Sunday, December 08, 2013

WINZ, Spin Doctors and 'Healthy Work'

Sir Mansel Aylward

On 30th Sept the NZ Herald quoted Welfare Minister Paula Bennett as reporting that on average 3500 benefits are cancelled weekly, 2000 being due to 'other reasons than the recipient finding employment). Most of these are presumably results of the harsh new sanctions regime against those failing to comply with job-seeking requirements. Amongst these will be sickness and invalid beneficiaries who have been declared fit to work by WINZ’s designated doctors. Enquiries made under the Official Information Act have revealed that designated doctors are being indoctrinated at WINZ training seminars in the ‘health benefits of work’ and in the doctrine that benefit dependency is an addiction

In its crusade to reduce benefit numbers by 40,000 the government has found a powerful ally in the Royal Australasian College of Physicians (RACP) and its Australasian Faculty of Occupational and Environmental Medicine (AFOEM), which is currently conducting a campaign to convince doctors of the health benefits of work. So well does this fit with the government’s plans that WINZ quotes the AFOEM's Position Statement on the application form for the work capacity medical certificate in a blatant attempt to educate doctors signing it. The WINZ form erroneously attributes the quotation to the AFOEM's Consensus Statement, misleadingly implying that the signatories have all examined the evidence for the hypothesis advanced and agree that it is "compelling." (Thanks to George Bush Jr and Tony Blair we have learned that when government agencies start to talk of "compelling" evidence, it is time to start doubting).

The other words, the government is cynically intervening in the education of doctors to promote a theoretical model of dubious validity, not out of any concern for the health of the population but because it happens to correlate so well with neo-liberal policy goals of workfare to drive down wages and restore profits.

The medical theory it is promoting is the so-called bio-psycho-social model of illness (BPSM), which has some grounds for criticising traditional medicine for ignoring social and environmental factors in the causation of illness. But while it has indeed become part of regular medical practice to mobilise multi-disciplinary teams comprising psychologists and social workers in the treatment of illness BPSM has failed to achieve recognition as a comprehensive theory of medical causation.

Moreover, the BPSM restricts its definition of social to the immediate social situation of the patient without inquiring into the mediated power-based relations of the class-based wider society. As expounded by some of its champions, it claims that if a person is treated as if they were ill they are likely to become so, which is not much of an advance on Christian Science and Norman Vincent Peale.

Prominent among the advocates of the health benefits of work is Sir Mansell Aylward, formerly Chief Medical Adviser, Medical Director and Chief Scientist at the UK Department of Work and Pensions, and now HOD in an academic chair sponsored by Unum, the world's largest disability insurer. The AFOEM has acknowledged his leadership and he has had the ear of Welfare minister Paula Bennett. Not only has Unum been thoroughly discredited for the scale on which it has attempted to evade payouts, it has demonstrated an interest in taking over the UK welfare system.

It was Sir Mansell who devised the Personal Capability assessment (PCA) to which British claimants are subjected, the administration of which is contacted out to a private sector firm ATOS. The United Kingdom is further down the path of work-focused welfare reform than is New Zealand, and the results it has achieved- little published in New Zealand, are truly alarming

The Express’ Jan 17th 2013 reported: Former Labour minister Michael Meacher accused the firm (ATOS) of “ruthlessly” pressurising the sick and disabled into work. Opening a Commons debate, he said 1,300 people had died after being placed in the “work-related activity group”, for those currently too ill to be in a job but expected to take steps towards an eventual return to employment. Some 2,200 died before the assessment process was completed and 7,100 died after being placed in the group for those entitled to unconditional support as they are too ill or disabled to work.

No wonder the disability support group opposing the UK's benefit reforms has adopted as its symbolic title "Black Triangle" after the stigma worn under duress by disabled citizens in the Third Reich.

To return to AFOEM’s position statement: this document does not shrink from making recommendations to the government, but recommendations that poverty be abolished are not amongst them, despite the link between ill-health and poverty clearly shown in the evidence it marshals, which demonstrates beyond doubt that the children of welfare beneficiaries are more than averagely prone to illness.

This is something the Child Poverty Action Group, the Children’s Commissioner, and a wide variety of community health practitioners have been pointing out for years. Is the fact that the government has been able to ignore this for so long due to the influence of the RACP and those who in turn influence it? Do the learned physicians of the AFOEM really believe that it is lack of work that is making the children sick? Should we anticipate a return to Victorian era child labour laws? The Position Statement includes further evidence that it is poverty, not unemployment that creates ill-health by acknowledging the existence of an unemployed stratum of capitalist parasites which is nevertheless able to remain in good health.

We say the pressure to force the poor into work is to drive down wages and create cheap jobs so that the whole working class is forced to pay for the bosses’ crisis. No way! For the working class to live parasitic capitalism must die!

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