MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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“This approach is quite inappropriate and positively harmful for many common health problems that do not have any
good medical answer. The traditional sick role can then become a trap, in which the patient continues futile attempts to
find a medical solution.
“Conceptually, chronic pain, fatigue or comparable syndromes do not meet the criteria of severe and
permanent impairments. Pragmatically, it is impossible to set any threshold for severity, while the epidemiology and
the North American experience show they could possibly lead to explosive growth. For all these reasons, we would
argue that they should not be regarded as severe and permanent impairments, but are better treated as
potentially recoverable”.
Then comes the possible explanation for the “eradication” of ME and the reclassification of CFS as a
functional somatic (behavioural) syndrome: in order to qualify for benefits “the illness must be recognised by a
respected body of medical opinion and in practice, conditions which are specifically mentioned in major classification
systems such as the ICD‐10 or DSM‐IV are very likely to be accepted as being ‘clinically well recognised’ ”.
In the Wessely School’s syllabus, “CFS/ME” is a mental (functional somatic) disorder. From this it seems
certain that if “CFS/ME” were to be formally re‐categorised as a “mental” disorder in the major classification
systems, the insurance industry would have cause to rejoice because, quoting Peter White, Waddell and
Aylward say:
“the insurance industry approach to total and permanent disability generally consists of … independent medical
evidence that the claimant is suffering from a diagnosable functional disorder (and) the claimant has received at least
two years of optimal medical treatment (OMT) by a recognised medical specialist. It is surprising how many claims
fail to meet this criteria (sic). The commonest reasons for failure are that the consultant has not considered a
biopsychosocial approach to rehabilitation”.
Common sense asks why an informed consultant would refer for psychotherapy a patient with a classified
neurological disorder who is clearly incapable of work and thus under their policy entitled to PHI payment
purely in order to convince the patient that s/he does not have a classified neurological disorder and is
capable of work, especially given that Professor Trudie Chalder herself is on record as acknowledging that:
“Part of the problem of the BPS (biopsychosocial) model is that it is so broad and non‐specific to render it almost
completely meaningless. It is theoretic and it doesn’t lead us anywhere” (Biopsychosocial Medicine, OUP 2005).
The answer is to be found in the UNUMProvident literature (see Appendix IV) and in Waddell and
Aylward’s book:
“There is good evidence from the insurance industry that it is often more useful to have the independent examination
(sic) carried out by a doctor qualified in disability assessment medicine or by a non‐medical health professional such as
an occupational therapist or occupational psychologist”.
For the avoidance of doubt, the training of occupational therapists and occupational psychologists does
not qualify them to assess complex neuro‐immuno‐vascular disorders such as ME/CFS.
In the same year that the book by Waddell and Aylward was published, on 22 nd August 2005 another of the
Woodstock attendees, Professor Derick Wade from the University of Oxford and the Rivermead
Rehabilitation Centre, Oxford, wrote to Dr Roger Thomas, Senior Medical Policy Adviser in the Benefit
Strategy Directorate at the DWP advising that – despite the WHO classification ‐‐ ME/CFS is not a
neurological disorder but a “non‐medical illness”.
When challenged about his views by the person about whom he had written, on 7 th July 2006 Wade replied :
“ME/CFS is not a neurological condition in that there is no pathology in the nervous system.