You’d have thought that The Guardian would have had a look through their own archives before entering into a lucrative “partnership” with Unum that has let it to heavily promoting the products of what has been described as, (in an article that appeared in their own newspaper in 2008), – “An outlaw company. It is a company that for years has operated in an illegal fashion”.
The work and pensions secretary, James Purnell, announced that all incapacity benefit claimants will face the new work capability assessment. Read the Hansard transcript and you get the strong impression of Labour triangulating the Tories.
In fact, welfare reform has been for some time a key battleground to outflank Cameron, by playing tough to the tabloids. In the process, the welfare state is being transformed by marketisation. As I’ve argued in other blogs, the Labour movement and centre-left generally have abandoned claimants to these reforms, having accepted the idea that workfare and its ideology of “active welfare” is a progressive measure.
In fact, the origin of active welfare – the idea that the poor are the cause of their own poverty because they fail to take advantage of the opportunities “available” to them – lies in the American right. For those who play by the rules, says Purnell, there is a world of opportunity. But for those who don’t, “there will be clear consequences from their behaviour”. So what are these rules, and who made them up?
The history of the work capability assessment provides some answers. In 1994, the Tory government hired John LoCascio, second vice-president of giant US disability insurance company, Unum, to advise on reducing the numbers successfully claiming IB. He joined the “medical evaluation group”. Another key figure in the group was Mansel Aylward. They devised a stringent “all work test”. Approved doctors were trained in Unum’s approach to claims management. The rise in IB claimants came to a halt. However, it did not reduce the rising numbers of claimants with mental health problems. The gateway to benefit needed tightening up even more.
In 1999, New Labour introduced its first Welfare Reform Act. All new claimants had to attend a compulsory work focused interview. Mansel Aylward, now chief medical officer of the DWP, devised a new personal capability assessment (PCA). The emphasis was no longer on entitlement, but on what a person is capable of doing. The task of administrating the PCA was contracted out and is now run by the US corporation Atos Origin. Its computerised evaluation of claims driven by clearance time targets has resulted in significant numbers of rejected claims, particularly for those with mental illness.
Unum has built up its influence in Britain. In July 2004, it opened its £1.6m Unum Centre for Psychosocial and Disability Research at Cardiff University. The company appointed Mansel Aylward as director following his retirement from the DWP in April. The launch event was attended by Archie Kirkwood, recently appointed chair of the House of Commons select committee on work and pensions. Malcolm Wicks, minister of state in the DWP, gave a speech praising the partnership between industry and the university.
The aim of the centre is to transform the ideology of welfare and so help develop the market for Unum’s products. In 2005, the centre produced a monograph The Scientific & Conceptual Basis of Incapacity Benefits (TSO, 2005) written by Aylward and his colleague Gordon Waddell. It provides the framework for the 2006 welfare reform bill. Its methodology is the same one that informs the work of Unum.
In a memorandum submitted to the House of Commons select committee on work and pensions, Unum define their method of working: “Our extended experience … has shown us that the correct model to apply when helping people to return to work is a bio-psychosocial one.” Waddell and Aylward adopt the same argument in their monograph. Disease is the only objective, medically diagnosable pathology. Sickness is a temporary phenomenon. Illness is a behaviour. IB trends are a social phenomenon rather than a health problem. The solution is not to cure the sick, but a “fundamental transformation in the way society deals with sickness and disabilities” (p123). The goal and outcome of treatment is work, because work is therapeutic. Worklessness is a serious risk to life. It is “one of the greatest known risks to public health: the risk is equivalent to smoking 10 packets of cigarettes per day” (p17). No one who is ill should have a straightforward right to incapacity benefit. David Freud adopts the same spurious sociology in his report.
In the US, Unum claims management had been coming under increasing scrutiny. In 2003, the Insurance Commissioner of the State of California announced that as a matter of ordinary practice and custom, it had compelled claimants to either accept less than the amount due under the terms of the policies or resort to litigation. The following year, a multistate review forced Unum to reopen hundreds of thousands of rejected insurance claims. Commissioner John Garamendi described Unum as, “an outlaw company. It is a company that for years has operated in an illegal fashion”.
This is the company that has played a leading role in shaping welfare reform in Britain. It has promoted the ideas behind the new work capability assessment. The more stringent the assessment, the more people fail it or fear failing it, and so the larger the potential market in private disability insurance. Fifty per cent of IB appeals against the refusal of claims found in favour of the claimant. In 80% of these, the problem was poor assessment of mental health problems. I doubt James Purnell would want to play by his own rules.
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