prof malcolm hooper vs wessely school dept of health dwp uk

Discussion in 'Fibromyalgia Main Forum' started by simpsons, Aug 30, 2011.

  1. simpsons

    simpsons Member

    reposted with permission
    Permission to repost granted for public domain

    this is a battle that prof malcolm hooper is fighting not just for patients in the uk but for those around the world whose treatment is influenced by the wessely school. the usa insurance unum and their involvement can clearly be read in the magical medicine doc on me acion uk.



    On the 18th of July, Professor Hooper sent a letter to the Secretary of
    State for Work and Pensions and to the Secretary of State for Health on the
    discrepancy between the departments' classifications of ME. This letter is
    already in the public domain:

    <http://www.meactionuk.org.uk/dwp_doh_classification.htm>
    http://www.meactionuk.org.uk/dwp_doh_classification.htm

    To date he has received no response from the Secretary of State for Work and
    Pensions but has received a reply from the Department of Health. The
    following letter is Professor Hooper's response to that reply:

    <http://www.meactionuk.org.uk/Butler-letter-reply-28-8-11.htm>
    http://www.meactionuk.org.uk/Butler-letter-reply-28-8-11.htm

    From Malcolm Hooper Ph.D.,B.Pharm.,C.Chem.,MRIC
    Emeritus Professor of Medicinal Chemistry
    University of Sunderland, SUNDERLAND SR2 3SD

    Chief Scientific Adviser to the Gulf Veterans' Association
    President: the National Gulf War Veterans and Families Association, NGVFA,
    (2002)

    Mr Adam Butler
    Customer Service Centre
    Department of Health
    Richmond House
    79 Whitehall
    London
    SW1A 2NS

    28th August 2011

    Your ref: TO00000632586

    Dear Mr Butler

    re: The major discrepancy between the Department of Health and the
    Department for Work and Pensions on the same medical issue

    Thank you for your letter of 11th August 2011 sent in response to my letter
    of 18th July 2011 to The Rt Hon Iain Duncan Smith MP, Secretary of State at
    the Department for Work and Pensions that was copied to The Rt Hon Andrew
    Lansley MP, Secretary of State for Health, on whose behalf you replied.

    I am grateful for the courtesy shown by Mr Lansley, a similar courtesy not
    having been shown by Mr Duncan Smith from whose Department I have received
    no acknowledgement, so this letter will be copied to him.

    In my letter I drew attention to a serious error in the Statutory Payments
    Manual (SPM 50605) used by decision-makers, namely the categorisation of ME
    as a mental health disorder.

    In your reply you confirm that this error was the responsibility of the DWP:
    “You suggest that guidance used by decision-makers in the Department for
    Work and Pensions (DWP) is unsatisfactory. The DWP’s Health and Benefits
    Division was responsible for drafting the guidance”.

    It is, of course, the case that Professor Peter White, a psychiatrist who
    works for the permanent health insurance industry, was and remains lead
    advisor on “CFS” to the DWP and, despite irrefutable evidence that he is
    incorrect, he is firmly committed to his belief that ME is a somatoform
    (mental) disorder and he advises the DWP accordingly.

    Herein lies the major discrepancy between two Departments of State: whilst
    the DWP rejects the WHO ICD-10 classification of ME as a neurological
    disorder and follows Professor White’s beliefs that it is a mental disorder,
    the Department of Health nominally accepts the WHO ICD-10 classification of
    it as a neurological disorder.

    There are in fact two related issues, one being the discrepancy between two
    Departments of State outlined above and the other relating specifically to
    the DoH, this being the failure of the DoH to comply with the 1995 mandate
    to observe the WHO-ICD-10 classification system (see below).

    The first issue

    To summarise (and reiterate) the position of both Departments of State and
    their previous public statements about the nature of ME:

    1. the Department of Health accepted ME as an organic disease in 1987
    (Hansard, HC 27th November 1987, column 353)

    2. in a letter dated 13th March 1992 to James Pawsey MP (ref: POH (3)
    2484/200), in his capacity as Parliamentary Under Secretary of State for
    Health, Stephen Dorrell MP set out the official view of the Department of
    Health on ME: referring to the Disability Handbook produced by the
    Disability Living Allowance Board, the Minister stated: “The Handbook
    recognises that in some persons with ME there is evidence of persisting
    viral infections in muscles, with some evidence of muscle damage. Hence, a
    physical cause for ME is recognised”

    3. on 16th August 1992, Stephen Dorrell MP, Minister of Health, went on
    public record confirming that “ME is established as a medical condition”
    when he addressed a meeting of the Leicestershire ME Group

    4. not only the DoH but also the DWP recognises that ME is a physical
    disorder. In the British Library Current Awareness Topics Update for March
    2000 is listed (on page 6) the following: Social Security Ruling, SSR 99-2p;
    titles II and XVI; evaluating cases involving chronic fatigue syndrome
    (CFS). Fed Regist 1999 Apr 30;64(83);23380-4: “In accordance with 20 CFR
    402.35(b)(1), the Commissioner of Social Security gives notice of Social
    Security Ruling SSR 99-2p. This Ruling clarifies disability policy for the
    evaluation and adjudication of disability claims involving Chronic Fatigue
    Syndrome (CFS). This Ruling explains that, when it is accompanied by
    appropriate medical signs or laboratory findings, CFS is a medically
    determinable impairment that can be the basis for a finding of “disability”.
    This Ruling ensures that all adjudicators will use the same policies and
    procedures in evaluating disability claims involving CFS, and provides a
    consolidated statement of these policies and procedures”

    5. this was reported in the Disability Rights Bulletin, Summer 2000, in the
    following terms: “In assessing DLA higher rate mobility component for people
    with ME, recent guidance advises decision makers to assume in the vast
    majority of cases that the claimant has a physical disablement. The
    Commissioner, in CDLA/2822/99, held that an award of the higher rate
    mobility component can be made on the basis of the physical element of the
    condition. Guidance (DMG Memo Vol 10-3/00) advises decision makers that, in
    the vast majority of claims, if a doctor says the claimant has ME or CFS
    then that can be taken as an opinion that they have a physical disablement”

    6. on 18th September 2002, the Director of Communications at NICE issued a
    Communications Report which stated: “Following discussions with the
    Department of Health and other national agencies the Institute has adopted a
    new classification system that will be applied Institute-wide” (2.7.1.1);
    “The ICD classification has been used as a basis for the new Institute
    classification directed at the informed reader” (2.7.1.4);
    “ICD-10…classification codes are mandatory for use across England” (2.7.1.5)

    7. ME has been included as a neurological disorder in the UK Read Codes
    (F286) used by all GPs since 2003

    8. by letter dated 11th February 2004 to the Countess of Mar, the
    Parliamentary Under Secretary of State at the Department of Health, Lord
    Warner, confirmed that the DoH accepts the WHO classification of ME as a
    neurological disorder. That letter was placed by Lord Warner in the House
    library for access by all MPs.

    9. ME has been included in the National Service Framework for long-term
    neurological condition since its inception in 2005

    10. the DoH has confirmed on numerous occasions, many documented in Hansard,
    that the DoH itself and the UK Government accepts ME to be a neurological
    disorder, for example on 2nd June 2008 the then Parliamentary Under
    Secretary of State, Lord Darzi, was unequivocal: “My Lords, the Government
    accept the World Health Organisation’s classification of CFS/ME as a
    neurological condition….I have acknowledged that CFS/ME is a neurological
    condition…the Government…have made it clear that… it is a neurological
    rather than a mental condition”

    11. by letter dated 3rd August 2011 (reference TO00000632783), Tim Morgan
    from the Department of Health Customer Services Centre confirmed the
    following: “The ICD-10 is an NHS Information Standard….The NHS has a long
    history of using the ICD. There is a legal obligation for Department of
    Health to provide ICD data to the WHO for international comparison. The NHS
    was mandated to implement ICD-10 on 1 April 1995, at which time there was a
    formal consultation (emphasis added)….Implementation…applies to NHS
    organisations and their system suppliers, such as acute and foundation
    trusts, primary care trusts, and the NHS Information Centre”. (It is, of
    course, the case that Government officials such as yourself may use bogus
    names -- known as “office names” -- when writing to members of the public
    [“Civil servants use bogus names to sign official letters”; Roya Nikkhah;
    Sunday Telegraph; 20th June 2004], so the true authorship of both your own
    letter and that of Tim Morgan remains unconfirmed but must nonetheless be
    taken as authoritative documents).

    You say in your letter: “As you may know, in 2007, NICE published Clinical
    Guideline 53 (CG53) on the diagnosis and management of CFS/ME in adults and
    children, to advise the NHS on the treatment of CFS/ME in England and
    Wales”. The documentary evidence outlined above makes it all the more
    troubling that the NICE Guideline Development Group which produced CG53
    expressly rejected the WHO classification of ME as a neurological disorder
    and voted to remove from its deliberations its initial acceptance of ME as
    an organic disorder, this being confirmed by patient representative Tanya
    Harrison in her letter of resignation dated 16th July 2007 from the GDG:
    “the final straw came when the group voted to remove that ME/CFS is a
    physical illness”, which reflects the beliefs and advice of Professor Peter
    White to the DWP.

    Mindful of the above evidence, it will not be sufficient for you to reply to
    this current letter saying that this discrepancy between two Departments of
    State is a medical matter for the PCTs to address.

    It is a policy issue and thus a matter for the two Secretaries of State
    themselves to address and resolve without further delay.

    The WHO has classified ME as a neurological disorder since 1969 and ME
    cannot be taxonomically considered by the DWP or any other Department to be
    a somatoform disorder; that the DWP persists in doing so is all the more
    disturbing when, in another Department of State, the entire NHS is mandated
    to regard ME as a neurological disorder.

    The second issue

    Given that the NHS has been mandated since 1995 to implement the ICD-10
    classifications, and given that “mandatory” means “obligatory, compulsory”
    and that a mandate is “an official or authoritative instruction or command”,
    not only the DWP but also the NHS has patently failed to comply with the
    1995 mandate to implement ICD-10 classifications.

    Influenced by the Wessely School (who act as advisors to other Government
    departments and to NICE as well as to the DWP), not only the Wessely School
    themselves but also many NHS neurologists are in breach of the 1995 mandate
    that pertains throughout the NHS: 84% of neurologists questioned stated that
    they do not believe ME exists as a neurological condition (J Psychsom Med
    9th April 2010), despite the reported evidence of markers of severe
    ganglionitis having been found in the central nervous system in several post
    mortem samples.

    In one particular case, that of 32 year-old Sophia Mirza who died in
    November 2005 (whose death certificate recorded that she died of [ME]CFS),
    examination of her spinal cord showed inflammatory changes affecting the
    dorsal root ganglia, which are the gateways for all sensations going to the
    brain through the spinal cord. These inflammatory changes affected 75% of
    Sophia’s spinal cord.

    At the inquest held on 13th June 2006, one of the pathologists stated: “ME
    describes inflammation of the spinal cord and muscles. My work supports the
    inflammation theory because there was inflammation in the basal root
    ganglia”.

    Dr O’Donovan (the neuropathologist who had examined the spinal cord) stated
    that ME “lies more in the realms of neurology than psychiatry, in my
    opinion”.

    Given that NHS staff are mandated to use ICD-10 codes, I should be grateful
    if you would explain why such a medically unsustainable situation has been
    allowed by the DoH to remain unchallenged for the last 16 years, since there
    is a legal obligation for the DoH to provide accurate ICD data to the WHO.

    Recently, 26 expert authors (from 13 countries) produced the International
    Consensus Criteria for ME (Carruthers B et al; J Int Med 20th July 2011) and
    they strongly advocate that ME be removed from the NICE CG53 definition of
    “CFS/ME”.

    This should become a priority since, despite the fact that in ICD-10 the WHO
    currently indexes “CFS” only to ME at G93.3, the Wessely School
    psychiatrists and their adherents who work for the insurance industry have
    hijacked the term “CFS” to mean a syndrome of “chronic fatigue” (which is
    classified in ICD-10 at F48.0 as a mental disorder but which the Wessely
    School erroneously insist is synonymous with ME).

    It is essential that in relation to internationally defined ME, UK
    Departments of State begin implementing evidence-based policy instead of
    creating expedient policy-based evidence (which the Wessely School has done
    successfully for almost 25 years) and separate ME from “CFS/ME”. This is now
    very important, especially as Professor Peter White confirmed in writing to
    the Editor-in-Chief of The Lancet (a copy of which was sent to me) that:
    “The PACE trial paper refers to chronic fatigue syndrome (CFS) which is
    operationally defined; it does not purport to be studying CFS/ME”. That
    statement is mystifying, since the PACE Trial documentation consistently
    refers to “CFS/ME”. Professor White’s statement also raises the question as
    to why he received £5 million from the MRC (co-funded by the DoH, the DWP
    and the Scottish Chief Scientist’s Office) to study chronic tiredness that
    is prevalent in many primary psychiatric disorders, yet he asserts that the
    results of his PACE Trial are generalisable to those with a serious
    neurological disorder that he now claims he was not studying after all.

    These issues are of utmost importance not only to 250,000 people in the UK
    and their despairing families who are struggling to cope with a devastating
    neurological disorder, but also to the clinicians who see for themselves
    that people with classic ME are physically, not mentally, ill but who are
    thwarted in their attempt to investigate and support them by the overarching
    influence of the Wessely School.

    I therefore once again call upon both Secretaries of State to provide
    informed and firm leadership by re-circulating directions that the 1995
    mandate to comply with the ICD-10 classifications must legally be complied
    with by clinical and clerical staff in both Departments of State and that
    any individuals who refuse to comply are held personally and publicly
    accountable for any failure to observe that mandate.

    It is obviously imperative that different Departments of State have a
    unified position regarding the nature of a serious disease such as ME and it
    is equally important that the legal requirements of the WHO be observed by
    the UK, which currently is not the case as far as ME is concerned. I should
    therefore be grateful if you would clarify what action is being taken by
    your own Department about these important issues.

    Yours sincerely,

    Malcolm Hooper

    cc. The Rt Hon Iain Duncan Smith MP, Secretary of State, Department for Work
    and Pensions.
  2. simpsons

    simpsons Member

    http://www.spectator.co.uk/coffeehouse/7202658/mind-the-gap.thtml

    mind the gap a common phrase used in london on the tube to advise peopel steppin off the tube to not fall down the gap between the tube train and the pavement the title of an aritcle yet more press on behalf of wessely in his latest media attack

    the above letter is published in the comments on this link and an interesting debate is allowed by the spectator

    i thought it may be of interest to some and other who may wish to add to the debate
    with some good science refs