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RADSTATS  November 2011

RADSTATS November 2011

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Subject:

Re: GPs and 'signing off'

From:

Socialist Health Association <[log in to unmask]>

Reply-To:

Socialist Health Association <[log in to unmask]>

Date:

Sun, 20 Nov 2011 16:59:53 +0000

Content-Type:

text/plain

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Parts/Attachments

text/plain (332 lines)

I look forward to seeing scientific evidence to support the propositions 
of Calvinism.  Has this project not been tried before?

On 20/11/11 16:05, Alastair Greig wrote:
> Paul, I am not criticising the work that has been done on well-being 
> and work.  Like any field, the results are likely interesting and the 
> use of other techniques even better to aid discussion.  However, I am 
> not sure I have come across a problem in social science where 
> assumptions and model selection do not go some way to predetermining 
> the conclusions.  As such, this should be at the core of debate in 
> 'evidence based policy'.
>
> In my view, scientific results, including those which use statistics, 
> cannot support a normative proposition.  In the case of the labour 
> market, what we seem to be talking about is an attempt to use 
> statistics to establish an evidence base for pursuing policies which 
> promote a very old Northern European concept, the protestant work 
> ethic.  I am saying it is no coincidence that Britain, of all places, 
> is, firstly, pursuing research to meet these ends, and, secondly, 
> finding evidence in support of the fundamental tenets of Calvinism.  
> As such, I will probably remain very sceptical on these results, and 
> would advise others to be.
>
> Alastair
>
> > Date: Sun, 20 Nov 2011 11:19:28 +0000
> > From: [log in to unmask]
> > Subject: Re: GPs and 'signing off'
> > To: [log in to unmask]
> >
> > The point about work and well-being has indeed been gone over many 
> times statistically, moving from a simple correlation on towards more 
> complex methods to tease out whether there is a simple selection bias 
> - those who are recovering go back to work, and those who aren't, 
> don't, or whether it is an independent effect of working, and whether 
> it is just 'work' or a socially-approved activity that has social 
> interaction and routine.
> >
> > Carol Black's first report (2008) to which you linked the summary 
> gives a fair number of references. No doubt the new one will also be 
> referenced.
> >
> > The first Black report buttressed the Labour Government's 
> replacement of Incapacity Benefit by Employment and Support Allowance 
> - after 3 months, you get tested by ATOS and the computerised program 
> run by ATOS says whether you are fit for work or not. Legally, that 
> has to be run by a set of known descriptors against which appeals can 
> be heard. Statistically, it might be more sensible to take the model 
> from the data - using a survival analysis technique, and make the 
> decisions on the predicted values resulting from the model. Helpful if 
> the model and base data were publicly available so everyone could run 
> the analysis - in SAS or R or Stata or whatever. If you can understand 
> Therneau and Grambsh (2000) 'Modeling Survival Data: Extending the Cox 
> Model' 
> http://www.springer.com/statistics/life+sciences,+medicine+%26+health/book/978-0-387-98784-2 
> (which I might add I don't) you can do this.
> >
> > What was left over was the employer-provided Statutory Sick Pay. 
> This is what the current report was supposed to address. Employees 
> don't get anywhere near the ESA system until their SSP has run out - 
> for long-term employees, that's six months. For that first six months, 
> the employer can manage sickness absence, but statutory sick pay is 
> paid over (through the employer) on the basis that the employer has 
> accepted GP sicknotes.
> >
> > Those employers with occupational health available can refer sick 
> employees to them for a second opinion as to whether the sicknote 
> should be accepted. That doesn't go for the 95%+(guess) of employers 
> (SMEs) who don't have occupational health on contract or in post.
> >
> > Occupational health does more - reintegration and rehabilitation 
> services and plans etc, but the second opinion point is releavent here.
> >
> > It sounds, without reading the draft (which none of the press 
> reports seem to link - a major fail), that the proposal is to cut 
> short the GP-only period and have an 'independent assessment' - which 
> won't be a panel of doctors - it'll be a computerised assessment 
> reviewed by a 'healthcare professional' trained to read the reports. 
> Probably via ATOS, though they may decide that this should be opened 
> up to competition in which GP consortia could play.
> >
> > The press reports about moving shorter-term sick people onto 
> Jobseeker's Allowance is just numbers - the benefit entitlement (££) 
> for Assessment Phase ESA is the same as JSA. They've been upset that 
> ESA numbers haven't been going down as planned because of an 80,000 or 
> so appeal backlog of people who are appealing against being found fit 
> for work. Shifting them on to JSA while the appeal is pending 
> increased JSA numbers and cuts ESA numbers.
> >
> > Paul Bivand
> >
> > ---------------------------------------------------------
> > Paul Bivand
> > Head of Analysis and Statistics
> > Direct Line: 020 7840 8335
> > Mobile: 07709431039
> >
> > Inclusion
> > 3rd floor, 89 Albert Embankment, London SE1 7TP
> > Tel: 020 7582 7221
> > Fax: 020 7582 6391
> > Inclusion website www.cesi.org.uk
> >
> > See Inclusion’s www.indusdelta.org.uk for the latest news and 
> opinions in welfare to work
> >
> >  Consider the environment - do you really need to print this email?
> >
> > The contents of this e-mail and any attachment(s) are intended 
> solely for the use of the addressee. If you are not the intended 
> recipient please return the e-mail to the sender and delete from your 
> mailbox.
> >
> > The Centre for Economic & Social Inclusion is a company limited by 
> guarantee. Registered in England & Wales number 2458694. Registered 
> address: 89 Albert Embankment, London SE1 7TP
> >
> >
> > From: email list for Radical Statistics 
> [mailto:[log in to unmask]] On Behalf Of Clive Durdle
> > Sent: 19 November 2011 23:32
> > To: [log in to unmask]
> > Subject: Fwd: GPs and 'signing off'
> >
> >
> >
> > From: "Clive Durdle" <[log in to unmask]>
> > Date: 19 November 2011 11:29:31 PM
> > To: Socialist Health Association 
> <[log in to unmask]>,[log in to unmask]
> > Subject: Re: GPs and 'signing off'
> > But what about the huge amount of support Mr SH gets?
> > Clive Durdle
> >
> > 4 Toronto Road
> > Ilford
> > Essex
> > IG1 4RB
> >
> > 0208 554 5889
> > 0794 198 8846
> > [log in to unmask]
> >
> > http://clivedurdle.wordpress.com/about/
> > http://web.me.com/clivedurdle
> >
> >
> > On 19 Nov, 2011,at 07:14 PM, Socialist Health Association 
> <[log in to unmask]> wrote:
> > There is plenty of clinical evidence that work is beneficial to health.
> > But I have never seen any evidence that suggested that looking for work
> > had any similar benefit. There is also evidence, I think, that levels
> > of claims for incapacity relate to levels of unemployment. I don' t
> > think it is necessary to bring in fraud as an explanation. If there is
> > work available people who are not 100% fit may apply for jobs. If jobs
> > are in short supply they are less likely to do so, and employers are
> > more likely to prefer to employ fitter people.
> >
> > Of course there are people who pretend to be sick, but in the 
> absence of
> > any genuine objective test of capacity there is no way of knowing 
> how many.
> >
> > I have a number of friends who are very disabled - confined to a
> > wheelchair, blind, nasty neurological conditions, psychotic illness and
> > the like. I think they could easily hold down an intellectually
> > demanding job such as senior research scientist or chief executive
> > where the terms of employment are in practice pretty flexible and
> > allowances would be made for personal circumstances. But they couldn't
> > hold down an entry level job where you are expected to turn up at a
> > certain time and place and perform your duties which are strictly 
> defined.
> >
> > On 19/11/11 18:59, Alastair Greig wrote:
> > > >From an economist perspective, I find the situation intolerable. I
> > > am steering clear of 'out-of-work' benefits for this reason. While
> > > Fothergill's worklessness paper on hidden unemployment is 
> interesting,
> > > to provide this as a framework for analysis, and worse policy, there
> > > is an a priori that a large amount of people you are observing are
> > > committing fraud. Applying it to regional studies makes it a bit more
> > > challenging, we seem to be suggesting that the North East, the Welsh
> > > and the Scots are more likely to commit fraud than the clean cut 
> South
> > > East.
> > >
> > > While this report does appear different, the ethos is still certainly
> > > "getting people back to work". The aim of the report presents ways to
> > > get the sick into employment. To mask this in "well-being" is a bit
> > > fraudulent in my opinion. The major issue is that no reputable work,
> > > certainly in economics, really presents a truly balanced perspective
> > > on the extent and seriousness of the problem. This appears, at least
> > > to me, a way of legitimising crude economic assumptions about benefit
> > > benefit claimants which are, at best, gross simplifications which 
> make
> > > some modelling easier but not particularly useful in evidence-based
> > > labour market policies.
> > >
> > > > Date: Sat, 19 Nov 2011 18:28:27 +0000
> > > > From: [log in to unmask]
> > > > Subject: Re: GPs and 'signing off'
> > > > To: [log in to unmask]
> > > >
> > > > At 18:05 +0000 19/11/11, Socialist Health Association wrote:
> > > > >There is also a more profound problem. If Steven Hawking can hold
> > > > >down a job, what does incapable of work mean?
> > > >
> > > > It means: it depends on the job.
> > > >
> > > > Steven Hawking loves his work.
> > > >
> > > > Bob Hughes
> > > > --
> > > > Home: +44 (0)1865 726804 * Mobile: +44 (0)7968 292499 * Mail:
> > > > [log in to unmask] | [log in to unmask]
> > > > Personal site: http://www.dustormagic.net | No One Is Illegal:
> > > > http://www.noii.org.uk
> > > >
> > > > ******************************************************
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> > > sender and cannot be assumed to be representative of the range of
> > > views held by subscribers to the Radical Statistics Group. To find 
> out
> > > more about Radical Statistics and its aims and activities and read
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> > > web site www.radstats.org.uk.
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> > > of the range of views held by subscribers to the Radical Statistics
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> > > *******************************************************
> >
> > --
> > Martin Rathfelder
> > Director
> > Socialist Health Association
> > 22 Blair Road
> > Manchester
> > M16 8NS
> > 0161 286 1926
> > www.sochealth.co.uk
> >
> > If you do not wish to be on our mailing list please let us know and 
> we will remove you
> >
> > ******************************************************
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> more about Radical Statistics and its aims and activities and read 
> current and past issues of our newsletter you are invited to visit our 
> web site www.radstats.org.uk.
> > *******************************************************
> > ****************************************************** Please note 
> that if you press the 'Reply' button your message will go only to the 
> sender of this message. If you want to reply to the whole list, use 
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> to [log in to unmask] Disclaimer: The messages sent to this list 
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> Group. To find out more about Radical Statistics and its aims and 
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> invited to visit our web site www.radstats.org.uk. 
> *******************************************************
> >
> > ******************************************************
> > Please note that if you press the 'Reply' button your
> > message will go only to the sender of this message.
> > If you want to reply to the whole list, use your mailer's
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> > Disclaimer: The messages sent to this list are the views of the 
> sender and cannot be assumed to be representative of the range of 
> views held by subscribers to the Radical Statistics Group. To find out 
> more about Radical Statistics and its aims and activities and read 
> current and past issues of our newsletter you are invited to visit our 
> web site www.radstats.org.uk.
> > *******************************************************
> ****************************************************** Please note 
> that if you press the 'Reply' button your message will go only to the 
> sender of this message. If you want to reply to the whole list, use 
> your mailer's 'Reply-to-All' button to send your message automatically 
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> are the views of the sender and cannot be assumed to be representative 
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> Group. To find out more about Radical Statistics and its aims and 
> activities and read current and past issues of our newsletter you are 
> invited to visit our web site www.radstats.org.uk. 
> ******************************************************* 

-- 
Martin Rathfelder
Director
Socialist Health Association
22 Blair Road
Manchester
M16 8NS
0161 286 1926
www.sochealth.co.uk

If you do not wish to be on our mailing list please let us know and we will remove you

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Disclaimer: The messages sent to this list are the views of the sender and cannot be assumed to be representative of the range of views held by subscribers to the Radical Statistics Group. To find out more about Radical Statistics and its aims and activities and read current and past issues of our newsletter you are invited to visit our web site www.radstats.org.uk.
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