005.

The total cost of these services from 1 March 2008 to February 2009 was 80,589,204. This figure not only covers the total number of examinations undertaken across all benefits, but also costs relating to written and verbal medical advice, fixed overheads, administrative costs, investment in new technology and other service improvements.

Using the Atos Origin 11% operating margin stated in the annual accounts for their UK business, the profit is an estimated £8.9 million.

Atos Origin Workload

Using figures given to Parliament I estimate the cost per assessment to be £135. For the work needed, if the work was undertaken as Parliament intended, this amount is far less than should be expected even if National Minimum Wage was paid to all staff involved. The Contract between the DWP and Atos Healthcare specifies “qualified” medical practitioners should be used.

Hansard

https://www.publications.parliament.uk/pa/cm200607/cmhansrd/cm071025/text/71025w0021.htm

In the 12 months to September 2007, Atos Healthcare undertook 528,380 personal capability assessments.

  • Income (£80.6 million) – Profit (£8.9 million) = Cost (£71.7 million)
  • Cost (£71.7 million) / 530,000 (assessments) = Cost per assessment (£135)

My case should have cost the time for a qualified medical practitioner to review my ESA information and then advise the DWP either my condition was terminal or my medical condition was not yet stable. In both cases the advice should have been to pay the allowance and defer indefinitely Work Focused Health Related assessments and Pathways to Work appointments. Atos Healthcare could have contacted the consultants whose contact details were all listed in the ESA information submitted. They did not contact my GP or my consultants.

If Atos Healthcare had carried out the above procedure and if they used a medically qualified practitioner, as they are contractually obliged to do, it would near impossible to do this work for around £135.

Of course Atos Healthcare decided on a much more profitable approach. In addition to the above they added the costs of making unnecessary appointments and a two hour interview by a medical practitioner without specialist knowledge and without access to the medical history. They added their handling charge of processing travelling expenses. Instead of charging £135 they should be able to charge the DWP at least ten times this amount. Atos Healthcare confirmed to the Health and Safety Executive that they run their operations in standard offices as they do not need specialist medical facilities. A very profitable piece of work for Atos Healthcare.

It is true that the Contract between the DWP and Atos Healthcare specifies that “redo” work will be paid for by Atos Healthcare. It seems that all complaints and appeals and other costs incurred by both Atos Healthcare and the DWP are paid for by the DWP. In my case the need for “redo” work has not yet arisen. A reasonable person might suspect that the motive for long delays in investigating and resolving complaints is to increase Atos Healthcare profits. To quote Dickens’ Bleak House, “Jarndyce and Jarndyce drones on”. If Dickens were alive today perhaps the plot of Bleak House would perhaps be concerned with the business practices of Atos Healthcare.

All the complaints and appeals procedures of Atos Healthcare have to be followed first. Then those of the DWP. Then those of the Parliamentary and Health Services Ombudsman. If Gilbert and Sullivan were alive today, I am sure they would draw attention to the absurdities. Unfortunately too many people are suffering and some of these die before their time, cold and uncared for. When I swooned and near fainted on the Tube after the medical assessment by Atos Healthcare, it would have been a very vigilant Coroner to put as my cause of death: Corporate Manslaughter through the negilience of Atos Healthcare.

Atos Origin Recruitment

Here is a recruitment that appeared September 2010.

Job Description
We are looking for experienced healthcare Recruiters whose main responsibility
will be the end to end recruitment of medical professionals. You will be working
in a fast paced, team environment, delivering a volume recruitment solution whilst
working towards tight deadlines.

As a Recruiter your main responsibilities will involve:
-Using proven negotiation and sales skills to "sell" Atos Healthcare opportunities to
 prospective candidates.
-Reviewing application forms and making decisions on the suitability of a candidate
 against a defined specification
-Carrying out telephone screening/interview calls of clinicians.
-Arranging subsequent interviews with Hiring Managers
-Assisting with organising and representing the company at local, national and on
 occasion, international recruitment campaigns, events and assessment days
-Analysing recruitment activity and process, producing statistics as required
-Regularly reviewing recruitment procedures and highlighting any areas of concern
 or areas of potential improvement to the Recruitment Manager.
-Liaising with the HR Department, issuing contracts and processing offer paperwork
-Liaising with the candidate and the training department to set up new entrant
 training courses at the nationally located academies
-Maintaining effective communication with candidates and internal and
 external customers
-Preparing accurate reports for management to enable
-Travelling across the UK and NI to attend interviews, workshops and meetings

As a Recruiter your skills and qualifications will include:

-Strong healthcare recruitment experience, preferably clinical recruitment experience
-Experience of working in high volume area
-Proven and demonstrable Negotiating/Influencing/Sales Skills
-Experience of compliancy procedures within healthcare
-Strong PC literacy including the use of MS Word and Excel.
-Ability to produce statistical reports
-Experience in database management
-Ability to work in a highly pressured environment and manage workload efficiently
-Excellent organisational skills
-Target focus and proactive approach
-Professional telephone manner

What we will be looking for in you:
As a Recruiter you will be an excellent communicator who is able to deal with
people in a caring, courteous and professional manner. You will also be an
initiative-taker with the time management and organisation skills needed
to meet deadlines.

The good news is this was for a temporary position which finishes December 2012. Hopefully Atos have been told their contract is not likely to be extended. It also suggests they have a high turnover of staff. It appears even those, like in my case, who are unable to read and write English up to the standard defined in the Contract are not willing to work for Atos. Who can blame them?