MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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“A person’s past social experiences…are written into the body’s physiology and pathology.
“Tackling effectively the social determinants of…health is not a matter for public and occupational health alone. In the
United Kingdom it is central to the Government’s realisation of its aspiration for an 80% employment rate for the
working age population.
“The great majority of these health problems are largely subjective complaints with limited evidence of
disease and frequently associated with psychosocial influences.
“Psychological and social factors aggravate and perpetuate ill health and disability, and act as barriers to recovery and
return to work.
“Persuaded by the formidable evidence in support of a bio‐psycho‐social approach for return to work interventions, the
British Government began a series of pilot studies in 2004. This Pathways to Work (PTW) initiative prominently
featured cognitive and educational methods, modification of illness‐behaviours, fear‐avoidance beliefs and had a clear
work focus.
“The results of this initiative have been most encouraging to the extent that the British Government has recently
extended PTW throughout Great Britain.
“The need to modify beliefs and behaviours in the achievement of the PTW initiative went well beyond the
target population of benefit recipients by engaging successfully with senior politicians and civil servants,
health care professionals, employers and other stakeholders.
“Methods for securing engagement with …the stakeholders were highly dependent on a structured, robust and
authoritative communications strategy (and) providing compelling evidence‐based arguments that barriers to return to
work resided not only in dealing with health problems alone but tackling psychological social and cultural constraints
impacting upon an individual’s beliefs and behaviours”.
When the Green Paper “A New Deal for Welfare: empowering people to work” was released in January
2006, it was analysed and assessed by Alison Ravetz, Professor Emeritus of Leeds Metropolitan University
who writes on welfare reform, who in March 2006 wrote “An independent assessment of the arguments for
proposed Incapacity Benefit reform”, from which the following quotations are taken:
“In the lead‐up to the Green Paper and its publication on 24 th January 2006, the media had a field‐day at the expense of
those enduring illness and disability, conveying the impression that they were scroungers living at public expense. The
mismatch between this and my personal experience of severe, long‐term illness within my own family led me to look
into the reportedly successful ‘Pathways to Work’. Seeing the weakness of the evidence for their success, I was curious
to look into the body of research and theory on which the Green Paper is based, which is used to validate its proposals”.
Ravetz soon found that the source of much of the Green Paper was “The Scientific and Conceptual Basis of
Incapacity Benefits” (TSO, 2005) written by Waddell and Aylward and published by the DWP, who were
asserting that the then system of benefits was “based on the wrong model of sickness / disability – the ‘medical
model’ ”.
“The aim was nothing less than a reversal of the common attitude towards sickness, disability, and the capacity for
work.
“In practical terms, it meant opting out by the State of responsibility for a large section – estimated at two‐thirds – of
those afflicted by illness or disability.
“Its proposals appear to be backed by voluminous reports from the DWP, DoH, OECD and (the) Prime Minister’s
Policy Unit. Most of these publications bear the hallmarks of academic authority and objectivity. They are presented