Journal of IiME Volume 5 Issue 1 (May 2011) The Involvement of the PACE Trial Principal Investigators and the Director of the Clinical Trials Unit with the Department for Work and Pensions continued “My intention would be for this report to be repeated on an annual basis and so become an authoritative and informative document on the current state of medical thinking on those issues which are of greatest importance to us. “Dr Lipsedge (and) Dr Sharpe have identified the importance of cogni-tive behaviour therapy of (sic) influencing the outcome in …chronic fatigue syndrome. This again represents a challenge in ensuring that people are directed towards this approach”. Thus the interest of the DWP and the insurance industry in ME/CFS is clear: it is a disorder that poses “difficulties” for them, so it seems it must be “eradicated”, preferably by those who already work for these agencies. It appears that it is those commercial interests, not the plight of sick people, which are paramount. It also seems that, as part of the triple strategy of the “CFS” clinics and the NICE Clinical Guideline on “CFS/ME”, the PACE Trial was the ideal vehicle to remove the “difficulties”. Extracts from the DWP Medical Services Training and Development on Chronic Fatigue Syndrome Guidelines: “This training has been produced as part of a Continuing Medical Education programme for Health Care Professionals (HCPs) approved by the Department for Work and Pensions Chief Medical Adviser to carry out assessments”. “…it must be remembered that some of the information may not be readily understood without background medical knowledge and an awareness of other training given to Health Care Professionals”. “The series is designed to encourage consistency in our approach to complex conditions, provoke reflection on our own Invest in ME (Charity Nr. 1114035) In the first self-assessment exercise, Medical Services assessors are instructed to read the questions and then tick one of the boxes, one of the questions being: “Most cases of chronic fatigue [sic] are attributable to abnormal illness behaviour”. “Chronic fatigue” is not the same as “CFS/ME”, but even if applied to “chronic fatigue”, this is a Wessely School assertion that is not supported by clinical evidence: when carefully examined and diagnosed, patients with many organic illnesses have chronic fatigue, including patients with cancer, COPD, thyroid disease, multiple sclerosis, Parkinson‟s Disease, liver disease, TB, and many viral illnesses, none of which disorders can be categorised as “abnormal illness behaviour”. The training programme then presents a case study: “Mrs D is a 42-year old woman. You have been asked to assess her and provide a report for a non-medical decision maker. She has completed a claim form herself, amplifying it with several additional pages of hand-written text and a pamphlet describing features of „ME‟ ”. Such loaded wording immediately introduces denigration, disparagement and bias into the Continued page 36 www.investinme.org Page 35/58 perception with regard to them, and foster awareness of current medical thinking” (i.e. the Wessely School‟s thinking). “Chronic fatigue syndrome (CFS) is a disorder, or group of disorders, which continue to cause considerable difficulties for clinician and disability analyst alike (no mention of difficulties caused to patients). Since the terms „myalgic encephalomyelitis‟ and „post-viral fatigue syndrome‟ both carry implications relating to causation, the generic term CFS is preferred”. “The purpose of this module is to encourage Health Care Practitioners working in disability analysis to adopt a common approach to this difficult and complex illness”.
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