From the Parliamentary Under Secretary of State Department of Health
The Lord Warner
Joan Humble MP Richmond House
House of Commons 79 Whitehall
London London
SW1A OAA SW1A 2NS
Tel: 020 7210 3000
17 AUG 2004
Thank you for your letter of 17 May following my letter of 21 April 2004 regarding Myodil.
With your letter you enclosed recent comments from the Myodil Action Group (MAG) on the letter that former Health Minister, Baroness Hayman sent to the Chair of the MAG on 1 February 1999. Baroness Hayman's letter went into some detail on why she had concluded that it would not be justified either to hold a public enquiry or provide compensation to those suffering from arachnoiditis. That letter reflected Government policy taking account of all the facts at that time, whatever may have been considered in Opposition prior to 1997.
I have read MAG's current comments with considerable sympathy. I do understand the strong feelings of those involved and the suffering they have experienced. However, after reflecting very carefully on all the representations I do not believe there are new grounds for reopening the issues, which were examined so comprehensively during 1998/9.
I am sorry that this has to be such a disappointing reply.
NORMAN WARNER
From the Parliamentary Under Secretary of State Department of Health
The Lord Warner
Richmond House
79 Whitehall Your Ref: SR/IM London
SW1A ZNS PO1041265
Tel: 020 7210 3000
Joan Humble MP
Thank you for your letter of 5 January referring back to our meeting on 30 October 2003 when you came to see me with other members of the All-Party Parliamentary Group on Myodil. Thank you also for sending me a copy of Dr Charles Burton's position paper "on the Subject of the Pathologic Process "Adhesive Arachnoiditis" and its Relationship to Oil Myelography". I apologise for the delay in replying, while we have collected necessary detail.
At our meeting we discussed possible mechanisms for developing clinical guidelines on the diagnosis, and treatment and management, of adhesive arachnoiditis. I have taken the first steps to seek the advice of the National Institute for Clinical Excellence (NICE) on issues pertaining to adhesive arachnoiditis; in particular, its diagnosis, including referral for diagnostic tests to assist the diagnostic process, and treatment of the condition, including pain relief. I will ensure that you receive copies of any resultant NICE advice.
I also said I would look into the implications of the proposed NHS Redress Scheme. The proposal is that the NHS Redress Scheme will provide redress for patients who have been harmed as a result of seriously substandard NHS hospital care. This was the subject of a consultation paper issued by the Chief Medical Officer in June 2003. Responses to the consultation are now being analysed and the outcome is expected to be announced shortly. It is proposed, inter alia, that there should be a duty of candour requiring clinicians and health service managers to inform patients about actions which have resulted in harm.
It seems unlikely that the Redress Scheme will be of help in the Myodil cases because these all arose some time ago and it is not proposed that the Scheme should be retrospective. In order for the Scheme to apply there would also need to have been an element of negligence, the extent and details, which have been the subject of the consultation.
We have taken up your points about benefits with officials in the Department for Work and Pensions and we have been advised that entitlement to disability benefits depends on the effects of disability on the person's life and not on the particular disability or illness. Decision makers, who consider claims for disability benefits, are given special training to enable them to deal with claims for these benefits. The role of the decision maker is to consider all the relevant evidence and make a decision in accordance with the legislation. This evidence may include the customer's statement on the claim pack, information from a carer or a report from a doctor. The decision maker may request a medical examination from a specially trained and approved doctor working on behalf of the DWP. The decision maker is able to make a decision without seeking medical evidence.
Decision makers are able to use the Disability Handbook, which offers authoritative information about the likely range of care and mobility needs arising from the more commonly occurring conditions. The content of this Handbook is the culmination of much consultation with groups of and for disabled people as well as various health professionals and the Disability Living Allowance Advisory Board (DLAAB).
It is accepted that there are many difficult cases which require hard decisions to be made. In these instances, decision makers can seek the advice of the approved doctor. If further advice is needed, the question may be referred to the DLAAB.
Entitlement to incapacity benefits is determined by the Personal Capability Assessment (PCA), which was developed by a panel of experts who identified a set of functional physical areas relevant to the assessment of incapacity for work. A sub group of experts in the field of mental health identified the areas of psychological functioning, which are important in the work situation. The work of the sub-group was informed by close consultation with the Royal College of Psychiatrists.
The DWP Chief Medical Adviser issues detailed guidance to approved doctors (medical officers) which sets out the approach required when considering the available evidence and conducting examinations/assessments for benefit purposes. Their reports to the decision maker consider carefully all the evidence in a
Case, including factual medical information from the customer's own General Practitioner or Specialist.
The effect of medical conditions in limiting physical ability varies widely over time and between individuals. There are few conditions where the diagnosis alone will indicate the severity of any incapacity.
Eligibility for both disability and incapacity benefits is not dependent on the nature of the medical condition, however in making both assessments, the effects of pain and variation in the condition are fully considered.
If customers are dissatisfied with the outcome of a claim, an appeal process exists for both assessments. The Appeal Tribunal may consider or ask for further medical evidence.
Would you please share this information with members of the All-Party Parliamentary Group on Myodil.
NORMAN WARNER