Following the recent press release concerning Professor Hooper's report and
official letter of complaint about the MRC, I draw your attention to the
attached letter from Professor Hooper to Professor Sir Michael Rawlins,
Chairman of NICE, which raises serious doubts about the validity of the
psychogenic model of 'CFS/ME' and the conduct of the MRC trial that will
further underpin it.
Clearly there are attendant ethical and legal implications for NICE and for
all practising NHS clinicians".
From Malcolm Hooper Ph.D.,B.Pharm.,C.Chem.,MRIC
Emeritus Professor of Medicinal Chemistry School of Sciences
University of Sunderland
SUNDERLAND SR2 3SD
Chief Scientific Adviser to the Gulf Veterans' Association
President: the National Gulf War Veterans and Families Association, NGVFA,
19 February 2010
Dear Sir Michael,
I am a 'blast from your past'. I was at Sunderland School of Pharmacy and
you were at Newcastle in Clinical Pharmacology when the M.Pharm course in
Pharmacokinetics was developed. Congratulations on your eminent status and
Since 1997, when I retired as Professor of Medicinal Chemistry, I have been
involved with the emerging and widespread complex chronic multi-system
illnesses (Gulf War Syndrome/Illness, Myalgic Encephalomyelitis/Chronic
Fatigue Syndrome, ME/CFS, multiple chemical sensitivity, MCS, Aerotoxic
Syndrome, organophosphate and other pesticide poisonings) that are of
growing concern and are medically challenging -- writing and lecturing,
locally, nationally and internationally.
This letter is linked to my concerns about ME which involves some 240,000
people in the UK with varying degrees of disability. Some 25% are housebound
or bed bound and have formed their own group, www.25megroup.org/ .
The 442 page report "Magical Medicine, how to make a disease disappear",
copy attached with the press release, together with a copy of my letter to
the Minister, Lord Drayson, currently the Minister responsible for the MRC,
brings together an extensive and fully referenced review of the literature
It provides the evidence supporting my complaint about the MRC PACE Trial to
The entire report, the press release and the letter of complaint have now
been circulated worldwide on the internet and have received much acclaim and
support from the major ME organisations in various countries and numerous
individuals, as well as academic institutions. The report is to be discussed
by the International Association of CFS/ME at its next board meeting in
early March, as confirmed by the President, Professor Fred Friedberg from
Despite the vast amount of biomedical literature (some 5000 papers) going back to 1934 and the classification of ME as a neurological illness by the WHO (ICD-10 G93.3) since 1969, the official UK attitudes as demonstrated by the MRC, DWP, Department of Health, and to some extent your own organisation NICE:
a. ignore all this evidence
b. show an ideological commitment to a psychosomatic/behavioural model of the illness which is no longer tenable
c. recommend only cognitive restructuring techniques (CBT and GET) that are
"not remotely curative" and have been shown to be of no lasting value and in
the case of GET to be positively harmful (Peter White's assertion that this
is because the interventions have been incorrectly administered has been
shown to lack credibility)
d. proscribe any investigative tests to identify the disorder, leading to
missed diagnoses and misdiagnosis
e. support cruel, even vicious, actions that lead to patients being wrongly
sectioned and parents, particularly mothers, accused of
f. the result is that essential benefits and insurance payments to support
patients and their families have not been paid or have been granted only
after protracted and expensive legal action. All this adds to the burden of
the illness for patients and for those who care for them.
The psychiatrists' argument that what they refer to as "CFS/ME" is
substantially different from past epidemics of ME does not withstand
scrutiny in the light of current knowledge. It is beyond question that ME is associated with a severely disrupted immune system which renders patients
more susceptible to both further viral and chemical challenge and
reactivation of latent viruses and persistent viral-specific symptoms.
For the psychiatrists to amalgamate 25 different disorders (Holgate, RSM
July 2009) and to focus on "medically unexplained fatigue" whilst ignoring
cardinal symptoms of ME is a travesty of medical science.
Of special concern and relevance are the legal and ethical requirements
facing doctors today, in particular, the legal requirement for doctors to
keep up to date with developments in medicine and medical science (as
clearly set out in "Good Medical Practice: Duties of a doctor. The duties of
a doctor registered with the General Medical Council: 'Keep your
professional knowledge and skills up to date' and 'Never abuse your
patients' trust in you or the public's trust in the profession'
Ignoring vast swathes of evidence is not keeping up to date. For any
registered medical practitioner – consultant or GP -- to dismiss or ignore
this widely available evidence which invalidates the behavioural model of
"CFS/ME", together with the prescription of inappropriate interventions, is
in clear breach of the GMC regulations and consequently raises issues of
As noted in the report: "since the general body of knowledge known about by
other clinicians and researchers working in the field of ME/CFS is now so
great, the question repeatedly asked is: at what point will that body of
scientific knowledge be so great that it will be considered serious
professional misconduct to ignore it and to continue to deceive patients by
pretending that it does not exist?".
The recommendation not to carry out appropriate investigative tests is
inconsistent with the Hippocratic Oath in its ancient or modern form.
The offering of treatment that is known even by its proponents to be
ineffective is a betrayal of doctors' responsibility to their patients.
Merely to pronounce that the onus is on the individual doctor, when
adherence to NICE Guidelines is to become compulsory, is unacceptable.
Inappropriate sectioning of patients and false diagnoses such as MSBP
represents a further betrayal.
To rely on only a few studies, showing very modest efficacy, all of which
having been shown to have very serious flaws (as is the case with the PACE
Trial) and enshrine this inadequate information in official directions,
publications and statements from authorised bodies, including NICE, is
utterly unacceptable and dishonours the name of medicine as well as being
destructive of lives of sick people and those who care for them.
I draw to your attention the commissioned editorial in last week's BMJ by
Alistair Santhouse, who you will be aware was a member of the CG53 GDG.
Please read the attached eBMJ response submitted by Horace Reid, a former
long-serving NHS clinician. It was rejected for publication, a fact that is
revealing in itself, given that it is impeccably accurate.
I would ask you in your role as Chairman of NICE to engage fully with our
report and act accordingly to right the long standing wrongs that people
with ME have suffered for the last 20 years.
With best wishes,