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Psychiatrists Paid by Outside Interests

Extracts from “CORPORATE COLLUSION?” by Margaret Williams

Wessely School control of ME/CFS issues

For over two decades, in their role as advisers to Government Departments, Wessely School psychiatrists have been tirelessly influencing Government Ministers and Departments of State on behalf of their paymasters, known to be Big Pharma and the medical insurance industry, about what they term "medically unexplained" disorders, notably ME/CFS and Gulf War Syndrome, both of which they assert do not exist.

Simon Wessely, Michael Sharpe, Peter White -- and to a lesser extent their colleague Anthony Cleare -- are deeply involved with the medical insurance industry. Written evidence exists showing that claims for "CFS/ME" are inter-referred amongst themselves, and that claimants are coerced into being assessed only by this group of psychiatrists. Claimants are told: "If you agree to see (Dr) Michael Sharpe, we will agree to be bound by his opinion", when the insurance company knows full well that Sharpe lectures to insurance companies, business schools and employers, advising that those with ME/CFS seeking payment of benefit under their policies "should not qualify for such payments". Is it justice for Sharpe to be paid by insurance companies when he directly or indirectly advises the non-payment of claims for patients with ME/CFS? It was on 17th May 1995 that Wessely, Sharpe and Wessely's colleague, behaviour therapist Trudie Chalder, all spoke at a Business Symposium in London attended by UnumProvident's Dr John LoCascio: information presented included informing attendees that ME/CFS has been called 'the malingerer's excuse'. Extracts from UnumProvident's "Chronic Fatigue Syndrome Management Plan" are pertinent: "Diagnosis: Neurosis with a new banner. UNUM stands to lose millions if we do not move quickly to address this increasing problem. Attending physicians (must) work with Unum rehabilitation services in an effort to return the patient / claimant back to maximum functionality with or without symptoms".

This important issue of vested interests has been repeatedly raised in the House of Commons, most recently in the 2006 Report of the Gibson Inquiry (see below), and Members of the Scottish Parliament have written to Allied Dunbar about their concerns over Michael Sharpe's suitability to give an unbiased view when assessing people with ME/CFS; Sharpe has asked MSPs to withdraw their statements to Allied Dunbar about him.

The Wessely School psychiatric lobby and ME/CFS patients' charities

The ME Association: that Wessely School psychiatrists have sought absolute control of the ME situation is beyond doubt. Almost 20 years ago, Professor (then Dr) Simon Wessely wanted to become Medical Adviser to the ME Association and was recommended for the post by the then Medical Adviser Dr David Smith. Dr Melvin Ramsay's response as President of the ME Association was "over my dead body". Dr David Smith left his position at the ME Association and Dr Charles Shepherd took over as Medical Adviser.

Shepherd brought with him different (but perhaps related) problems in that he is, on his own admission, an active member of HealthWatch, an organisation that has received funding from both Big Pharma and the medical insurance industry. Simon Wessely has had connections with HealthWatch since its inception in 1989; soon after the press launch, he was listed as one of its leading campaigners. In its literature, one of its clearly-stated aims is to oppose "diagnoses that are misleading or false, or that may encourage unnecessary treatment for non-existent diseases", and Wessely assiduously teaches that ME is a non-existent disease.

Despite its vehement denials -- including intimidatory letters sent by its lawyers inexplicably refuting its own literature -- HealthWatch (which started life in 1989 as the Quackbusters Campaign Against Health Fraud) has an indisputable and documented track record of opposing alternative and complementary medicine and of promoting pharmaceutical interventions as the best way of ensuring public protection. It is a matter of record that patients with ME/CFS are unable to tolerate pharmaceutical interventions; given the lack of NHS care apart from psychotherapy, they not unnaturally turn to alternative and complementary practitioners in their efforts to find some relief from their distressing symptoms, so Shepherd's role in the ME Association has been controversial.

In particular, it is difficult to understand Shepherd's strong opposition to advanced investigations for those with ME, notably nuclear imaging, immunological assays and testing for RNase L and other anti-viral pathways, all of which provide evidence of the biomedical nature of ME/CFS. On 17th July 2001 Shepherd wrote to the Chief Medical Officer confirming his opposition to such testing. People with ME/CFS have incredibly up-regulated interferon production (that is what the RNase activity literature is all about), so on what evidence does Shepherd (a part time private GP) oppose such testing, when internationally acclaimed ME/CFS experts - clinicians and academics alike - support it? In his notes of the ME Alliance meeting held on 20th January 2005, Shepherd wrote: "I'm now going to reorganise what I've written, especially in the 'call for research' section. We decided not to campaign on the issue of finding a diagnostic test".

Most people hold the view that until there is a diagnostic test for ME/CFS, the plight of those suffering from it will not improve.

Action for ME: the other main UK patients' charity, Action for ME (AfME), has had a chequered history. In September 1993 it changed its name and logo to "Action for ME and Chronic Fatigue". Complaints were made to the Charity Commission and the charity subsequently dropped "Chronic Fatigue". On 24th July 2003, in a statement approved by its Council of Management, the charity announced that it is funded by the Department of Health.

Psychiatrist Michael Sharpe (infamous for his "undeserving sick" comment quoted above) is one of its medical advisers, though his name does not appear on the charity literature. It is well-known that in UnumProvident's Chief Medical Officer's Report (Trends in Disability, December 2002) Sharpe wrote: "Functional symptoms are not going to go away. Privatised doctors will collude with the patient's views that they have a disabling and permanent disease. An increase in insurance claims is to be therefore anticipated. It will be imperative that social policy addresses this problem. This will not be easy. However, there are glimmers of progress. One of the major patient charities, Action for ME, is aligning itself with a more evidence-based approach. If this convergence of rehabilitation-orientated clinicians and a patient's advocacy group is successful, there could be very positive implications for insurers".

This liaison is encapsulated in the statement by Lord Turnberg (the former Sir Leslie Turnberg, President of The Royal College of Physicians): "The largest patients' charity, Action for ME, is working closely with Wessely and his colleagues on new research initiatives funded by the MRC and the NHS" (Hansard [Lords]: 22nd January 2004: Vol 656: No. 27:1186). It was under the auspices of Turnberg that the biased and highly flawed 1996 Joint Royal Colleges' Report CR54 on "CFS" was produced with his full support (see below).

Professor Anthony Pinching is currently AfME's Principal Medical Adviser. He is lead adviser on "CFS/ME" to the Department of Health and was responsible for allocating the £8.5 million grant from Government for the new "CFS" Centres that deliver only psychotherapy. His views on "CFS/ME" were set out in his article in Prescribers' Journal in 2000:40:2:99-106, published when he was Deputy Chair of the Chief Medical Officer's Working Group on "CFS/ME" ("CFS is not related to on-going exertion"; "the Oxford criteria are too narrow for clinical use"; "over-investigation can [cause patients] to seek abnormal test results to validate their illness"; "complementary therapists sometimes introduce or reinforce unhelpful illness beliefs"; "the essence of treatment is activity management and graded rehabilitation").

In March 2001 AfME produced an excellent report, Severely Neglected: M.E. in the UK. This report was the result of a membership survey of 2,338 respondents, making it the biggest survey ever done on ME in the UK. Its confidential Preliminary Report of 28th February 2001 stated: "graded exercise was reported to be the treatment that had made most people worse" but in the published version, this was changed to reporting that graded exercise made 50% of respondents worse. This makes it all the more surprising that AfME "is working closely with Wessely and his colleagues on research initiatives funded by the MRC and the NHS" when those "initiatives" are based on graded exercise.

AfME's report found that 77% of respondents experienced severe pain because of ME; nearly two out of three had received no advice from their GP on managing the illness; 70% were either never able, or were sometimes too unwell to attend a doctor's clinic; 80% of those who were bedridden by ME reported that a request for a home visit by a doctor had been refused, and that many people did not receive State benefits to which they were clearly entitled and desperately needed in order to survive.

By aligning itself with the Wessely School, who have a 20 year published track record of denigrating patients with ME, AfME has done patients with ME a massive disservice and may well have devalued the charity's own important report.
Michael Sharpe has a similar published track record to that of Wessely:
he asserts that in "CFS/ME", personality factors have been shown to perpetuate disability; that no immunological, virological or nuclear imaging tests should be carried out on such patients; that "the label of CFS avoids the connotations of pseudo-diagnoses such as ME"; that "change in belief is an important factor in recovery"; that psychosocial factors are important in "CFS"; that his own view has long been "the issues around CFS/ME are the same as those surrounding (patients) who suffer conditions that are not dignified by the presence of what we call disease".

Peter White, another key member of the Wessely School, misinforms medical students and clinicians about ME/CFS: together with Anthony Clare, Professor of Clinical Psychiatry at Trinity College, Dublin, Peter White contributed the section on Psychological Medicine in the medical textbook that is likely to be on the desk of every GP in the UK as it won the 'Highly Commended' British Medical Association Award (Clinical Medicine: Kumar and Clark, 2004, 5th edition: published by Saunders: ISBN 0 7020 25798). It is promoted as "one of the most highly respected textbooks of medicine in the world. It is used by medical students and practising doctors, as well as by many other health professionals. It has been translated into several languages". One of the editors is Parveen Kumar, Professor of Clinical Medical Education at St Bartholomew's and The London, Queen Mary School of Medicine (ie. the same institution as Peter White). The entry for Myalgic Encephalomyelitis directs the reader to the entry for CFS, which in turn directs the reader to Section 21 (Psychological Medicine) where CFS/ME is listed under Functional or Psychosomatic Disorders: Medically Unexplained Symptoms. White and Clare assert that the psychiatric classification of these disorders is "somatoform disorder", which the authors state were previously known as " 'all in the mind', imaginary and malingering".

It is only when dealing with "CFS/ME" (and Gulf War Syndrome) that these psychiatrists are regarded by Government bodies and the medical insurance industry as "experts". These psychiatrists are on record as being actively involved in social engineering via the deliberate creation of "psychosocial" illness. They believe that the biomedical approach to healthcare (ie. that ill-health and disability is directly caused by disease and its pathological processes) is (quote) "a blind alley" and that the correct approach is the psychosocial one, in which "aberrant" thoughts, feelings and behaviour can be "modified" by their own brand of cognitive behavioural therapy with graded exercise (CBT/GET), resulting in restoration of health and productivity.

Such a retrograde belief is fallacious, as the regime in question has been shown to be ineffective and even the proponents of the regime are themselves on record as acknowledging that (i) it is not remotely curative (ii) modest gains may be transient and even illusory (iii) these interventions are not the answer to "CFS/ME" (iv) patients have a tendency to relapse and (v) evidence from randomised trials is no guarantee of treatment success.

For more information see www.meactionuk.org.uk/Concerns_re_NICE_Draft.pdf and for a detailed review of Wessely School indoctrination of State agencies, and the impact of this on social and welfare policy, see www.meactionuk.org.uk/Proof_Positive.htm .