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 This “Expert Group” advised that: “The Chief Medical Adviser (at that time, Dr Mansel Aylward) is very anxious to ensure consistency of medical advice which is based on the prevailing consensus of informed expert opinion on this subject (ie. on the advice of Simon Wessely, Peter White and Michael Sharpe, again with no mention of the substantial biomedical evidence-base). “The following interests and disciplines were represented: academic research into CFS, clinical interest in the field (from psychiatry, neurology, infectious diseases and general practice), occupational medicine, the insurance industry…and the Disability Living Allowance Board”. Key recommendation of this “Expert Group” were: “The sooner appropriate management was started, the better the prognosis” and “Activity should be increased in a managed, step-wise manner”. The “Expert Group” agreed that: “Recovery should not necessarily be equated as getting back to the same condition as before the illness” (which seems to be a portender of the PACE Trial results). “Recovery” is defined in The Penguin English Dictionary as “To regain health after sickness”, which means restoration of full health after sickness; the term “recovery” is not open to idiosyncratic interpretation by the DWP or its “Expert Group”. The “Expert Group” recommended that its report to the DWP‟s Chief Medical Adviser should be widely available to all those with an interest in CFS (ie. throughout the NHS). At the end of the Training Programme, assessors were asked to tick more boxes and informed that “If the objectives have been achieved, you should have no difficulty in responding correctly”: one of the tick-box choices was: “The combination of cognitive behavioural therapy and antidepressants should be the mainstay of treatment”. The signed, completed form (together with the person‟s GMC or NMC registration number) Invest in ME (Charity Nr. 1114035) was to be returned to the “Medical Manager at your Medical Services Centre”. The 2010 version The Foreword to the DWP Medical Services 2010 version (Training and Development: Chronic Fatigue Syndrome [CFS] and Fibromyalgia Learning Set Continuing Medical Education) states: “The 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 to carry out assessments”. For the DWP Medical Services to conflate “CFS” and fibromyalgia is in breach of the WHO ICD-10 classification which classifies FM as a separate disorder from “CFS/ME” at M79. This version is particularly prescriptive and has become even more didactic: it ensures that only one message about ME/CFS and FM (the Wessely School‟s message) is delivered and received: “A Learning Set is dedicated to the sharing of team knowledge, and must be conducted using internal sources only. External speakers are not acceptable at these events”. (This is knowledge control, which is unacceptable ethically, morally and academically). “This Learning Set is designed to encourage competency based on the subject of CFS and FM and the functional effect of these conditions on the claimant”. “The learning aims are defined and the „manager‟ of the Learning Set is encouraged to ensure that these are kept prominently to the fore-front throughout the event, keeping them in view of all participants”. “The only absolute givens are that the essential Continued page 38 www.investinme.org Page 37/58
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