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The NICE debate extends to Parliament

Saturday 21 March 2009

Big Ben The furore over the legal judgement in favour of the NICE Guidelines [see earlier articles here and here] shows no sign of abating – and now peers in the UK Parliament have joined in.

The Countess of Mar, who is the chairman of Forward-ME and patron of several ME/CFS charities, addressed the Parliament on Wednesday 18 March with these words and more:

“While I recognise that there are some patients with a variety of conditions apart from mental illness—cancer, for example—who might benefit from cognitive behaviour therapy, or CBT, as it is known, I would like to introduce another note of caution. The noble Lord, Lord Rea, has already introduced his. CBT is not the cure for all ills that it is sometimes held up to be. Indeed, it is not, strictly speaking, a treatment at all, since its purpose is to support patients in recognising and managing their symptoms.

However, there is a group of chronic illnesses where overwhelming post-exertional fatigue is a major factor, causation is poorly understood, and for which there is no single or comprehensive treatment—CFS/ME, fibromyalgia and irritable bowel syndrome, for example—that do not respond positively to CBT.

Patients expect doctors to provide answers, and doctors are, naturally, reluctant to admit defeat. Current advice to doctors is that, after routine tests have failed to point to causation, there is no need for further investigations.

Some doctors take the easy route by concluding that the illness must be psychological and that CBT will provide the answer. However, many clinical tests listed in the Canadian criteria do show disease/disorder dysfunction in many bodily systems.”

A comprehensive article about the Countess’s contribution to the debate can be found here:

The ME Association: Countess of Mar slates NICE and the health insurance industry

And the full transcript of the speech in Parliament is on the UK Parliament’s website. It starts halfway down the page (look for “18 Mar 2009 : Column 316” then “9:20pm”):

United Kingdom Parliament: House of Lords Hansard for 18 Mar 2009



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