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					A Personal Statement by Peter Ruberry regarding Dr Sarah Myhill‘s
appointment as GPSI to Shropshire, Telford and Wrekin CFS/ME Service
Re GMC hearing case reference numbers: PC/2005/2755/01 and 2005/2757/01.

By prior arrangement I agreed to a telephoned interview on Tuesday 29th May with Miss Hannah Fellows
para-legal secretary to Field Fisher Waterhouse Solicitors. She explained that this was a ―fact-finding‖
interview in preparation for a hearing before the General Medical Council‘s Fitness to Practice Panel. She
has informed me by letter that the hearing against Dr Sarah Myhill is scheduled to take place from 18th-28th
September 2007 at the GMC offices St James‘ Buildings, 79 Oxford Street, Manchester M16 6FQ. The
reason why I was being interviewed was because I sat on the interview panel who appointed Dr Myhill on
26th April 2005 to the post of Lead Clinician for Shropshire CFS/ME Service.
Miss Fellows has since sent me 2 transcripts of the interview with a request to make any necessary
amendments and to return one signed copy. However I found a number of errors and changes of emphasis in
the transcript so have decided instead to write my own statement, which contains all relevant information
from Miss Fellows‘ transcript, plus additional background information which I consider very relevant. I
believe that the history of the illness Dr Myhill was engaged to treat and the mismanagement of it generally
by the medical establishment in UK is pertinent to this case.

My first comment to Miss Fellows (but not included in her transcript) was that I considered it was the GMC
and the Health Insurance Industry who should be on trial – not Dr Myhill.
I described my qualifications for being on the interview panel – that I had been an agricultural lecturer in
Shropshire from September 1969 until ill health forced me to give up the career I loved in September 1987,
although I had been unwell, with an undiagnosed illness for two or three years prior to that date. After a year
on sick leave I applied for and was granted early retirement and a teacher‘s pension on ill-health grounds.
In spring 1988 I joined the ME Association who were then subsidising the IV1 (enteroviral virus protein
test) developed by Prof. Mowbray in London) which confirmed my diagnosis of Myalgic Encephalomyelitis
(ME).

A few months later I joined Shropshire ME Self-Help Group and was soon invited onto the Group
Committee as Newsletter Editor. My first newsletter was in November 1988 and I have continued with
publications almost monthly ever since. I have remained on the Committee up to the present, taking on in
turn the additional posts of assistant Treasurer (for 1 year), Membership and General Secretary. Following a
second heart attack in January 2004 I gave up the latter 2 posts but continued as Editor until June 2006, since
when I have assisted as Sub Editor. I have today taken Newsletter number 184 to the printers. In 1998 I
helped reform our Shropshire ME Self-Help Group into Shropshire & Wrekin ME Support (S&WMES) as
registered charity no 1072171. We currently have a membership of around 170 out of over 1000 ME/CFS
sufferers in Shropshire. In nearly 19 years of compiling newsletters I have corresponded and spoken with
hundreds of local ME sufferers, plus editors and other contacts from many other support groups throughout
the UK. I consider that I have thereby built up a considerable knowledge of the illness and how it has been
treated and MISTREATED by the medical profession and health insurers.

In most years since 1990, during ME Awareness Week each May, our support group has invited one or more
visiting speakers to address our members. The long list of speakers includes Dr Betty Dowsett, who is a
patron of our Group and has visited us on many such occasions. As a bacteriologist she worked with Dr
Melvin Ramsay who was at the Royal Free Hospital, London when a major outbreak of ME among nursing
staff caused temporary closure of the hospital in 1955. Dr Ramsay defined the illness, that was later named
ME in ‗The Lancet‘. Drs Dowsett and Ramsay researched the illness for many years and plotted the history
of outbreaks and compared them with polio epidemics through the 20th Century. (There have been more than
70 major ME outbreaks worldwide in addition to smaller sporadic outbreaks). They noted that ME outbreaks
grew in intensity following successful polio vaccination, occurring as epidemics every 10 years and
pandemics every 20 years. They determined the cause to be polio-related enteroviruses. As a GP for over 30
years Dr Dowsett has treated well over 3,000 ME patients during nearly 4 decades in general practice. Her
close colleague, Dr John Richardson, who died in 2002 after 50 years treating ME patients, asserted that ME
involves poor blood flow to the brain. It is a neurological illness involving inflammation of the brain and
classified under neurological disorders in ICD10 by the World Health Organisation since 1969.


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 Such stalwarts in the field did much pioneering work and a lot of progress was made until 1988, when ME
 was subsumed into the very broad-spectrum illness Chronic Fatigue Syndrome.
 Problems had started for ME in 1970 when McEvedy and Beard wrote a PhD thesis claiming the
 Royal Free Disease outbreak of 1955 was due to MASS HYSTERIA. Prof Malcolm Hooper,
 speaking in Shrewsbury in May 2007 said this was ―totally bogus research. They examined no
 patients and few patient records, interviewed few patients and no staff physicians involved.‖ But
 that thesis sowed the seed of disaster for ME sufferers.
 The term Chronic Fatigue Syndrome (CFS) was introduced in 1988 with pressure from the USA health
 insurance industry to reclassify ME as a psychological, rather than a biological or physical illness. This
 move was to reduce the fast-growing permanent health insurance claims resulting from the 1980s epidemic
 of ME.
 A group of physicians including Prof Anthony Komarof instituted the change, which was carried by only
 one vote! Komarof has since said, ―None of us in creating this CFS case definition ever expressed any
 concern that it might trivialise the illness. We were insensitive to that possibility and we were wrong!”

This new absorption of ME into a psychosocial classification was only too readily adopted by the medical
establishment in Britain, particularly the psychiatrist fraternity led by Prof Simon Wessely School
psychiatrists who believe ―CFS/ME‖ to be a behavioural disorder. Many of them have advanced
their careers and become professors, while those in mainstream medicine who continued to treat ME
as a physical illness have found this approach to be a career breaker. Some have been pilloried by
the GMC and left the NHS. Dr Barry Durrant-Peatfield had his medical licence suspended, a victim of the
GMC's witch hunt on doctors using less orthodox procedures. His colleague Dr Skinner now faces similar
sanctions as does Dr Sarah Myhill, despite the fact that no patients have made any complaint against her. Any
complaints apparently have come from doctors reluctant to follow the treatments and/or laboratory tests she
suggests.

 Since the introduction of CFS, millions of pounds of drug companies‘, insurance industry and Government
 money has been ploughed into research into ―psychological and psychiatric aspects of the illness‖. Simon
 Lawrence from the 25% ME Group said in a press release issued 5th June 2007, "If the funding
 available for cancer research was going towards researching the personality of patients
 rather than looking at the physiology of the illness there would be an outcry”.

 One of the many scandalous aspects of ME/CFS is the fact that research into the underlying
 physical cause of this illness has never been given a high priority by the Medical Research Council
 (MRC) - the government funded body that plays a major role in stimulating and funding medical
 research activity here in the UK. Added to this is the fact that pharmaceutical companies don't
 generally regard ME/CFS as a useful avenue to pursue, unless to sell antidepressants. As a result
 virtually all money for biological research has come from individual ME sufferers and their support groups.

 Editorial bias has meant that no research bearing the name ME has been published in leading British medical
 journals in the past 2 decades, so doctors, who read these publications have received a very biased view of
 the illness. Medical Schools‘ training has treated ME/CFS as a minor footnote under psychiatric illnesses.
 Published work on ―CFS‖ has for years mainly concentrated on fitter members of the CFS spectrum who are
 able to travel to research clinics. High dropout rates of those unable to complete treatment programmes have
 not been counted in research papers.

 Severely affected ME patients who are mainly bed-bound or housebound don‘t feature in research and many
 are never visited by a doctor. Large-scale surveys carried out by ME Support organisations have been
 ignored by the medical establishment and policy makers, despite being featured in the Chief Medical
 Officer‘s Report on ME published in January 2002.

 Questionnaire-based research carried out by ME Support charities carry little weight and are largely ignored
 by medical policy makers. For example:

                                                                                                       2 of 11
The 25% Group (for severely affected PMEs) Survey results:

Treatment                                     Helpful           Unhelpful
Personal centred counselling                    54                 46
Psychotherapy                                   10                 90
Cognitive Behavioural Therapy                    7                 93
Graded Exercise Therapy                          5                 95
Pacing activities                               70                 30
Alternative therapies                           60                 40
Symptomatic care                                73                 37
Pain management                                 75                 25

These results indicate that graded exercise and cognitive behavioural therapies were helpful to only a very
small proportion of ME sufferers and were harmful in over 90% of cases.
Many 25%ers claim they only became severely debilitated following exercise programmes imposed by their
medical carer and/or insisted on by their health insurance companies. Some health insurers refuse to pay
until the claimant has undergone CBT programmes.

In another survey 2,338 members of the patient charity Action for ME (AfME) reported that CBT and GET
were more likely to make them worse rather than better.
Such surveys, reflect the personal experience of thousands of ME sufferers, who are after all the only people
who know what it is like to suffer from the illness, plus the added indignity of being disbelieved by ill-
informed doctors. But such surveys are dismissed as anecdotal by a medical profession who would rather
rely on very few randomised controlled trials involving very small numbers of ill-defined patients when
formulating treatment recommendations.

E.g. The NICE guidelines, published in November 2006, recommend CBT and GET as the treatments of
choice for all CFS sufferers, including those with ME, with ―activity management‖ for the most severe
cases.. They admit that these are not a cure, but make no other treatment suggestions. These guidelines are
based on a few research trials which had many shortcomings:
— A flawed patient selection process.
— A limited number of outcome measures. (many only record ―fatigue‖ and ignore neurological symptoms)
— No objective measure of activity levels to confirm that the aim of GET was achieved.
— No evidence to show a significant increase in activity levels in patients. Indeed, in some cases, activity
levels actually fell (e.g. the Friedberg trial).
— It is also known that the outcomes of CBT and GET are usually transient. These approaches do not
    resolve the long-term problem.
— High drop out rates which are ignored or not explained
NICE failed to consult with experts in the field of ME/CFS who have other views of treatment, which offer
evidence based alternatives to GET and CBT, e.g. PACING. (Jason, Taylor, Goudsmit, Wallman, Ho-Yen).
NICE do not offer CBT and GET as the only choice for any other illness, but merely suggest them as an
adjunct to other treatments. Why should ME be singled out for such discrimination?

I consider that I was fortunate to have contracted the illness ME before the implications of the name change
to CFS had gained currency. It is now virtually impossible for a teacher with ME to obtain early retirement
pension on medical grounds, despite being unfit for work, which can result in dismissal for being unable to
fulfil one‘s duties. Many have to try to struggle on at work, or resign and have to rely solely on State
benefits. Access to the benefits system is controlled by Benefits Agency doctors, many of whom believe
ME/CFS to be psychological, and decision makers who reject a higher proportion of claims from ME
patients than for other similar illnesses like MS. Fortunately there is a higher success rate from appeals
where the patient is given opportunity to demonstrate the full impact of their illness.

E.g. the 2006 analysis of our annual survey of S&WMES Group members indicates that 83/143 (53%)
members have made at least 1 application for Disability Living Allowance (DLA).


                                                                                                       3 of 11
Of these only 33 (40%) were successful on first application. 21/32 appeals were successful (66%) and 1
result was pending. But 43 unsuccessful applicants (52%) did not bother to appeal and many more deserving
cases have not applied because of the stress involved.

In my own case it took me 5 years, from 1988 to 1993 to obtain DLA. This involved examination by 13
different doctors, most of whom informed me that they didn‘t believe in ME, or that it did not exist.
The appeal chairman at one hearing, determined to refute my claim, completely misrepresented the
events of the examination and walking test. An appeal to the Social Security Commissioner on
legal grounds eventually led to a tribunal hearing which awarded me full DLA back-dated to my
original application. This was a very stressful experience which exacerbated my ME symptoms and
considerably hindered any chance of recovery. Had I been given the support and advice I needed
from the start I may well have improved sufficiently to return to work and not been dependant on
benefits for all these years.

Over the years I have read many papers relating to the illness ME/CFS, including articles by Dr
Sarah Myhill who often answered questions from ME sufferers to the doctors panel in
‗InterAction‘, the magazine published by national support organisation Action for ME. Also, as Dr
Myhill had a private practice in Knighton, close to the Shropshire border, she has treated many
S&WMES members and I often heard very favourable reports from them. I have never heard any
criticism of her treatment and advice from any of her patients. I have not personally consulted Dr
Myhill as my limited income for many years has precluded any form of private treatment, but I
have followed her advice on diet, etc and found it most beneficial. In May 2002 we invited Dr
Myhill to speak at our annual conference. Her talk was very well received by a large audience who
could relate personally to much of what she told us. She talked a lot of sound sense based on many
years of research and practice treating ME/CFS patients. A few extracts are worth repeating here: -

Sarah explained that CFS is poorly treated in general practice. It is often misdiagnosed as stress or
depression because routine tests are usually ‗normal‘. All drugs have potential toxic effects. In
USA the 3rd most common cause of death, after heart disease and cancer, is drug related (overdose
and side effects). [E.g.many ME sufferers, including I have been treated with antidepressants to
which we have reacted very badly and which have worsened our symptoms.]

She explained that symptoms are often job-related or due to home environment, e.g. farmers with
sheep dip, Gulf War Syndrome, etc. CFS is commonly due to organophosphate (OP) poisoning and
household chemicals, e.g. timber preservatives, damp-course treatment, cavity insulation,
insecticides, etc. Prof. Peter Behan, Cons. Neurologist in Glasgow, found that the mechanism in OP
poisoning is the same as that in CFS.

PACING is the key to combating CFS. The personality type which pushes one into CFS also
prevents one getting better. Overexertion, both physical and mental sends one on a constant roller
coaster of fatigue/ enforced rest/ overexertion. To get better one must break this cycle. Self-
discipline is essential. You MUST RATION your ENERGY expenditure.

Graded Exercise Therapy
This is not suitable in severe ME. All people with ME (PMEs) have a narrow activity window. It is
vital to reserve any energy for everyday living (eating, washing, etc.) and important and pleasurable
activities. Any exercise must be in short spells spread throughout the day, with adequate rest
periods in between. PACING and SWITCHING your activities is vitally important.
 (This is diametrically opposite to treatment propounded by the psychiatric lobby and NICE).




                                                                                                   4 of 11
Vitamins and Minerals
Stephen Davis, who started ―Biolab‖ has done over 48,000 nutrition tests. Dr Myhill found that all
her early tests came back with results showing that Magnesium, Zinc, Selenium, B-group Vitamins
and Essential Fatty Acids are almost universally deficient in CFS patients. Therefore she now
recommends supplementation with multivitamins and minerals for all her CFS patients.

Thyroid Deficiency
As Prof. Behan found, CFS is commonly associated with dysfunction of the Hypothalamic/
Pituitary/Adrenal (HPA) axis. Thyroid activity is controlled by the hypothalamus (situated in the
brain) and this delicate feedback mechanism.

‗Normal‘ thyroid function is determined by the indirect measurement of Thyroid Stimulating
Hormone (TSH). The standard reading is between 13 and 21 on the TSH scale. Most CFS patients
will be at the bottom end of this ‗normal‘ range and most GPs will not start treatment. But
Dr Gordon Skinner at Birmingham believes that PMEs improve by treatment to maintain the TSH
level in the mid-high range.
A trial of 141 CFS patients was reported in the Journal of Nutritional Medicine. At the start all
were at the lower end of the TSH scale. After 6 months of thyroxine treatment 30 patients (22%)
had improved in all ME symptoms and 106 (76%) had improved energy, memory and
concentration – the core ME symptoms.

Dr Myhill finds that a quarter to a third of her patients improve with thyroxine treatment. Some
patients who have normal T4 levels are poor at converting this to the active T3 hormone (This
conversion requires adequate selenium levels.) She uses combined T3 & T4 treatment in such
cases.
The thyroid may not function due to excess fluoride intake (from water supplies, toothpaste, etc.)
The fluorine displaces iodine, which is essential for thyroid function. Good thyroid hormone output
assists in weight control.
An under-active thyroid reduces body temperature, causing poor immune activity. Raising body
temperature is a major factor in combating disease.

Adrenal function:
Adrenal output of cortisol should be high in the morning to wake us up. It can be low in CFS, thus
upsetting the diurnal rhythm. A small physiological dose of hydrocortisone in the morning can
restore diurnal rhythm and help energy levels. At this (5mg.) dosage there is no risk of suppressing
adrenal function. Adrenal output can be measured from cortisol levels in saliva swabs taken at
intervals throughout the day.

Peripheral resistance to thyroid hormone
Prof Malcolm Hooper, Emeritus Professor of Medicinal Chemistry University of Sunderland, spoke
at our May 16th Conference in 2007, hotfoot from the International Invest In ME Conference in
London.
He believes that one of the key misdiagnoses is failure to identify clinical hypothyroidism.
Most patients have ‗normal‘ results for common thyroid tests. However ME/CFS patients have a
much higher level of a protein which is 98% identical to T3, the active form of thyroid. This
foreign protein can bind to T3 receptors, so that T3 is excluded, preventing it from performing its
vital role in activating cell metabolism.
Dr Sarah Myhill “will back her clinical judgement against a biochemical test.”
―She is right to do so – that’s what we expect skilled clinicians to do‖, said Prof. Hooper.




                                                                                               5 of 11
Sarah has a rule of thumb that if her patients‘ thyroid test is in the lowest 25% of the ‗normal‘ range
then almost certainly they will benefit from treatment with thyroid. The real issue is T3, not
thyroxine. ―Thyroid is a key player and needs to be looked at very carefully and extensively.
Another key feature in thyroid function is selenium and most of us are Se-deficient.‖

Over the years Dr Myhill has been constantly improving her website, always at the forefront of
useful and sensible, patient-focussed information and guidance on ME/CFS, so many of our
members have derived so much benefit in so many ways thanks to Dr Myhill's generosity in the
straightforward way she shares helpful information and makes available simple, safe, ecologically
sound, holistic health advice and treatment. Her website is an oasis for us.
People with ME/CFS have benefited from her experience and knowledge, beyond the 4,000
ME/CFS patients she estimates to have seen and treated herself over the past 25 years.

Dr Myhill‘s appointment as GPSI to Shropshires CFS/ME Service
                       [This is based on my telephone statement transcript.]
In March 2003, the Government announced that they were giving 8.5 million pounds towards helping
set up CFS treatment centres in England. Our local support group set up a sub committee, which
consisted of myself, Bruce Cusworth, Monica Dalby and Sarah Bailey.

As a working party we undertook research to determine the needs of our 150 members. We sent
questionnaires to all 250 local GP's, and received completed forms from 47.

We prepared a report and presented our findings, to the local health authority.
We went into negotiations with Stella Townsend, lead clinician of the Shropshire Enablement Team
(SET) which is a multidisciplinary team providing assistance similar to that needed for our
members. Stella read our report and backed us. She was happy to take us on board and to make
an application for us to get the funding that we needed.

The first joint application with Staffordshire Health Authority was unsuccessful, so in April 2004
Stella made a second bid for £84,000 for a Shropshire service. In July or August 2004 we were
successful, being granted £75,000. Once we received the promise of money we were able to help set
up a local Multi Disciplinary Team (LMDT) for ME/CFS. Bruce Cusworth, Monica Dalby, Sarah
Bailey and I were all invited to form a steering committee with Stella and local NHS representatives.

Jan 31st 2005 Steering Committee meeting minutes
Stella T; PC Ruberry; Bruce Cusworth; Monica Dalby; Emma Davies (Minute Secretary)
Item 5. Advert for GPSI

ST written to GPs in Shrops and Powys - 2 enquiries but no definite uptake. Suggested we
needed another approach
PR suggested we contact Dr Myhill from Knighton Medical Practice on 01547 550331, who spoke
at (S&WMES) conference 2 years ago and sees ME Patients privately (working without
insurance*) but currently has a large waiting list. PR will e-mail contact details to ED.

* I later provided a letter from Sarah Myhill "NO MEDICAL INSURANCE HERE" Aug 18
2002. (copied below)


For her subsequent interview copies of the following letter were attached to copies of Sarah
Myhill's Application form for all on the interviewing panel.



                                                                                                6 of 11
 Dr Sarah Myhill MBBS, Upper Weston, Llangunllo, Knigliton, Powys, LD7 1
                                                                     SL
Tel 01547 550331 Fax 01547 550339 smvhiH@g!obalnci co.uk _
                                                          AUGUST 18th 2002

                 NO MEDICAL INSURANCE COVER HERE!!!

My patients need to know that I am currently practising medicine
with no insurance cover as from August-1st 2002. I have insured with
the Medical Defence Union since 1981 (plus 3 years with St
Paul's). They have refused me medical insurance this year and have
given no reason for that.
Apparently it is their right to give no reason and I have no right
of appeal.

I have asked the General Medical Council if I am allowed to
practise medicine without insurance, to which they reply "We are
not allowed to answer this question - you must ask the British
Medical Association". I am not a member of the BMA (the doctors'
trade union), so have to join and await their reply. However, my
feeling is that if I was not allowed to practice without insurance,
they would have said so. Clearly it must be considered good
medical practice to have insurance, but if this is not
forthcoming, then this should not effectively take away my
right to practise- medicine .

I have found out that in America doctors can practise without
insurance, but they have to tell their patients - hence this
notice!

At present I am applying to the Medical Protection Society for
insurance.

Obviously, I always try to do the best for my patients and my
treatments are fundamentally safe (vitamins, minerals, diets as
opposed to drugs and surgery!), although 1 do use a few
prescription drugs. So, -if you wish to sue me for medical
malpractice, please, just remember that I do not have unlimited
resources and will have to go broke and escape the country!




                                                                    7 of 11
Dr Myhill was sent information about the GPSI post and later attended a formal interview.

I was one of the panel members who interviewed Sarah for the GPSI post on 26/04/05. She impressed me
with her presentation and how she answered questions put to her. Sarah was asked if there was any problem
with her licence to practice and she assured us there was not, since an earlier hearing brought against her by
the GMC had been cancelled with no evidence against her having been presented. The fact that she had
answered ―no‖ to her application form question, “Have you been or are you currently subject to any fitness
to practise proceedings by an appropriate licensing or regulatory body in the UK or other country?” was
therefore true and honest at the time.
I consider that the GMC are scraping the bottom of the barrel by raising this issue as part of their
current campaign against her.

Dr Myhill proved to be a most knowledgeable, experienced and suitable candidate and was offered the post.

Shropshire was the envy of ME Support Groups around the country and particularly in the West
Midlands, where many of their members had been delighted by advice and treatment they had received
privately from Sarah Myhill. We were congratulated that we had achieved the coup of getting Dr
Myhill as our CFS/ME clinician.
Dr Myhill took up her new post with enthusiasm and did much to get the new CFS/ME Service off to a
flying start. I understand that she had a good rapport with her patients and the rest of the SET team with
whom she communicated regularly. She also undertook staff training as part of her remit.

It was, therefore a great shock when I learnt by email in November2005, from a S&WMES member
who was also a GP representative on the local CFS/ME Consensus Group, that Dr Myhill was resigning
from her post with the CFS/ME Service in Shropshire. This bad news was confirmed officially at the
Strategy meeting in December, when Stella Townsend informed us that Sarah was leaving at the end of
January 2006, but she would do a scheduled training course for staff in February. At that meeting I
expressed my deep regret that Sarah was leaving and that we should make every effort to employ her as
an advisor to the service in the future.

I asked Dr Myhill for a press statement so that we could fully appreciate her reasons for resigning her post:
She replied:
To: Peter Ruberry        Dictated on 15 January 2006
Dear Peter,

Thank you for your e-mail. I confirm that I have decided that it is impossible for me to continue in a clinical
role with SET (Shropshire Enablement Team) in their new venture offering services for patients with chronic
fatigue syndrome. The fundamental problem is that I have not been given the clinical freedoms that I need in
order to be able to treat patients effectively.

 Not only do I not have any prescribing rights, but the clinical tests which I would like done have been refused
funding. Furthermore, many of the very standard and very successful interventions that I routinely recommend
for patients I am not allowed to recommend to GPs.

So, for example, a very standard work up for any patient with chronic fatigue syndrome would include tests for
mitochondrial function, hormone studies, together with recommendations for nutritional supplements (many of
which are on NHS prescription), B12 and magnesium injections, desensitisation treatments and so on. But none
of these am I allowed to implement, nor even recommend to General Practitioners. This has made it extremely
frustrating for both me and for patients, because I can tell them exactly the interventions they need to put in
place, but I do not have the power to do them. Worse than that, when patients ask me how they can go about
putting these things in place themselves, I am not even allowed to tell them that, because this would result in a
conflict between my NHS practice and my private practice.




                                                                                                        8 of 11
As you probably already know, I have a six-month waiting list for new patients and since I started work at
Shrewsbury, this has got much worse because I have not been able to spend my time treating and advising
patients efficiently. Therefore my role at Shrewsbury has been changed from a clinical role to a teaching one.

I have to say I am very disappointed that this post did not work out and I sincerely apologise for raising the
hopes of sufferers in the Shropshire and Wrekin area who had been promised an appointment to see me and now
of course that is not possible.
Very best wishes to you all.              Sarah Myhill

The fact that Sarah is being retained in a teaching role indicates that there was no fall out with the
rest of the SET team, who still hold her in high esteem. The affection felt for Dr Myhill by
S&WMES is evident from the fact that we invited her as the main speaker at our 2006 Conference
entitled ―Towards Better Diagnosis and Management of ME‖. This involved an afternoon session
for doctors, physiotherapists, OTs, welfare service, etc. and an evening session open to ME
sufferers (PMEs), their families and carers. Both sessions were well attended, attracting over 90 in
total. As a result of these meetings a number of the professionals who attended asked to be placed
on our newsletter mailing list and we recruited several new Support Group members.

It was simply the intransigence and dinosaur-age thinking of the medical profession generally that
has caused Dr Myhill‘s frustration with the system and led to her resignation.
A major tenet of the Hippocratic oath is surely “FIRST DO NO HARM”.
Blinkered thinking is instead preventing dedicated, experienced practitioners like Dr Myhill from
doing GOOD, their VERY BEST for their patients. Instead the current wisdom is to impose
psychiatry-based treatments that have been shown by large-scale patient feedback to be at best of
no help and at worst to have rendered thousands of ME sufferers housebound, wheelchair bound
and housebound.

At the S&WMES Conference May 2005 Paediatrician Dr Nigel Speight gave a stimulating talk. He started
by apologising to ME sufferers for their mistreatment at the hands of many in the medical profession,
because the illness has been hijacked by psychiatrists for thirty years. “ME is the last stand for the worst
authoritarian tendencies in doctors, who have to be dragged kicking and screaming to be polite.”
Dr Speight quoted one of his medical students who had been subjected to maltreatment by doctors when he
succumbed to ME at university. He switched his career to medicine believing,
―I can be a much better doctor than the ones I have met during my own ME.‖ And from a 14-year old
Australian ME sufferer, “ME is a condition that induces an emotional disturbance in doctors
confronted by it”. Dr Speight went on to say that he has had to intervene in many cases of child-abuse by
the medical profession where parents of children with classic ME have been accused of Munchousens
Syndrome by Proxy and children with ME detained in locked psychiatric wards with parent visits banned.

Many of the 13 Clinical Network Co-ordinating Centres established to run the LMDTs are headed by
Psychiatrists and based at units in mental hospitals. E.g. Dr Hugh Rickards at Birmingham CNCC.
Dr Nye,clinical coordinator for Merseyside has stated that WHAT WILL STOP PMEs RESPONDING TO
TREATMENT are
1.rigid illness beliefs
2.membership of a self help group
3.dependency on benefits
This attitude is disgusting and degrading for M.E. sufferers and an absolute disgrace.

The King’s College (London) Training DVD
This DVD purports to train GPs to treat people with "Chronic Fatigue*. So far so good, but then the
practitioners talk about "CFS" and it is here that the problem lies: it is produced and acted by psychiatrists,
members of the Wessely school, and contains advice that is totally at odds with the advice that experienced
PWMEs and experts know to be best practice. Examples of this are the advice to exercise even when
exhausted as "it will do no harm," not sleeping during the day even when tired as it would adversely
affect night-time sleep and discouraging people from getting advice from the ME Association!

                                                                                                          9 of 11
*(Chronic fatigue is not CFS, which is not ME, just as Anorexia is not the same as Anorexia
Nervosa, but the terms are often interchanged by careless doctors).

In November 2006 Nancy Klimas, Professor of Medicine at Miami, and Anthony Komaroff,
Professor of Medicine at Harvard (both of whom are not only clinicians but also long-time
researchers into ME/CFS) attended the launch by the US Centres for Disease Control (CDC) of its
―CFS Toolkit‖ and its campaign to advance knowledge of ME/CFS.

At the launch, Professor Klimas said: "Historically, the lack of credibility afforded this illness has
been a key obstacle to understanding it. Today, with solid evidence that CFS has identifiable
biologic underpinnings, and with evidence that people with CFS experience a level of disability
equal to that of patients with multiple sclerosis, advanced HIV disease and undergoing
chemotherapy, I hope we can begin to put an end to the stigma surrounding this illness."

Also at the launch, Professor Komaroff said about the lingering belief that (ME)CFS is
psychological and somehow imagined: ―That debate raged for 20 years, and now it’s over‖.

As reported on 3rd November 2006 by United Press International, there are over 3,000 research
papers that have established ME/CFS as a valid physiological illness, with evidence of
inflammation, reduced blood flow and impaired cellular function. (None of these appear to have
been heeded by the NICE Guideline group). It was described as a ―brutal‖ disease which often
occurs in conjunction with other diseases such as lupus and Lyme disease, and its symptoms can be
as severe and painful as renal failure, AIDS or multiple sclerosis.

But the medical establishment has a poor record for adopting new ideas and advancing
knowledge throughout the profession.

It was many years after John Snow's death that the miasma theory of cholera finally bit the dust,
when the evidence against it became just too overwhelming. Can we easily dismiss the horrible,
fatal errors of the past and smile indulgently at our less open-minded predecessors?

Consider Barry Marshall and Robin Warren, who discovered Helicobacter pylori and proposed the
causal link between this bug and stomach ulcers. What an implacable wall of resistance they first
faced.
Stomach ulcers, it was known, were caused by stress. No bacteria can live in the human stomach -
end of story. Even when presented with stomach wall specimens with H. pylori in them,
mainstream researchers asserted they couldn't even see the bacteria.

The truth is that, while science has moved us forward in a quite astonishing fashion, there seems
little advance in our understanding of knowledge itself. Why do people believe in certain things?
What makes some beliefs so powerfully held that they are defended by attacking those who dare to
question them?

Dissenters are not welcome. They are ignored, rejected, and sometimes attacked.
Your latest victim is Dr Sarah Myhill.
Because of the commitment of the UK medical establishment to a view that ME is psychogenic in
origin patients are being neglected, wrongly diagnosed, and given inappropriate treatments.
We need more doctors like Dr Myhill rather than a witch hunt to suppress her
healing arts and skills.


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I fail to understand how the GMC can choose to act against such a positive force in medicine,
particularly when she treats patients with so much respect, allowing them to feel as if they really
matter, and there have been no complaints at all from patients. The only complaints have come
from other apparently less well-informed doctors who, I presume, feel threatened by Dr Myhill's
common sense, frank, open, holistic, natural and safe approach to medicine, patients and the
complex and controversial condition ME/CFS.

I ask that the GMC immediately withdraw from this ludicrous position and cease this unwarranted
persecution of Dr Myhill so that she can get on with what she does so well, helping patients, rather
than being forced to spend time preparing her defence against ridiculous accusations. This doctor
should be receiving public honours for her groundbreaking work, not having to risk her career.
People with ME need doctors like her who are putting forward realistic and useful solutions to help
them get well; rather than those with the ear of NICE and the Medical Research Council who can
offer only a ―one size fits all‖ CBT/GET treatment regime.

Thank you for reading this statement. I apologise for its length, but feel that Dr Myhill deserves the
full support of the quarter million ME sufferers in the UK, who have been so badly neglected and
mistreated by mainstream medical orthodoxy.

Peter Ruberry (PME, Shropshire & Wrekin ME Support Sub-Editor and representative on CFS/ME
Service Strategy Group and Consensus Group).

12th June 2007.




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