The perfect storm around disability

The American news website Huffington Post recently published an article headlined, ‘Austerity in the United Kingdom Leaves Disabled in Fear for Their Lives’.

Author Paul Vale reported the sense of dread currently hanging over many disabled people, who worry about losing essential vehicles or even their homes if their benefits are removed. He also pointed out, "Despite the government's contention that it is now saving money by weeding out cheats, official estimates published in 2011 found fraud and error within the DLA system accounted for only 0.5 per cent of the total cost."

One indication of the anguish felt by some disabled people is their symbolic use of the Black Triangle, originating from Nazi Germany. As Jews were forced to wear a yellow star, black triangles were used to label the ‘Arbeitsscheu’ or workshy.

Many disabled people feel this is how they have been portrayed in the media, as a precursor to having their benefits cut.

This may seem an unduly emotive way of drawing attention to their concerns, but with headlines in the Daily Mail like "75 per cent of incapacity claimants fit for work: Tough new benefits tests weed out the workshy", it is understandable.

The Citizens Advice Bureau has reported soaring numbers of disabled people going to them with problems, and has co-produced a report which says that matters will get even worse under the proposed Universal Credit.

In a foreword to the report Baroness Tanni Grey-Thompson writes,
"Cuts - such as those to support for most disabled children, and disabled adults living alone - are going to make the future considerably bleaker for many of the most disadvantaged households in Britain.”

The real scandal here is that there is no outcry from the general public. In the Independent, Sharon Brennan has described it as an "ethical crisis", saying "the constant cry of 'scroungers' and 'benefit cheats' has now permanently affected the public’s view of disabled people"… "disabled people are regarded with suspicion, viewed with sceptical eyes as to whether their illness really is as bad as they say."

It could be argued that this negative media coverage of disabled people and the resultant decline in empathy is part of a cultural shift, which has been brought about for political and financial reasons.

A key factor in this shift could be the Biopsychosocial (BPS) model of disability, which appears to redefine illness and disability, placing less emphasis on medical aspects, and strongly emphasising social and psychological factors. The model was formulated in 1977 by American psychiatrist George L Engel, who was editor of the journal ‘Psychosomatic Medicine’.

A leading proponent of the BPS model in the UK is Professor Sir Mansel Aylward, a former Chief Medical Adviser to the Department for Work and Pensions. He has given a presentation, ‘Rethinking Our Attitudes Towards Work and Illness’, in which he outlines some of the principles of BPS. These include;

"Main determinants of health and illness depend more upon lifestyle, socio-cultural environment and psychological (personal) factors than they do on biological status and conventional healthcare."

"Obstacles to recovery and return to work are primarily personal, psychological and social rather than health-related “medical” problems."

Now, if you are a politician looking to make big savings in your welfare budget, this way of looking at illness and disability must seem tailor-made to suit your requirements. To a sick or disabled person, it may seem like blaming them for their own illness or disability. It could be perceived, by someone already struggling, as, ‘It’s all in your mind’ or ‘Pull your socks up, you’re not trying hard enough.’ As the model was devised by an expert in psychosomatic medicine, perhaps this is not surprising.

Professor Sir Mansel Aylward "played a key role in development and evaluation of the UK’s medical assessment for incapacity (the All Work Test), and was heavily involved in developing the Personal Capability Assessment (PCA). He led the Corporate Medical Group on the UK Government's Welfare Reform initiatives".

Also involved in the DWP working groups which set up the current system of work capability assessments was a US insurance company called Unum.

In 1994 Secretary of State for Social Security Peter Lilley employed John Le Cascio, a Vice President of Unum, as an adviser. Unum uses the BPS model of disability, and in 2004 part-funded the establishment of the Unum Centre for Psychosocial and Disability Research at Cardiff University. Professor Mansel Aylward, having left the DWP, was appointed Director. The Centre has since shed its Unum tag.

When it’s not advising governments, Unum sells Income Protection insurance, which is designed to pay out if you are unable to work due to illness or injury, and has started advertising on UK television.

Private Eye has alleged that Unum’s involvement with welfare reform represents a conflict of interest, because as state support is reduced, more people feel the need to take out this type of insurance.

In the United States, Unum has a troubled and troubling history. A 2007 Yale Law School report stated, "Regulatory authorities and courts have now established that Unum/Provident Corporation, the nation's largest disability insurance carrier, was engaged in a program of deliberate bad faith denial of meritorious claims."

In 2011, a US legal news website reported
"Unum is consistent. Even though it got severely reprimanded back in 2005 for its claims-handling practices (i.e., bad faith practices), … even to this day, it unfairly denies and delays thousands and thousands of claims."

As stories of seriously ill people being declared fit for work abound, and the Royal College of GPs calls for the abandonment of Work Capability Assessments, shouldn’t more questions be asked about how the current system was arrived at, and what purpose it was meant to serve?

Both government and insurance companies have a vested interest in downplaying as far as possible the seriousness of any illness or disability: the former to save money on benefits, the latter to avoid paying out on claims. Have these vested interests, combined with a political belief in a small state, and an economic crisis which can be used to justify cuts, converged to form a perfect storm for sick and disabled people?

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© Bernadette Meaden has written about religious, political and social issues for some years, and is strongly influenced by Christian Socialism, liberation theology and the Catholic Worker movement. She is a regular contributor to Ekklesia.