David J Black: Economic fallacies and public health realities 27 Nov 2024 Reading time: 8 minutes In part two of his series on dysfunction in our health system, David J Black reminds us that the cost of bad medicine is people’s lives. Read part one here. It is one of those facts which cries out to be universally acknowledged: when it came to understanding the nature of such illnesses as ME/CFS, Lord Freud, despite being Sigmund’s great grandson, was almost wantonly ignorant, yet he was the ‘expert’ to whom the government had turned for advice. He had once wittered: “Our approach is – and this is rather a mouthful – akin to the biopsychosocial model.” This speculative doctrine would later resurface in Sir Mansel Aylward and Gordon Waddell’s 2009 manual Models of Sickness and Disability. Aylward, medical director and head scientific adviser to the DWP, and a promoter of the Woodstock conference, would become director of the UnumProvident Centre for Psychosocial Research at Cardiff University. The phrase “conflict of interest” should not be overlooked. The stark conclusion of Aylward/Waddell manual was that individuals retain free will and bear personal responsibility for their actions; they must answer the question whether their health condition is such that it would be unreasonable to seek or be available for work – the biopsychosocial model provides the tools and the framework for that endeavour. Continues at: https://www.scottishlegal.com/articles/david-j-black-economic-fallacies-and-public-health-realities
Part 1: David J Black: The great health expenditure catastrophe – diagnosing a failed panacea Extract from the article: The crystallisation of Britain’s vendetta against the suffering was the notorious Malingering and Illness Deception conference held at Woodstock, Oxford in 2001. This was sponsored and funded by the DWP in association with the American health insurance giant, UnumProvident, and was something of a masterclass in the persecution of the sick and ailing. Its follow up manifesto, an anthology edited by psychiatrist Peter Halligan (OUP, 2003) was a study in demonisation much praised by the Institute of Psychiatry’s Simon Fleminger who boldly speculated “that many of our patients may be deceiving us, and that much of this deception may be conscious. We are introduced to the debate as to whether or not malingering should be identified as a psychiatric disorder, a disorder of free will, or simple criminal behaviour.” But just who were the criminals in this case? Might it be a tight-knit psychiatric faction and its state backers which clearly had an agenda to denigrate a cohort of benefit claimants who were in no condition to fight back? Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality. Fiscally obsessed politicians were only one aspect of the problem. Given the policy-framing role assigned to Chatanooga-based UnumProvident, which the Insurance Commissioner for California described as “an outlaw company” in 2004, and which, furthermore, was induced to settle a class action lawsuit over its “claims denials” in 2008 for $40 million, any resulting dissertation could be a riveting diagnostic Gothick Horror for sure. And that, it seems, is where our tale is headed.
Other threads with articles by David Black: Blog series: "Orthodoxy on trial: the pathogenesis of a diagnosis" by David Black David J Black: Is anyone listening? Does anyone care?
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Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality. There is enough material in this whole shabby tale to justify a few careers for historians of medicine.