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Thursday, November 29, 2012

(Extreme) sensitivity to initial conditions: Employment - Sickness

There was an item today on BBC Radio 4's You and Yours on the government's Fit for Work tests.

The new fitness for work assessments have been under review. The discussion featured Professor Malcolm Harrington and his final report on the Work Capability Assessment Review and highlighted the humanistic and mechanistic dimensions of this very complex issue (see also the back-to-work programme?). Points raised include:

  • the impact of certain medications and treatments on an individual's ability to partake in an interview;
  • the meaningfulness of an appeals process that once won, then sees subsequent recalls;
  • 4/10 appeals are won;
  • the need to balance decision making and the computer based process, with the former utilising documentary evidence;
  • people with mental health and cognitive problems may be less able to advocate for themselves.
What troubled me is (the admittedly) single example were a client attending a review was advised not to bring documentary evidence. What this does is to effectively switch OFF three of four care domains: SOCIAL, INTERPERSONAL and (remarkably) the SCIENTIFIC.

What are the purposes to which clinical assessments, tests, reviews can be put? Why do clinicians and the social care team create records?

Relying primarily upon, or being driven by a computer based algorithm makes this a POLITICAL 'exercise'.

As such it will be seen SPIRITUALLY as cold and uncaring.
POLITICAL neglect reinforcing similar neglect and disinterest in the CITIZENRY.

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