September 17th By George Berger for DPAC
Debbie Jolly, Jonathan Rutherford, and Mo Stewart have discussed the influence of UNUM on the Work Capability Assessment (WCA) . Here I study relations of UNUM to DWP and ATOS that implicate Professor Sir Mansel Aylward and a UNUM employee in apparent irregularities .
I begin with some history. Sir Mansel and others worked on the All Work Test (AWT) for a new Incapacity Benefit (IB) from 1993 to 1995. It was the first ‘functional capacity evaluation’ tool to use descriptors to assess ‘capacity for work,’ what one can do. The Social Security (Incapacity For Work) Act of 1994 placed them in a new regime intended to make access to disability benefits more difficult. The Act came into force in 1995 .
The AWT was rolled out in 1997, the year New Labour took power. As it did not adequately reduce inflow to IB, Aylward tightened it up, with others, e.g. UNUM’s John Locascio. The result was the Personal Capability Assessment (PCA) . The PCA did not decide on benefits. Decision Makers (with medical advice if necessary) did that. Entitlement to benefits as a perceived right gave way to granting themconditionally, upon compliance with the regime and the results of (re)assessments. This agrees with Tony Blair’s Third Way communitarian notions of social rights and obligations . We see a similarity of New Labour and Tory ideology: both are coercive and punitive, both use conditionality to instill fear of losing or not getting benefits.
The Sema Group, an IT firm with no medical experience , got the PCA contract in 1998. In that year ATOS ORIGIN (AO) contracted with the Department for Social Security (DSS, a predecessor of DWP) for IT work (renewed 2005). PCAs began in 2000. Schlumberger acquired the Sema Group in 2001 and AO acquired Sema on 29 January 2004. It began running the PCA for Blair’s DSS .
(Gordon Waddell, Pilowsky, and Bond modified the conservative American sociologist Talcott Parsons’ controversial sick role analysis of rights and obligations during sick leave , in a 1989 article on low back pain. Following Gill Thorburn’s discussion of the sick role in my note 2, reference b, I will show elsewhere that this paper is crucial to our understanding of benefit conditionality in the WCA).
The PCA was a paper – based assessment, which by 2001 had a large clinical database developed by AO and DWP . The decision was taken then to computerise the PCA. The resulting software was LIMA, Logic Integrated Medical Assessment. Trials began in 2002. LIMA was rolled out nationally in 2003, 2004 ,
and was operational by July 2004 at the latest, with AO in charge .
LIMA documentation included ‘LiMA v2 Technical Manual’, dated 12 October 2004, and ‘LiMA V3 Technical Manual’, dated 10 November 2005. A Schlumberger document of 11 August 2003 is ‘EBM Cardiorespiratory and Mental Health’ . According to a Black Triangle post, the first document is or was used in WCA assessments . Call this claim (*).
Angela Rhodes has been working for UNUM since 1999 . Documents ‘LiMA V3 Technical Manual’, and ‘EBM Cardiorespiratory and Mental Health’, both already mentioned, have her at ‘Training and Development Unit’ (an AO name) 3300 Solihull Parkway Birmingham Business Park Birmingham B37 7YQ’, today an ATOS address . As late as 2014 AO (ATOS since 2011) handled courses in ‘disability assessment medicine’ for the Faculty Of Occupational Medicine, with Ms Rhodes as a contact person in Birmingham. (The FOM website placed her at ‘Atos Origin’, with a Birmingham phone number and an AO email address ). We have then, an American insurer in direct contact with a French company that worked then on health matters for DWP, quite possibly influencing Government policy decisions, e.g. as follows:
Mansel Aylward joined the Civil Service in 1985. In 1996 he became Chief Medical Advisor, DSS and in 2000 Medical Director and Chief Scientist, DWP. He was appointed Professor at Cardiff University in October 2004, and headed its UnumProvident Centre For Psychosocial And Disability Research, starting June 2004 . Aylward left DWP in April 2005 . This conflict of interest is well – known (see my note 1, esp. Mo Stuart’s papers).
Now consider the document ‘LiMA v2 Technical Manual’, mentioned above. It states that in 2004 ‘The Medical Director for DWP’ was its ‘Owner and approver’. By B, this was Aylward. Thus we have,
(**) if (*) is true, then in 2004 Mansel Aylward owned
the document ‘LiMA v2 Technical Manual’ already
mentioned, which would later be used in the WCA.
One cannot conclude from all this that he knew in 2004 that
‘LiMA v2 Technical Manual’ mentioned above would be so used, or that he had ever worked on the WCA. But one can say by this document alone, that in 2004 Aylward owned and approved a LIMA document already mentioned, namely ‘LiMA v2 Technical Manual’, prepared by DWP and AO, and that this together with documents ‘LiMA V3 Technical Manual’ and ‘EBM Cardiorespiratory and Mental Health’ already mentioned, connect UNUM with AO and DWP via Ms Rhodes . This shows us an apparent irregularity involving Mansel Aylward:
his being in a position open to indirect influence by UNUM. Opinions can differ as to the propriety of this position. To some it is a temptation to corruption, to others an unacceptable irregularity. Moral political conduct by three governments – Brown, Blair, Cameron – would not have allowed Aylward’s position to exist .
- Debbie Jolly ‘A Tale of Two Models,’ http://dpac.uk.net/2012/04/a-tale-of-two-models-disabled-people-vs-unum-atos-government-and-disability-charities-debbie-jolly/ , Jonathan Rutherford ‘New Labour, the Market State, and the End of Welfare, ’ Soundings Summer 2007, https://www.lwbooks.co.uk/soundings/36/new-labour-market-state-and-end-of-welfare , Mo Stuart, Cash not Care, forthcoming, and her January 2015 paper at Research Gate,‘The influence of the private insurance industry on the UK welfare reforms’.
- I could not have written this without the constant inspiration and almost daily assistance of Gill Thorburn. See her well – argued and insightful articles at (a) https://internationalgreensocialist.wordpress.com/illness-as-deviance-work-as-glittering-salvation-and-the-psyching-up-of-the-medical-model-strategies-for-getting-the-sick-back-to-work/
and (b) https://blacktrianglecampaign.org/2012/09/18/dwpatosunum-scandal-an-academic-responds-with-disbelief-to-professor-aylwards-statement-to-black-triangle-and-dpac-outside-the-ifdm2012-conference-on-11th-september-2012/ .
- Gordon Waddell & Mansel Aylward, The Scientific and Conceptual Basis of Incapacity Benefits,TSO 2005. A key text.
- Rutherford, see my note 1, p. 42. E.g, the Howker Decision http://www.disabilityrightsuk.org/howker-v-secretary-state-social-securityaccessed 5 September 2016.
- See Tony Blair, ‘New community, new individualism’ 1993 & ‘The rights we enjoy, the duties we owe’ 1995. Both in his New Britain: My Vision of a Young Country. Fourth Estate, London,1996. It is worrying that such poorly argued talks helped determine New Labour’s policies.
- Beastrabban\’s Weblog, https://beastrabban.wordpress.com/2015/01/31/from-2000-sema-the-atos-of-its-day/ accessed 30 August 2016.
- Schlumberger website; AO http://atos.net/en-us/home/we-are/news/press-release/2005/pr-2005_03_16_02.html & http://atos.net/fr-fr/accueil/nous-sommes/newsroom/communique-de-presse/20040/pr-2004_01_29_01.html both accessed 31 August 2016.
- Talcott Parsons, The Social System, New York, Free Press 1951, Chapter X, also London, Routledge 2005.
- DWP was formed on 8 June 2001.
- ‘The Computer Says No’ Disability News Service 189, December 2005.
- ‘LIMA’ and that date occur in the Atos Origin Medical Services ‘Rapport Conference Special’, available at Maxwell Head’s issuu spacehttps://issuu.com/maxhead/docs .
- Dropbox links: (1) https://www.dropbox.com/s/yrot14lrt4vfhr6/LiMA%20v2%20Technical%20Manual2.pdf?dl=0 (2)https://www.dropbox.com/s/6agxw63t91fbxxp/LIMA%20V3.pdf?dl=0 (3)https://www.dropbox.com/s/ckgh3m4v03x78ex/SCHLUMBERGER%20EBM.pdf?dl=0
- https://blacktrianglecampaign.org/2011/06/08/lima-v2-technical-manual-download/ accessed 5 September 2016.
- https://touch.www.linkedin.com/?sessionid=2764603441055079&as=false&rs=false&can=https%3A%2F%2Fwww%2Elinkedin%2Ecom%2Fprofile%2Fin%2Fangela-rhodes-8b752815#profile/52062475/name:7XGp accessed 6 September 2016.
- http://uk.atos.net/en-uk/home/contact-us/locations/birmingham-business-park.html accessed 6 September 2016.
- http://www.fom.ac.uk/education/non-specialist-qualifications-and-training/diplomas/ddam accessed 1 September 2014.This link is still active (6 September 2016), but its page differs totally from the older content. One suspects possibly long – term influences of UNUM on FOM’s disability analyst training, via Ms Rhodes.
- Rutherford, see my note 1, p. 43. Also my note 11.
- http://webarchive.national.gov.uk/20121128010755/http:www.wales.nhs.uk/siteplus/888/page/44565 accessed 9 September 2014.
- I do not know if ownership of the document ‘LiMA v2 Technical Manual’ already mentioned, was bound to the job or to the person (Aylward, in 2004).
- For a study of the social climate that enabled the WCA, see Shakespeare et al, ‘Blaming the Victim All Over Again’ Critical Social Policy, 2016 Vol. 36(4): 1 – 20.
Thanks go to Anita Bellows of DPAC for much support, for telling me about the Howker Decision, and for critical comments on the penultimate draft. To Alice Besch of Amsterdam for forming some of my positions by example, and to some members of the international ME community for inspiration and education.