The Countess of Mar, who is chairman of the Forward ME Group of ME charities and patient support groups, got the training bit between her teeth with a series of four written questions which were answered in the House of Lords on 26 April 2011. They seemed to be related mainly to the professional standards applied by Atos Healthcare, the private company contracted by the Department of Work and Pensions to deliver medical assessments for benefits.
- To ask Her Majesty's Government why the Department for Work and Pensions Medical Services 2010 version of Training and Development: Chronic Fatigue Syndrome (CFS) and Fibromyalgia Learning Set Continuing Medical Education states, “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”; and what provision is made for trainees to be made aware of current biomedical scientific developments for both these conditions.[HL8526]
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud): Learning sets on relevant subjects are produced as part of the Continuing Medical Education programme for Atos Healthcare professionals. Learning sets are recognised as one of a range of personal development tools which can be used to learn new ways of working, share experiences and help with problem solving. They are based on the principle of self-directed learning and each learning set contains suggested sources of study. They also facilitate active participation, the sharing of knowledge, application of knowledge to practical problems and development of other skills such as facilitation skills. Although learning sets preclude the use of external speakers, other Atos learning events such as clinical conferences rely on the use of external speakers.
Trainees are updated on biomedical scientific developments for CFS and fibromyalgia that are relevant to disability assessment by accessing the sources provided in the learning set and by use of other training products relating to CFS and fibromyalgia, which are updated on a regular basis.
- To ask Her Majesty's Government upon what scientific medical evidence the Department for Work and Pensions Medical Services 2010 version of Training and Development: Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) tells participants to explore “Ways in which relevant functional problems can present in a claim”; and “The likely functional effects of CFS and FM” when neither illness is a functional disorder.[HL8527]
Lord Freud: The Department for Work and Pensions (DWP) recognises Chronic Fatigue Syndrome (CFS) and fibromyalgia as real and potentially significantly disabling conditions. Where a clinical diagnosis of CFS or fibromyalgia has been made, full account will be taken of their disabling effects.
The term “functional” in the training module refers to the effect of a condition on a person's ability to function on a day to day basis and has a different meaning to the term “functional” in the context of a “functional disorder”.
- To ask Her Majesty's Government whether training programmes for classified neurological diseases such as multiple sclerosis or Parkinson's disease are identical to that for myalgic encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) which is also classified by the World Health Organisation ICD 10 as a neurological disease under G93.3.[HL8528]
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): The content and standard of medical training is the responsibility of the General Medical Council, which is the competent authority for medical training in the United Kingdom.
The General Medical Council's Undergraduate, Postgraduate and Continued Practice Boards have the general function of promoting high standards of medical education and co-ordinating all stages of medical education to ensure that students and newly qualified doctors are equipped with the knowledge, skills and attitudes essential for professional practice.
- To ask Her Majesty's Government whether they will encourage Department for Work and Pensions and Atos Healthcare assessors to review their approach to myalgic encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS), in light of the findings by Jason et al in An Aetiological Model for ME/CFS, Neuroscience & Medicine 2011:2:14-27.[HL8529]
Lord Freud: Medical assessments done on behalf of the DWP look at the functional impact of a condition on an individual; entitlement to benefit is not based on medical condition/diagnosis. The DWP recognises that ME/CFS covers a spectrum and can be a significantly disabling condition.
The article, An Aetiological Model for ME/CFS, presents a theory (yet to be tested and proven) for understanding the cause of ME/CFS. The DWP's guidance to assessors appropriately focuses on the range of functional impairment related to particular conditions rather than on causation. This article does not address functional impairment; therefore there will be no change to the guidance as a consequence of it.