Government and Insurance companies - establishing the BPS model

https://twitter.com/user/status/1443627339838115841

 

Post copied, and subsequent posts moved, from
New NICE guideline on chronic fatigue syndrome: more ideology than science? 2022, Flottorp et al

I actually think it is the other way around.

The BPS programme was asked for by politicians. The BPS people were doing their bidding finding a cheap way to get people back to work. Now medicine has been taken over by the toadies of the politicians who are happy to sing the same tune. The NIHR was set up by politicians to bypass quality research and provide cheap answers.

The only way out of this is to have a government that acknowledges the need for an extra £80Bn in NHS funding to provide a safe and effective service whether for cancer or ME. Unfortunately mishandling of Covid has just made the situation twice as bad.

Those in medicine who believed in quality health care and reliable evidence were elbowed out by politics.

 

I agree fully with politicians supporting the BPS nonsense. There was a politician (James Bottomley? if not then someone in that bunch) whose wife/sister in law or some such was a psychiatric nurse. Their view transposed into policy --- get em out of bed in the morning --- better for them ---

So the whole thing was some mad bit of political influence.

Yes it's also about what can be done cheaply --- online CBT or whatever and what resonates with prevailing (political) psychology.

 

I suspect that you are thinking of Peter Bottomley. His wife Virginia Bottomley was Secretary of State for Health from 1992 to 1995, having formerly been a Minister of State at the department from 1989. She had been a mental health social worker. I believe that it used to be recorded that she liaised with the Maudsley. Her early career seems to have been largely expunged. It was available a few years ago.

 

It wasn't just the Conservative perspective.

What I would call the British interpretation of BPS, (to distinguish it from Engel's work) was taken forward by Mansel Aylward under a Labour Government. The explanation of why that happened is complex, but to massively oversimplify it - even in the late 20thC the UK Labour movement had a very reductive view of what made a citizen - essentially citizen = worker, children were worker/citizens to be, adults were worker/citizens and the retired were citizens by dint of having worked. It was (is ?) a very puritanical philosophy and it had huge difficulty accommodating worklessness that wasn't explained by heroic sacrifice - i.e industrial injury. Aylward offered a salve for this existential angst - the lepers were to be cured by the healing power of work.

The extent to which BPS was punitively applied to the Benefits system after 2010 election is arguably well outside of what the previous Labour Governments had envisaged, but it is notable that when Lady Marr made a serious miscalculation over one the debates she introduced in the Lords, which (as far as I can remember) put Wessely et al up for a knock down when three Labour Peers came to the defence of 'the science' i.e Wessely et al.

So - yes the malign influence of the Brit interpretation of BPS has been facilitated and promoted by politicians - but it's been from across the spectrum, very few clean hands. A somewhat florid history from a critical psychology perspective: Psychological Tyranny Masquerading as Welfare Reform
https://www.researchgate.net/public...ical_Psychology_Counselling_and_Psychotherapy

 

I have to confess that when I heard of New Labour's plan to reform Incapacity Benefit in 2006 when I was still in work I thought "good, I bet half of them could actually work if they wanted to". And that's without knowing anyone (except one neighbour) who was on it.
I think it might just be human nature to be jealous of people getting something you're not.

 

I was claiming benefits, and attended assessments and several of the 'training courses' over that period and the 'reforms' were in my opinion simply a way of redistributing public money to their cronies for doing nothing useful.

and of course there was the other side, the 'work placements' which, again IMO, were simply a way of subsidising some categories of 'employer' by providing free labour, which I am personally aware (i.e. I knew people affected) led to people who had had jobs no longer having them, as why pay some to do work if the government will supply people to do it for nothing, in fact actually pay your company to 'employ' them.

Both sides were no better than their opposition.

Many people like having someone to kick, and they would rather do that than help, especially with publicity machines saying that kicking people was helping them.

 

Absolutely John. Especially when they are struggling themselves 'Why the hell should i struggle & go through all this, draggin myself out of bed every morning and finishing every day knackered beyond belief, when you lot are sat on your fat arses watching daytime tv & eating crisps". The resentment is intense.

I'm ashamed to say that i thought like that. To my eternal shame i had no idea that only a tiny % were doing maybe doing that.
Previous to becoming ill myself i was certain that most people who reckoned they were too ill to work, just couldnt be arsed.
And successive Gov'ts (of all colours) have been well aware of that sentiment and played into it. That's how they have been allowed to get to where we are. Most people still think the system is only hostile to those who are blagging.

Little did i know back then, that i would soon be in a position where i would literally give you my left leg, if it meant i could exchange it for being well, & able to go to work, that nothing would make me happier. That id give almost anything for their view of us to be accurate.
Ahhhh.... what my life would be.....

 

Collecting the stories of many people for whom this attitude was the case (disbelief of illness and disability until becoming ill themselves) could prove to be helpful as a group letter that is shared on either social media or through a sympathetic journalist.

I have seen here on S4ME some twitter threads of people who have said they did not belief in ME although possibly not for the reasons mentioned but there is room for a range of reasons in this.

If only there was a way to do this.

 

Yip and thank you very much for the bio - I just need to be able to find it the next time I need it!

Slightly weird I once wrote to Peter Bottomley [then part of the APPG] asking that they lobby the Government to use the Government laboratories (in York?) to try to find a biomarker for ME/CFS --- oh the naivety --- to think they might help.

 

I think I too probably approved in principle of the plan, even if my thinking was rather more along the lines of: "There are probably loads of people out there on sickness benefit who've had to retire from their jobs due to e.g. a back injury, but who, given suitable support to get back into work, could take on a different job rather than slobbing around at home, and that would help with their self-esteem and general physical and mental health". But I was pretty disgusted at the campaigns in the tabloids and elsewhere portraying all people on benefits as scroungers.

 

The hard bit is making people care. Most sadly aren't going to read something long in order to have their assumptions/presumptions about ill people disabused. Focusing on the profits made and the fact that the upshot wasn't taxpayers making savings but companies and individuals making a quick buck - different. And yes, people becoming more ill than they might have done if policies hadn't encouraged exactly the wrong thing when they were first ill, which potentially has led to issues with productivity and costs to taxpayers etc.

The sad thing is who knows where science might take ME research one day and what we might find out to be relatively cheap that might help and have avoided all of this politics of 'what do we do with them' from certain ends

 

Thought I'd ask the question here although aware this might be considered 'tangential'.

https://moreunited.org.uk/about/team/

I'm assuming others are aware of Claire Gerada's position as convenor for this Movement? - I haven't looked further at who the other individuals involved with/directing this are yet but here is a good chunk of their messaging:

"More United was founded in 2016 as a reaction to the political events of that year. Brought together by convenors from all walks of life, and co-founded by the late Lord Paddy Ashdown, our movement believes that a More United country is a fair and thriving country.

In order to try and realise that vision, we encourage MPs to work cross-party in Parliament no matter who is in power and lead campaigns supported by More United members all over Britain.

Over the last three years, our movement has grown to more than 150,000 people and we have worked with MPs from 7 different parties to protect our shared values. We have been campaigning on the NHS, disability rights, plastic pollution, immigration and more. We have secured Parliamentary debates, changed government policies, contributed to Parliamentary inquiries and launched two cross-party consultations that will directly shape legislation.

We know that for many people who experience the choice and convenience of digital technology politics can feel analogue and out of date. More United members have the ability to work with MPs across the country, no matter where they live and are able to vote on which MPs our movement supports with money and volunteers at election time. At the last election, we crowdfunded £150,000 and now have a Network of 64 candidates across 6 political parties."

 

They are supposedly a network of 150,000 people and yet in the 2019 general election, they crowdfunded £150k. A measly quid each. I vagueLy remember assenting to email from them, as I was on a ton of continuity Remain mailing lists, so I’m possibly included in that 150k, but can’t find any emails from More United this decade.

So I’m not convinced that this convenorship affords Gerarda any clout, and if its doings take up thinking time at the Gerarda and Wesseley breakfast table (which I doubt), it’s a welcome distraction.

 

Ahh thanks for this. Indeed, is that because it is 'floundering' or is that because it's power is not really a democratic party crowdfunding type thing - I'm trying to sort of work it out if it isn't 'directed by' or 'representing' an end-user audience given what it seems to suggest it is representing?

I was more concerned about the number of MPs 'signed up' and the 'cross-party working' on policies ie the access and side-working that it might afford. It's intersting the website has lots for projects that were up until 2020 but I don't know whether it is floundering or I just haven't spotted the latest missions. That could be be not looking properly/website updates or layouts or it could be it winding down - it would be good to know I guess? e.g. what influence this might have had/how it is working.

 

Best evidence is that it is winding down or dormant. “Floundering” suggests a lack of direction but still some activity, and would be too kind a description for a political movement which has stopped tweeting for at least a year.

There are a lot of MPs signed up because they offered a sort of kitemark for political respectability and a good sized database, which would be obviously be attractive for any candidate. I bet the convenors had almost nothing to do after the first couple of meetings, though.

 

Thank you for this @Sly Saint

Several years ago, I came across one government institution in my neck of the woods whose seemingly insistent motto was, "Everyone can work." As in, "You're lazy or lieing, or both if you say you're too sick to work." Same old story. All grown from the same conceptual root.

 

Posts moved from this thread:
United Kingdom: Science Media Centre (including Fiona Fox)

The UNUM centre was: UnumProvident Centre for Psychosocial and Disability Research at Cardiff University - it was effectively created by Mansel Aylward after he stepped down as Chief Medical adviser at the Department for Work and Pensions. Aylward's position at Cardiff being "Director of the Centre for Psychosocial and Disability Research at Cardiff University". The UNUM sponsorship was for 5 years, with I think a five year extension and I don't think it continued after 2014 https://www.covermagazine.co.uk/news/2151231/unumprovident-teams-cardiff-university

Gordon Wadell was an Orthopaedic surgeon who became interested firstly in back pain and from that Occupational Medicine, and from there the BPS model https://link.springer.com/article/10.1007/s00586-017-5133-4

UNUM was certainly very interested in the BPS approach, https://issuu.com/maxhead/docs/unum_cardiff_newsletter_issue_2 an interest which was clearly motivated by commercial demands, how much Aylward, Wadell or any other BPS proponent specifically assisted commercial exploitation of a BPS approach by UNUM is an open question, there are a multitude of influences on a commercial operation and teasing out a single aspect in how a company operates is impossible without insider analysis.

I really don't see any basis for conspiracy. Aylward offered an attractive perspective to Government while in his DWP role, that perspective was of interest to commerce, commerce and Government developed a common interest, commerce sought PR and continued apeal to academic authority by sponsoring academia, and academia in turn has association appeal for Government. This a very standard web of interests - it of course requires close watching to make it understandable but there's no conspiracy in the sense of things being deliberately hidden, it's just business as usual. Of course it may not be a healthy way of doing business but that's a political question.

 

The 2018 link in the 1st post is now redundant - the article is however hosted on the Black Triangle site: https://blacktrianglecampaign.org/2011/09/07/new-labour-the-market-state-and-the-end-of-welfare/

I still don't see conspiracy though - commerce was doing what commerce does, Government was doing what Government does and to the extent academia was involved academia was doing what academia does.

Also I think Rutherford was wrong to write that "The company appointed Mansel Aylward as Director following his retirement from the DWP in April." - There's nothing to suggest that Aylward was not part of the Cardiff University staff and I think it gives a wrong emphasis as to what was going on - which in my view is that Aylward was bringing UNUM money and branding to Cardiff (and giving himself an academic position in consequence). Commercial tie ups with Universities were being heavily promoted by Government at the time and the UNUM sponsorship was one of many institutional brandings that happened in the early 2000s all brought about in very much the same way - a celebrity Prof serenades a large business and gets to set up a new Unit/Department with their name and money but his/her directorship.

 

Thanks.
It's useful to use words and terms correctly.

What I meant by the following:

is that the person wasn't convinced that a biopsychosocial model might save an insurance company much money.
With disability insurance, I think that's incorrect: if a disability insurance company can find a reason to turn down lots of claims, and a percentage of those refusals lead to money not being given out (e.g. from the claimant losing their appeal or giving up) that can save them a lot of money.