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Showing posts with label claim. Show all posts
Showing posts with label claim. Show all posts

Saturday 29 April 2017

Whiplash: the myth that funds a £20bn gravy train

Patrick Collinson in The Guardian


Ten years ago I was in a country lane in Leicestershire, indicating to turn right to go into a hotel for a family event. Seconds later my car was a write-off after a young driver careered round the bend, smashing into the rear of my VW Golf. Fortunately I stepped out uninjured. And from that moment I was pestered, again and again, to make a false whiplash claim.

One of the hotel’s guests was first in. “You’ve got to get down the doctors, tell them your neck is really hurting. You’ll easily get £3,000,” said one (I’m summarising here). But my neck, while a little stiff, wasn’t in pain. Others told me I was mad not to apply. But a decade later there is no evidence the crash caused anything other than a mild sprain that lasted a couple of days. And certainly not deserving of the £3,000-£6,000 that is routinely paid out to “victims” of even the mildest of rear-end shunts.

Now one brave consultant neurosurgeon, who has carried out thousands of operations involving neck and back issues, has declared that whiplash is a myth, nothing more than a multibillion-pound gravy train for lawyers, doctors and the victims suffering from “mainly non-existent injuries”.

In a remarkable piece for the Irish Times, Dr Charles Marks, a lecturer at University College Cork, says the medical profession is as guilty as the lawyers. “For 20 years I wrote medical reports which were economical with the truth … the truth being, there was very little wrong with the vast majority of compensation claimants that I saw. I was moving with the herd.” In Ireland, where payouts have reached levels that even the most avaricious ambulance-chasing lawyer here can only dream of, a doctor can earn as much as £3,000 a week in fees after spending 20 minutes with someone involved in a minor car crash, then writing a largely templated report. “It’s a fee of around €350 and you can easily do 10 a week,” Marks says.

Yet whiplash is “almost impossible to prove”, says Dr Marks, with patients self-diagnosing pain that can never be detected using sophisticated imaging techniques such as MRI and bone scans. “All whiplash is minor. Moderate or permanent whiplash is simply non-existent.”

He cites one study of 40 “demolition derby” drivers in the US who had an average of 1,500 collisions each over a couple of years. Compare that to a mild shunt in slow-moving traffic that, somehow, warrants payouts of thousands. Yet just two of the demolition derby drivers reported post-participation neck pain that lasted more than three months.

Dr Marks adds that in Greece and Lithuania, where there is no expectation of financial gain from whiplash, chronic neck pain following a car crash appears simply not to exist.

But one (British) consultant in Ireland is barely sufficient evidence. So I spoke to another whiplash expert, Dr Stuart Matthews, consultant surgeon in major orthopaedic trauma at the Leeds Teaching Hospitals. He sounded even more dismissive than Dr Marks. “There is not a single test that shows abnormality directly attributable to this condition. Diagnoses are purely on the say-so of the person involved. Many orthopaedic surgeons do not believe it is a genuine condition.”

He says early research that provided medical endorsement for whiplash claims has subsequently been rejected. “It’s the emperor’s new clothes. People just go along with it, there is a bandwagon.”

Neck sprain is genuine, he says, but recovery is relatively quick with little evidence of significant physical injury.

Yet the victims of whiplash receive £2bn a year in payouts, a fair chunk of which goes to personal injury lawyers. That’s £20bn over the past decade, paid for out of galloping increases in car insurance premiums. The forthcoming election means that reforms to whiplash payouts, promised in the prison and courts bill, have been shelved.

A new government, of whatever complexion, should reinstate the reforms – and order a major medical review to determine if we have all been conned for years.

Friday 10 August 2012

Unscrambling The Politician’s Prose



Salman Khurshid's article Dunk us All in Liquid Oxygen doesn't quite manage to conceal that the ongoing events at Jantar Mantar reflect the anger of a great many Indians at the extent and scale of the culture of corruption in India’s political class

K.V. BAPA RAO in Outlook India

The Indian people are pretty well hardened to the ineptitude and corruption of their politicians. But, as the recent grid crash—in a week that gave us a burning train, communal riots, highway deaths, attacks on women, on top of another grid crash—shows, the politicians are always a step ahead of the people’s ability to take things in their stride. They see to it that we never lose our sense of wonder: what sort of minds, what thinking process, what value system, could possibly drive such a single-minded commitment to failure and disaster?

It’s all very well to say that they are venal and stupid; but that really isn’t any kind of answer. Consistent and massive failure in all imaginable fields is never the result of mere individuals acting out of ill-intent; it needs organization. And an organization requires a guiding value system that drives a rationale for comprehensive failure and corruption. It is this value system and shared mental process that is revealed when a politician writes the rare article for public consumption.

Back in 1946, George Orwell wrote a short but insightful essay on Politics and the English Language,
explaining the connection between badly-written prose and slimy political lies. The creator of the fictional Ministry of Truth (actually a factory of lies) made a lifetime study of the lies of public figures and the language they use for telling those lies. Orwell has this to say about politicians’ words:

"In our time, political speech and writing are largely the defence of the indefensible. [atrocious
and morally unjustifiable things] can indeed be defended, but only by arguments which are too
brutal for most people to face, and which do not square with the professed aims of the political
parties. Thus political language has to consist largely of euphemism, question-begging and
sheer cloudy vagueness."

Orwell’s insight was that, when politicians write badly, the rotten prose is no accident but a direct result and symptom of the rotten values and rationale that the writer is trying to conceal. No one can write without revealing their brain at work; when you write to lie and deceive, it is hard for the brain to reconcile what it believes to be true with the deception which it is being asked to perpetrate in logical and clear prose. As a result, the writing ends up failing on both fronts: the prose comes out unclear and barely coherent, while the truth peeks out from the covers, and can be extracted, with some effort by the reader. This extracted truth is the “brutal argument” that Orwell is talking about.
Indian politicians usually keep their brains well out of public view; they carefully avoiding putting words down for people to read and criticize. So, Law Minister Salman Khurshid’s recent article in Outlook affords a rare opportunity to apply Orwell’s methods to probe an Indian politician’s mind and piece together the brutal argument that he is not giving us, but is not quite able to conceal either.
Khurshid article was titled Dunk us All in Liquid Oxygen, a wry allusion to a popular quotation attributed to the late Hindi film actor Ajit, known for his roles as clownish villains spouting quirky dialogue. Torment by “liquid oxygen” at the hands of Ajit’s henchmen would leave the victim in a painful state of being simultaneously notalive (due to the liquid) and not-dead (due to the oxygen).

The piece is evidently intended as a plaint against the India Against Corruption (IAC) organization that currently involved in a national agitation (against political corruption) and hunger strike at Jantar Mantar in New Delhi. Khurshid professes “caring” for Anna Hazare—a prominent member of activist who has been on hunger strike—but insinuates that Hazare, while himself a good person, is, sadly, a lousy judge of character who keeps company with some very bad persons whom Khurshid ostentatiously refrains from naming. Khurshid expends a great many words on the dangers that these unnamed persons pose to the delicate fabric of society, in a darkly conspiratorial tone reminiscent of entrenched old-school demagogues inveighing against “outside agitators” out to pollute, and destroy, our precious political system.

Khurshid leaves no doubts at all about the sheer intense wickedness of these nameless enemies of the
people. He signs off with a famous verse from the famous poem, The Second Coming by the famous poet W.B. Yeats:

“The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.”

It seems that Khurshid is actually quite angry with critics who have been giving his colleagues in the political class a hard time about corruption over the past year or so. In the article, he lays the blame squarely on these critics (who are “the worst”) for a deepening cynicism in the public about politics and the political system, and by conscious omission, holds the political class blameless and unjustly maligned. It is another thing that, to the public, it appears as though the political animals have been laying into the public weal like so many drunken monkeys unleashed on a banana boat. And just as those monkeys might, politicians become very cross indeed when someone has the nerve to try to thwart their orgy.

The gorging monkey analogy is rather unkind perhaps, but still apt. If the political class is driven by visions of loaves and fishes of office dancing in their eyes, they are hardly likely to take an interest in raising their standards of service to the public above simian levels, so to speak. Colossal power failures, trains lacking safety systems that were standard elsewhere in the 20th century, deadly roadways, subsistence levels of potable water, grinning indifference to enemy attacks on the nation’s cities, unspeakable sanitation, a disgraceful health care systems, a dodgy education system—these and the rest of the dysfunctions besetting India all make sense now; they are built and maintained by the political equivalent of partying monkeys, when they can spare the time, that is.

Khurshid devotes a considerable portion of his article fretting about what is to become of India’s pluralistic political system in the face of the debilitating demands of the dark forces, that is to say, the anti-corruption activists. On the face of it, this is nonsense—corruption, or its impact, is the most pluralistic thing there is, sparing no one of whatever persuasion. Khurshid’s article is rather incoherent but not altogether useless. If we apply Orwell’s ideas, and carefully read past, and into, the vaguely-worded but relatively well-written peroration, we can expose the “brutal argument.” Here are Khurshid’s concluding words:

The role of democratic politics is to find a workable arrangement between competing claims,
ensuring, in the process, the stability of society. Where this breaks down, we are left exposed to
the forces of unwholesome upheaval, even violence. The strength of Indian democracy is our
unity in diversity. If the accommodation of legitimate interests is questioned every time, politics
will not be a place for angels and idealistic young men and women. Young India will no longer
dream, but will suffer the agony of unending nightmares. With the death of innocence in our
times, what then will we tell our children? Who will join politics or become a judge? Will we
bequeath to generations to come the lost years, because courage failed the good?

Khurshid evidently means to say that stability is paramount, and trumps all other concerns. Agitating against defalcations by the political class, harshly criticizing politicians, reacting to their bad-faith pretence at responsiveness with anger and refusing to back down--all these things are the forces of unwholesome upheaval, and lead to bad consequences like the reluctance of young people to dream about becoming politicians, to be welcomed, nurtured and mentored as Khurshid himself was by his Congress Party.

But, the conditions in which the majority of Indians are forced to live —dangerous, deprived and unsanitary conditions engineered by Khurshid’s own political class—are hardly a reasonable interpretation of stability  or security, except by the inhumanly low standards that were imposed on the Indian people by persons like Khurshid, persons he evidently respects and admires. And if the Indian people don’t tear each other apart in despair and rage, it is no thanks to the politicians but due to the civilisational value system that Indians carry in their collective DNA. So, what, then, is this stability that would be threatened when politicians are criticized?

Well, the political class endeavoured, quite successfully, to insulate itself from the worst of the crippling consequences of their own corruption and comprehensive ineptitude, and the insulation has held steady. Anger directed at the political class could conceivably lead to a loss of this insulation, and politicians may have to actually put up with the consequences of their actions. With this in mind, we can now translate Khurshid’s words into plain English prose as follows, which would help us understand why he took the time to write his article:

Public corruption is not important. More precisely, it is far less important than political stability,
which is to be maintained by a system of sharing the spoils of office with all political actors who
can make enough trouble, thus pacifying them. When people actually confront corruption, but
won’t settle for a cut of the action, it disrupts this political order. In the politicians’ eyes, this is
the worst possible thing that can happen to India. Ergo, those that engage in such confrontation
are the worst possible persons and therefore deserve the harshest possible treatment.
It is serious business, but the operative phrase above is “harshest possible.”

Sometimes, harsh is less possible than at other times. After some experience, the politicians have learned to treat Anna Hazare with kid gloves. Less charismatic but still somewhat powerful colleagues of Hazare can be set apart from Hazare and blamed for destroying the country, but it is better to maintain a veneer of plausible deniability and avoid naming them, since they might possibly come around to be co-opted at some time. Then, there are powerless citizens like the hapless Gurgaon housewife Rajbala, (no doubt one of the dark forces that worry Khurshid so) whom it was entirely possible to beat to death when she irritated the politicians by protesting against corruption. In the meantime, it is only prudent that the enabling machinery of protest and confrontation be crippled by effectively criminalizing, by default, all use of the internet that Law Minister Khurshid and his powerful colleagues find objectionable.

If this is the honest rationale veiled by Khurshid’s opaque prose, then it is no wonder that, when tossing in the obligatory piety about commitment to accountability, debate and so forth, his prose dissolves into incomprehensible and self-contradictory near-gibberish:

Not for a moment should my position be thought to be seeking immunity from accountability.
Ipso facto treating it as such would mean reluctance of the adversary to join in an open debate—
the essence of democracy, in whose name many self-opinionated, harsh, even irresponsible
positions are being taken.

No one in their right mind would even try to interpret what the “ipso facto …” sentence could possibly mean. Considering the brazen opaqueness of that sentence and the evident impunity with which Khurshid utters it,what follows can only be a cliché-ridden falsehood:

Let me say it with all the emphasis at my command: We stand for the fullest transparency and
accountability.

Here is Orwell again, about what lies behind such insults to the language:

"The inflated style itself is a kind of euphemism. A mass of Latin words falls upon the facts like
soft snow, blurring the outline and covering up all the details. The great enemy of clear language
is insincerity. When there is a gap between one's real and one's declared aims, one turns as it
were instinctively to long words and exhausted idioms, like a cuttlefish spurting out ink.

When employed to camouflage a “brutal argument” with platitudes, cant and bombast, the frontal lobe of the
brain blows a fuse, prose rebels, twists itself into knots, and turns into a hideous caricature, albeit one which
still retains a flavour of the truth. What Khurshid’s article doesn’t quite manage to conceal is the reality that the ongoing events at Jantar Mantar reflect the anger of a great many Indians at the extent and scale of the culture of corruption in India’s political class. Anger induces rigidity of outlook; mass anger has a way of generating simplistic and ultimately unhelpful, even harmful answers. However, considering the depth, breadth and duration of the politicians’ malfeasance, and their stubborn imperviousness to self-correction, the expressions of anger have been rather mild, and the proposed solutions rational, lawful and fairly reasonable, for all their flaws.

Khurshid and his political colleagues are livid that people are angry with them; they simply refuse to admit the
fact that the people’s anger is entirely justified, and that it is entirely the politicians’ fault that the people are
angry. If today, the politicians feel trapped, tormented and hectored on all sides, it is but the proper and
deserved consequence of their own actions. Khurshid’s shoddily-written tantrum of an article is a symptom of the continued reliance of the politicians on bluff and bluster in their efforts to divide and neutralize the
organizers of the agitation and dissipate the people’s anger.

Khurshid’s concerns about the risks posed by the people’s anger to the stability of society are disingenuous.
The agitation has remained peaceful for over a year, a remarkable thing for a grassroots street movement.
Khurshid and his fellow politicians have vast, virtually unlimited powers, and they do use them quite ruthlessly
to protect their rather sweet little racket. Khurshid’s fear is that, once people feel empowered to scrutinize
politicians, they will turn on the politicians with the same fervour that politicians exhibit when thwarted. He
worries too much--unlike the government of which Khurshid is a member, the anti-corruption agitators, for all their anger, haven’t yet beaten anyone to death yet for confronting them, nor have they criminalized the use of the internet.

The minister is right about one thing—we do need capable young people of good character to enter the political profession, since the people cannot do without hired help to act as their proxies in the exercise of power and in the management and development of shared resources. A key requirement of the job would be the temperament to cheerfully accept intense scrutiny and criticism, even when it is unfair, all the while learning and striving to deliver higher standards of service, and communicating honestly, and clearly with the employer.

The apprentice politician might find Khurshid’s article of some use—as an Orwellian cautionary tale to show
that defending the indefensible is morally wrong and rots your prose.