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 „It‟s unfair to suggest that the system isn‟t working….If a decision is overturned at appeal, it does not necessarily mean that the original decision was inaccurate…‟. However, this doesn‟t really deal with the problem that the healthcare professionals doing the assessment are not…forwarding sufficient evidence to enable reliable decisions”. “At the meeting I asked how it was possible to know the variation in symptoms that a patient may have during a one-off assessment. I was told that this could be „difficult‟ but this was….a „functional assessment‟ ”. “The Citizens Advice Bureau…wants „better accuracy‟ in reports. But how can this be achieved when funding is devolved to Atos with no routine access to detailed specialist or general practice based information and opinion?”. Returning to the DWP‟s Medical Service 2010, its “Learning Aims” are: (i) (ii) (iii) (iv) (v) to define CFS and FM (perhaps more accurately, to “re-define” them as functional disorders) to consider “possible causes and functional effects of these conditions” to “consider current management and treatment guidelines (ie. NICE CG53) to “consider benefit issues in children and adults with CFS or FM” and to “consider effects of these conditions on work/occupation and effect of work on these conditions”. “It is essential that the Learning Set achieves its learning aims and covers the essential content….It is recommended that all attendees are reminded of the purpose of the Learning Set, the responsibilities of all those present and the learning aims reinforced”. During training discussions, participants must explore the following factors: Invest in ME (Charity Nr. 1114035)  “Ways in which relevant functional problems can present in a claim” (neither ME/CFS nor FM is a functional disorder)  “The likely functional effects of CFS and FM”  “Attitudes amongst the team towards the condition”  “The claimant‟s perceptions of their disability and barriers to recovery” (such a “barrier” is cited as belonging to a support group). “The challenge for the facilitator is to ensure that all participants are engaged and prepared to commit to the consensus conclusions” -- in other words, 100% commitment and absolute adherence to the Wessely School model of “CFS/ME” is obligatory on the part of all DWP/Atos Healthcare assessors dealing with patients with ME/CFS. Would such indoctrination be part of a training programme to assess those with other classified neurological conditions such as multiple sclerosis or Parkinson’s Disease? These DWP training programmes for assessors are extremely disturbing because, as Jason et al have pointed out in a compelling article looking at kindling as the underlying mechanism for the symptomatology seen in ME/CFS, these patients have evidence of extremely serious pathology (An Aetiological Model for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Neuroscience and Medicine 2011:2:14-27). Jason et al posit that kindling occurs when an organism is repeatedly exposed to an initially sub-threshold stimulus resulting in hypersensitivity and spontaneous seizure-like activity, and that in ME/CFS patients, chronically repeated lowintensity stimulation due to an infectious illness might cause kindling of the limbichypothalamic-pituitary axis and that, once this system is charged or kindled, it can sustain a high level of arousal with little or no external www.investinme.org Continued page 40 Page 39/58

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