Parliamentary Questions, getting to the bottom of WHO disease classification and enforcement, 19 May 2011

The difference between chronic fatigue and ME/CFS

Further to a written answer given by Lord Freud on 5 May 2011 in which he referred to Chronic Fatigue Syndrome and not Myalgic Encephalomyelitis/CFS, the Countess of Mar asked why the Department for Work and Pensions did not recognise the difference between chronic fatigue, categorised as a mental health condition in the World Health Organisation International Classification of Diseases 10th Revision, and CFS/ME.

In a written answer, Lord Freud (Parliamentary Under-Secretary of State at the DWP) replied:

The training programmes for Atos Healthcare professionals refer to chronic fatigue syndrome/myalgic encephalomyelitis. This was merely an omission from the Written Answer which should have clearly stated both, although – as I made clear in my answer to the noble Countess on 9 May ((Official Report, col. WA174) – assessment of entitlement to benefit does not depend on the condition itself, the underlying cause or how they are classified, but on the disabling effects of the condition(s) present.

Who in Government is responsible for the recognition, diagnosis and treatment of medical conditions?

Is Government under any obligation to enforce WHO classifications of disease?

The Countess then asked two questions, for which written replies were supplied by Earl Howe (Parliamentary Under-Secretary at the Department of Health).

Question 1: To ask Her Majesty’s Government who in Government are ultimately responsible for determining policy on recognition, diagnosis and treatment for particular medical conditions.

Question 2: To ask Her Majesty’s Government, in view of their agreement with the World Health Organisation’s classification of myalgic encephalomyelitis/Chronic Fatigue Syndrome as a neurological disease (under ICD10 G93.3), whether they are under any obligation to enforce recognition of this classification throughout government.

Earl Howe replied to both:

Clinicians are responsible, within their area of competence, for diagnosing medical conditions and for advising patients on the treatment options available. They are expected to take account of best professional practice, guidance from the National Institute for Health and Clinical Excellence and authoritative advice from other relevant bodies, including the World Health Organisation (WHO).

The department has no obligation, or powers, to enforce recognition of WHO’s classification throughout government.


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