UK Parliament Grand Committee Room debate 21st June 2018

A parliamentary debate on the topic of "M.E. Treatment and Research" was scheduled by the Backbench Business Committee and took place between 1:30pm and 4:18pm on Thursday 21st June 2018 in the Grand Committee Room at Westminster Hall, in the House of Commons in London, England. Members resolved to consider myalgic encephalomyelitis treatment and research. The debate was attended by approximately 25-30 members of parliament (MPs) representing Great Britain and Northern Ireland. MPs present represented all four nations: England, Scotland, Northern Ireland and Wales. Attendees represented several political parties including the governing Conservative Party, the opposition Labour Party, Plaid Cymru (Wales), Scottish National Party (SNP), the Liberal Democrats (LibDems), and the Northern Irish Democratic Unionist Party (DUP).

Supporting MPs

 * Carol Monaghan MP
 * Nicky Morgan MP (unable to attend)
 * Stephen Pound MP
 * Alex Chalk MP
 * Ben Lake MP
 * Kerry McCarthy MP

Government representative

 * Steve Brine MP (Parliamentary Under-Secretary Department of Health and Social Care)

Government opposition representative

 * Sharon Hodgson MP (Shadow Minister - Public Health)

MP speakers

 * Jim Cunningham MP
 * Mark Tami MP
 * Jeremy Quin MP
 * Robert CourtsMP
 * Patrick Grady MP
 * Liz McInnes MP
 * Andrew Selous MP
 * Michelle Donelan MP
 * Sir Henry Bellingham MP
 * Scott Mann MP
 * Sir Edward Davey MP
 * Michael Tomlinson MP
 * Dr David Drew MP
 * Alex Sobel MP
 * Jim Shannon MP
 * Kate Green MP
 * Stephen Kerr MP
 * Kelvin Hopkins MP
 * Luke Pollard MP
 * Liz Twist MP
 * Sir Desmond Swayne MP
 * Gavin Newlands MP

MPs in attendance
The following attended the debate, but did not speak:

Notable public gallery attendees

 * Charles Shepherd
 * Jonathan Edwards
 * Representatives of the UK ME/CFS biobank

Debate chairs

 * Andrew Rosindell MP (chair for first half)
 * Michael Gapes MP (chair for second half)

Professor Michael Sharpe
In advance of the debate, professor Michael Sharpe (lead author of the PACE trial) sent an email to Carol Monaghan MP accusing her of behaviour "unbecoming ​of an MP". Ms Monaghan read out a portion of the email during the debate, eliciting a response of "Hear! Hear!" from other members present. Monaghan continued by saying "I say to Professor Sharpe that if listening to my constituents, investigating their concerns and taking action as a result is 'unbecoming', I stand guilty."

The PACE trial
The PACE trial was criticised by several MPs.

"We now know that 13% of the participants in the PACE trial qualified at baseline as “recovered” or “within the normal range” for one of the study’s two primary measures—self-reported physical function—even though they were classified on the same measure as disabled enough to enter the study. That anomaly, which occurred because the investigators weakened key outcome thresholds after data collection, invalidates any claim that patients recovered or got back to normal. The overlap in entry and outcome criteria is only one of the trial’s unacceptable features." --Carol Monaghan MP

"PACE is unique in UK medical history, in that it was part-funded by the DWP. The links of some of its ​main authors to health insurance companies are troubling. One of those authors, Professor Michael Sharpe, states in his briefing for the debate: 'Several of the investigators had done small amounts of independent consultancy for insurance companies, but this was not relevant to the trial. The insurance companies played no part in the trial.' I will leave hon. Members to make up their own minds about that." --Carol Monaghan MP

"I have seen scientists writing in journals such as the Journal of Health Psychology calling out the PACE trial, so the idea that the scientists who produced that work have gone unchallenged by other scientists is simply not true. A huge amount of evidence from eminent people in the science community questions the PACE trials, including the methodology, the evidence they used and how they treated their patients, as the hon. Lady said." -- Sir Edward Davey MP

"Some £5 million was set aside for the PACE trial; if we could have a small amount of that money to start real, biomedical research into ME, we would be making a step forward." --Sir Edward Davey MP

"After spending more than £200,000 fighting a freedom of information request, Queen Mary University of London, PACE’s data custodian, had to share access to the data. Subsequent re-analyses have shown that changes to the criteria for recovery and improvement distorted the results.​" --Jim Shannon MP

"There has been discredited research, such as the PACE trial—and others, no doubt—which is now being dismissed, and not before time." --Kelvin Hopkins MP

"We must always make sure that there is a proper evidence base and that statistics are properly measured. We had a paper circulated to us that shows that the PACE statistics were false. They just did not work." --Kelvin Hopkins MP

"Merryn's (Croft) mum is critical of the PACE guidance given by NICE and attributes the worsening of Merryn’s condition to it." -- Liz McInnes MP (see Merryn Crofts)

"If the PACE trial were a drug, it would have been banned by now.” --Liz McInnes MP, quoting the mother of Merryn Crofts

"Patients with ME feel that they have been let down time and again as research such as the PACE trial — which, sensibly, we heard about — have been found to be seriously flawed. In fact, Jonathan Edwards, emeritus professor of medicine, said that the PACE trial would be a great example 'in an undergraduate textbook as an object lesson in how not to design a trial'." --Sharon Hodgson MP

Welfare benefits
The minister was criticised by Carol Monaghan MP for stating that those with M.E. could opt out of the treatments currently offered (CBT and GET):

"The Minister has rightly said that any patient has the right to withdraw from medical treatment. However, when the DWP is saying that patients must undertake graded exercise therapy, and when health insurance companies are saying that they must undertake graded exercise therapy, it puts the patient in a very difficult position."

Graded exercise harms
Sir Edward Davey MP raised the prospect that if graded exercise continued to be offered on the basis it was safe, this may lead to patients taking legal action against the government:

"If GPs, perhaps because they have not been trained, are making medical prescriptions for treatment following NICE guidelines because Ministers and the chief medical officer have not acted, if that treatment is harming people, and if that continues until October 2020 there will, as I said in my intervention, be a case for those who are harmed to go to court and seek compensation."

He asked the minister whether GET should be withdrawn:

"Should not graded exercise therapy be removed as a treatment option even before the NICE guidelines are reviewed, given the evidence that people are being harmed by it? The Minister is hearing that evidence today. Is there not a possibility that in future a court could compensate ME sufferers if they continue to be prescribed GET, given that we, the Minister and medical professionals know the evidence?"

Notable statements
"Today is the day when we finally start to take (Myalgic) encephalomyelitis seriously and stop condemning people suffering from this ghastly, debilitating disease. Today is the day when we say, Yes, we understand the pain people suffer. Yes, we are going to do something about it. Yes, we respect you. Yes, we value you. Yes, today we are going to start investing in diagnosis, analysis and, God willing, a cure." --Stephen Pound MP

Ricky Gervais
During the Minister, Steve Brine's, closing remarks he referred to a joke made by comedian Ricky Gervais in the past where he is said to have referred to M.E. as "Yes, that’s the one where ​they say I don’t want to go to work today". The minister urged Gervais to apologise, saying "perhaps he could retract that and apologise to the ME community today". Gervais stated on Twitter in January 2018 that he "understood the gravity of the disease".

The debate

 * Hansard debate transcript
 * Debate video
 * Parliamentary briefing document by patient groups, and House of Commons Library debate pack

Learn more

 * On Thursday 21 June, MPs will hold a debate in Westminster Hall on Myalgic Encephalomyelitis treatment and research
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 * Parliament to debate treatment of ME patients
 * SNP's Carol Monaghan to lead debate on treatment for ME patients
 * Glasgow MP Carol Monaghan secures parliamentary examination of controversial ME trial
 * Westminster Hall debate is turning of the tide for M.E.