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Aylward (key promoter of BPS welfare reforms) talks to some disability protestors

Messages
13,774
If you're interested, the link below includes responses to his statements, and also has links to references in the text, so may be better to read than what I've copied over to here.

I struggle to think of someone who has done more to hurt the sick and disabled in the UK than Mansel Aylward. He really is a loathsome man.

http://blacktrianglecampaign.org/20...onted-by-black-triangle-and-dpac-at-ifdm2012/


A video of this exchange will be available as soon as some technical issues have been resolved
Recorded Wednesday 12th September 2012 15.40 – 15.53 hrs B.S.T.
Sherfield-Bldg-Great-Hall.jpeg
Conference delegates are filing out of a heavily-guarded (four security personnel on the one and only door!) Great Hall in The Sherfield Building, Imperial College London, after a keynote speech by Professor Sir Mansel Aylward at the 6th International Forum on Disability Management a.k.a. ‘IFDM2012′ sponsored by Unum among other huge medical insurance companies with a vested ‘interest’ in influencing so-called ‘Welfare Reform’.

John: We want to speak to Sir Mansel Aylward! We want to hand in a letter signed by 420 disabled people protesting against what you’re doing! You’re denying disability and you’re causing suffering for hundreds of thousands of people, you should be ashamed of yourselves!
We want to hand a letter to Sir Mansel Aylward on behalf of 420 sick and disabled people!
Merry: You’re doing so much harm to disabled people …… I don’t know why you’re smiling… what you’re doing is not OK!
J: At least have the decency to come here and confront us and take a letter! The lives of hundreds of thousands of disabled people are being devastated … we want to hand over a letter to Sir Mansel Aylward signed by 420 people that’s going to be published in The Guardian newspaper! So I suggest he comes out and confronts us! We’re here to represent hundreds of disabled people. Nothing About Us Without Us! Nothing About Us Without Us!
Merry: Disabled people are suffering … that’s what we think of the BPS Model of disability!
J: The BPS Model is nothing short of a creation of the insurance industry which is denying disabled people their human rights! We demand to speak to Sir Mansel Aylward! We want to hand over a letter signed by 420 disabled people
(security approaches us to inform us that he’s going to come to talk to us)
J: So he’s going to come and talk to us. OK.
M: Disabled people are really suffering and this has to be stopped!
(Mansel Aylward appears out of the lecture theatre and approaches us)
M: We want to give you this letter which we sent to The Guardian.
A: OK – Can I look?
M: We are protesting against the use of the BPS Model. We are protesting against the denial of our benefits … being pushed into the arms of insurance companies … and the suffering and deaths that have been caused to disabled people.
Unum-Back-Up-Plan-Logo.jpg
A: What if I say that I uh … sympathise with your grievance?
Merry’s daughter: If you sympathise, what are you doing? What are you doing?!
A: Doing? I’ve just been speaking about the Biopsychosocial Model and I’ve been telling people that I find it unsatisfactory because it longer addresses the real needs of disabled people. It no longer addresses the exclusion of disabled people from society.
M: No it doesn’t and why …
A: I agree with you … and when the Biopsychosocial model was first announced by Engel in 1961 it was appropriate then, it was only talking about healthcare. What’s happened is … and I was saying today … although I’m an advocate of the biological … the psychological and the social approach … not just to … uh … medicine or healthcare but to life … I believe they are important … what’s not happening is that the social element has been neglected.
Merry: I agree
A: And I wish people would realise that I’ve never taken on any other view.
M: So surely the criteria for the ESA and the PIP are based on that
A: They may be … I don’t know now … I’m being honest with you … I’m no longer part of …
M: The DWP
A: Yeah – I left the DWP in 2005 … but what I do know is that the ESA is developed from the test that I introduced … I agree with that … I’m not denying that but my all-work test as it was called developed in the 1990′s was trying to understand … was primarily based to get rid of the Medical Model (of disability) I distaste … I have distaste for the Medical Model
Ron: The Biopsychsocial Model has become the ‘bio…bio…bio…model’
A: That’s absolutely right … I’ve got nothing to … I can’t disagree with you.
R: When are psychologists and social scientists going to stop collaborating with this absolutely inhuman régime, its pseudo-science and with what’s been described as an outlaw company?
M: I mean Unum Sponsors this … and Unum
A: Does Unum sponsor this? I didn’t know that Unum
M: Yes! I mean … You know … Unum sponsors this, Unum sponsors this doesn’t it? And Unum
A: I’m not aware … I didn’t know Unum were sponsoring this.
J: Unum are participants in this Conference, yes.
A: Participants, yes, but I didn’t know they were sponsors.
J: Well, seek clarification on this.
A: And you do know … (turns to John) well if they are then I admit I’m wrong … but the thing is they have no influence in the .. what the topics will be .. they have no influence in. But let me just diffuse the situation. Up until 4 or 5 years ago … the Unit in Cardiff which I am now the Head of … was sponsored by Unum … there’s no two ways about that. They didn’t sponsor … they sponsored it before I joined it … I was appointed as Chair … as professor to that Unit.. OK?
M: Right …
A: After I’d been there a couple of years, Unum no longer sponsored it.
M: Really?
A: There’s no spons … if you want to check…I have had … we have had no money at all … or sponsorship at all since Two Thousand and …
J: Nine
A: No, no it’s not …
J: Well, according to their own website, it says that they stopped sponsoring it in 2009
A: They might have said that but the money stopped it 2008 … it was three years and I came there in 2005.
J: And of course you’re aware of the lawsuits and the hundreds of millions of dollars which they’ve had to pay out in the United States and that … uh … you’re aware that part of this is that if you classify an illness such as … ME … as a psychological illness rather than a physical illness … which we assert that it is then …
A: I’ve never done that.
J: No but this is what Unum’s been doing … and to avoid paying hundreds of million of dollars … because a physical illness is a long-term …
A: (Cutting John off) I can’t speak for Unum, I must speak for myself…
J: (Cutting back in) But they have undue influence in British Public Health and Social Policy …
A: (Cuts back) They have … but they did not influence me … I’ve always said that Chronic Fatigue Syndrome is a real tradition (sic) which needs to be addressed and that it is not just a psychological element …
J: Professor Simon Wessley is speaking at this conference.
A: Yeah and he is speaking on Post Traumatic Stress Disorder.
J: Uh-huh … and he used to speak about ME but nobody will listen to him anymore … and now he’s speaking about PTSD.
M: What I don’t understand is, we have the social model of disability …
A: Which I’ve just been speaking about … oh, by the way, would you like to have my slides?
M: Would I like to …?
A: To have my slides … of my lecture.
M: Yes that would be …. thank you. What I can’t understand is why you felt the need to create a new model of disability when we …
A: I never created ….
M: Well you just said you did when you …
A: Engel created the Biopsychosocial model.
M: Oh sorry ….
A: I used it as the most … the only model ….that took into account …the social conditions of people… I come from the Welsh Valleys … I don’t come from a wonderful background …
M: Right …
A: I was bought up a Miner’s son … okay? I was the first person in my family not to go down the pit … because my mother wanted me to do something different … and I devoted my life to try and help improve the life of people in the Valleys … and the way of doing that was best to … get rid of the Medical Model … getting rid of that you had to adopt another model … you couldn’t just pick it up …. so the next one that was available was the Biopsychosocial Model … but … it was … you can look it up in history.
M: So that was before the Social Model?
A: No the Social Model came in the early .. it came out … quite rightly …. because disabled people felt that they weren’t empowered by society, that they were excluded by society … that the infrastructure of society was such that it excluded people and the answer was we haven’t seen that today … but I therefore had to have a stepping stone to get away from the Medical Model which was completely against any disabled people or any person …(inaudible) …and that’s the step I took … the Biopsychosocial Model … but today … you know …not knowing that you were going to talk to me … I actually said this on record … that I don’t reject the Biopsychosocial Model but I think the social element needs to take more (inaudible) … of disabled people.
M: It’s been left out.
A: I further believe ….
J: I’m sorry, so do you condemn, without reservation, the Work Capability Assessment as carried out by Atos?
A: No.
J: No. You don’t condemn it.
A: I can’t condemn it because I don’t know enough about it … I’ve been out of …
J: I find that very difficult to believe really, a person of your standing.
A: No … I’ve
M: Every single day there’s something …
A: What’s it got to do with me? I have no responsibility whatsoever. When Professor Harrington decided to look at the Work Capability Assessment he said to me “will you join me in doing that” and I said “what for?” because I cannot be involved in something which I no longer represent.
Ron: I mean I would say, as an academic of very high standing … you have a moral responsibility to … One …get yourself informed about it rapidly
M: Yeah…
R: And … Two … to speak out publicly about it.
M: Yeah….
A: Put it this way, I’ve got so many other things that I am doing, you know …. quite honestly, but I do take your point …
J: What could be more important than human life?
A: Well, I work as a doctor, I work in looking after the future in the healthcare service and … (seeing that) it is safer for the future.
J: If you’re motivated by ethical considerations, then I think you should make yourself aware …
R: 30 people a week are dying as a result of …
A: I will make myself aware … (as a result of this meeting) … alright … but I can’t say any more … but I will make myself aware … but I think that I’m a man of integrity … and if I think that the Work Capability Assessment … test or whatever … is not proper … I will speak out against it … but I can’t say that now because I haven’t .. evidence … you know …
J: We look forward to you … to you informing yourself and we look forward to hearing you speak out.
M: You know that many people take notice of you, don’t you?
A: Yeah, but if you would also …
J: You know that the British Medical Association has DEMANDED that the Work Capability Assessment ends with immediate effect because it’s causing …
A: I admit, I admit …
J: Well …
A: … I’ve been in New Zealand for three months …
J: Right, well …
A: … but that’s …
J: … The BMA voted on the 28th June to make that national policy and they’re working with us as disabled groups to … to bring about an end … and to instead institute a test which is rigorous, and safe …
M: And which does take into account social issues.
J: …and which doesn’t cause harm, avoidable harm, to some of the weakest and most vulnerable members of society.
A: I’ll tell you. I will commit now, right?
J: Right …
A: I’ve got to because of what I’ve just said today …
J: Uh hum …
A: …that a test must take into account social issues … must take into account a person’s disability, deprivation, disadvantage and poverty …
J: And evidence-based medicine …
A: Yes. It does. Of course it does.
J: Well it should do, but it doesn’t at the moment.
M: We look forward to seeing what you’ve got to say about it
A: And if you would tell people that there are a lot of things going around about me which are not true, right? You know, my origins, what I’ve done, what I’ve published … which I haven’t … what I’ve said … which I haven’t … if you are … tell them … you can call me what … but tell them the truth about what I’ve said today.
M: Alright.
J: Well … (nods towards the camera)
John Pring (Disability News Service): Can I question you as a journalist?
A: Yes
JP: You’ve talked about the Biopsychosocial Model as a way of getting from the Medical to the Social (Model) …
A: Yeah, uh … no no … a model that could adequately replace the Medical Model … which was the model which said “there’s a fault in the machine” …
JP: Lord Freud in the Lords talked about the Biopsychosocial Model ‘replacing’ the Social Model
A: Well, I think that’s wrong. I think the Biopsychosocial model, the Social Model is an integral part of the Biopsychosocial Model, but I feel that the current Biopsychosocial Model is a step in the right direction in moving away from the Medical Model … but the social element of the Biopsychosocial model needs to look at things like deprivation, needs to look at social exclusion, needs to look at the way in which society is organised which doesn’t address the needs of disabled people and that … it’s not going to take place overnight, I knew that … and therefore that was one step on the …
JP: So you would maybe then argue that Lord Freud got the wrong …
A: No, Lord Freud is … um … speaking on the chronology … and that is there was a Social Model … there are many Social Models … so you can’t say “The Social Model” there are several Social Models … and what he probably meant was that the Social Model is incorporated into the Biopsychosocial Model … I think … but I don’t know what he said. I do not believe that (the BPS has ‘replaced’ the SM) … I believe that it’s been incorporated but it needs to be much more elaborated than it is now. OK. Thank you.
M: Alright. Bye and thank you very much for speaking to us.
R: Cheers then. Thank you.
 
Messages
13,774
He sounded pretty proud of his work promoting the biopsychosocial model here:

Amid many amusing anecdotes about his past career, the
professor had some serious points to make. He said:
"I was very taken by what was discussed today at the
conference about pyschosocial issues and vocational
rehabilitation. I've been working hard to get this on the agenda
and to get the bio-psychosocial model adopted by those in
power. The fact you were talking about it today is a success I
want to claim."

https://dl.dropbox.com/u/32109159/Aylward/06.AtosConference2004.pdf
 

currer

Senior Member
Messages
1,409
What does he mean talking about the social exclusion of disabled people?

PWME are not disabled, they are SICK. There is a difference and the two groups must not be confounded.

http://forums.phoenixrising.me/index.php?threads/paralympics-for-people-with-me.19104/page-3
This has been a very useful thread in that it has exposed some fallacious thinking about disability which goes uninvestigated and unquestioned.

1. There needs to be a clear distinction drawn between the fit and healthy disabled, and the sick, who are unfit.
This distinction is not made as part of the disability benefits assessment process. It needs to be made, as it is relevant to what a claimant can realistically achieve.

2. The point is never clearly enough made that people with ME, uniquely among the sick disabled category, are medically untreated.
No wonder that when they try to return to work thay risk worsening their illness and relapsing.

I was present at an enthusiastic talk given by a member of Ian Duncan Smith's staff. She was most eager to say how much better off we would all be if we all returned to work as soon as possible. She utterly disregarded or was totally ignorant of the fact that ME patients are medically untreated.

Other patients with illnesses who do suceeed in returning to work are receiving medical treatment from their doctors. If these other diseases were left untreated too, these people would be no more successful than we are in making a useful recovery.

It cannot be emphasised enough that the untreated sick cannot be expected to recover.

3. The assumption that if you try hard enough you will succeed, and that success should be rewarded and failure punished, lies behind all the current right wing ideologies.

Rather than empowering the disabled, events like the paralympics can be used to change public opinion to imply that the sick and disabled who do not succeed are not making enough effort hence there is political justification in destroying the welfare benefit system for both fit and sick disabled.

4. Our current right wing politicians' ideology is too simplistic to deal with reality.

Some individuals, at some points in their illnesses may be able to make striking achievements.
That cannot be extrapolated to include everybody and all cases. Illness is complex, and complexity is what our current politicians have no patience with.
 

user9876

Senior Member
Messages
4,556
He sounded pretty proud of his work promoting the biopsychosocial model here:



https://dl.dropbox.com/u/32109159/Aylward/06.AtosConference2004.pdf

On page 2 there is a particularly shocking piece by Dr Bass. I have heard that he has also been involved with child protection cases pushing a muchausans by proxy diagnosis.

Seventy per cent of patients claiming Incapacity Benefits
are diagnosed with symptoms that are not fully
explained.
That was one of the striking facts highlighted by
Dr Christopher Bass, in his presentation – The
rehabilitation of patients with medically unexplained
symptoms and so-called ‘minor’ illnesses. Dr Bass,
Consultant in Liaison Psychiatry at the Department of
Psychological Medicine, at the John Radcliffe Hospital,
said it is essential to look at the patient’s psychosocial
background when attempting rehabilitation for people
with unexplained symptoms. Dr Bass said: “Doctors are
trained to deal with organic problems yet many spend
most of their time dealing with patients with non-organic
problems.”
Some of the common medically unexplained syndromes
linked to sickness absence include:
• Chronic fatigue syndrome (CFS)
• Fibromyalgia (chronic widespread pain)
• Chronic low-back pain
• RSI (repetitive strain injury)
• Non-cardiac chest pain
Dr Bass said: “Psychosocial factors – such as
personality, life events and psychiatric disorders – are at
least as important as physical factors in the onset and
maintenance of these conditions. Patients can make a
number of ‘secondary gains’ with these unexplained
illnesses, such as: work absence as a reward for years
of struggle; turning a socially unacceptable disability in
to a more acceptable ‘organic’ disability caused by injury
or disease beyond their control. They can blame their
failures on the illness; elicit care, sympathy and concern
from family and friends; avoid work or even sex; and
there are financial rewards associated with disability.”
Dr Bass added: “Take whiplash. In countries where no
compensation is paid for whiplash, there are no official
cases of whiplash recorded! Also, many patients with
RSI that I have seen, appear to have a problem with their
manager at work.” During his presentation he outlined
broad courses of action Occupational Heath consultants
can take to encourage rehabilitation with various types
of medically unexplained illnesses. These are:
• Make an early positive diagnosis
• Flag up psychosocial questions at the first appointment
• Provide a clear explanation of cause and
maintaining factors
• Limit the potential for iatrogenic harm
• Involve the family in illness management and
behavioural changes
• Establish clear communication with the GP and
workplace
• Take a stepped approach to care if initial treatment
is not effective.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
You guys might want to consder the social issues that disability advocates deal with. One of the terms they have coined is the "pity/heroism dichotomy".

You've seen the the media stories: xyz with a disability who achieved something or abc who was prevented from achieving something due to disibility. Yet the middle ground, the real struggle with disability doesn't make the news.

Disability means inability to do something, yet if someone with a disability achieves something, it shows that they aren't actually functionally disabled with respect to that task. (consider a handicap that can be overcome with an aid).

In either case it shows that many in our society don't truly understand or relate to living with a disability.

The social side is neglected, but not in the way that is being discussed. I feel Aylward should read articles like this to learn what it is really like:
http://onlinelibrary.wiley.com/doi/10.1111/j.1548-1425.2010.01254.x/abstract
 
Messages
13,774
Disability means inability to do something, yet if someone with a disability achieves something, it shows that they aren't actually functionally disabled with respect to that task. (consider a handicap that can be overcome with an aid).

I discussed some points along those lines in commenting on an Aylward doc which has been influential on government policy here: http://forums.phoenixrising.me/inde...cial-model-paper-from-2004.17783/#post-271134

(I was thinking I might copy my posts on that doc in to a new thread actually, as that pamphlet seems to be important).

To some extent, I don't think it's reasonable to expect most of society to understand or relate to living with a disability - it's really complicated, and there's way more fun stuff to do instead! What's worrying is when people start claiming that they know how the sick and disabled should live, despite not truly understanding those issues - and that seems to be what happens under a biopsychosocial approach.

re sick vs disabled: I've not thought enough about the use of either of those words. I traditionally thought of myself as 'sick' rather than 'disabled' as I expected to recover soon. Having read more CFS research, I'm rather less confident about that, and I'm not really sure if my understanding of the distinction between the two terms was accurate of meaningful. I don't think CFS is unique in not having a treatment though.

re Dr Bass, he also wrote an article in Pulse which caused some minor controversy: http://forums.phoenixrising.me/inde...-archive-somatoform-disorders-in-pulse.14253/



With a lot of this stuff , I feel like I'm still getting to grips with it all and want to keep doing more reading (although obviously, I'm now much better informed than any of the government ministers who are actually making policy in these areas). What's slightly distressing is that the more I learn about things, the more I realise that things are worse than I had assumed.