We do not target our employment programmes exclusively at individuals with particular conditions such as M.E. Chronic Fatigue Syndrome. The Department’s programmes, including its specialist disability employment programmes, aim to identify and meet the needs of the individual, including those with M.E. Chronic Fatigue Syndrome.

Access to Work provides additional support for individuals whose health or disability affects the way they do their job. It provides individuals and their employers with advice and support with extra costs which may arise because of an individual’s needs. Access to Work does not replace the duty an employer has under the Equality Act 2010 to make reasonable adjustments.

Work Choice is a specialist disability employment programme that provides tailored support to help disabled people who face the most complex barriers to employment, find and stay in work and ultimately help them progress into unsupported employment, where it is appropriate for the individual.

Jobcentre Plus Disability Employment Advisers can provide support and advice for disabled people who need help finding and retaining employment. They can refer individuals to specialist programmes, including Work Choice, and can use the professional expertise of Work Psychologists, who specialise in working with disabled people. Disability Employment Advisers can advocate with employers on the individual’s behalf and help employers to explore job solutions such as the restructuring of a job’s tasks/environment, or the provision/change of equipment.

The Government published ‘The disability and health employment strategy: the discussion so far’ on 17 December 2013. This paper sets out a range of proposals to further improve our employment support for disabled people and those with health conditions.

The Government recognises that getting the right support at the right time is particularly important for disabled people and those with a health condition so as part of our vision for future employment support we are developing a new Employment Gateway. This will be a light-touch process based on an individual's strengths and needs and will direct people to the most appropriate support.

In order to support individuals to stay in work where possible we are putting in place a new Health and Work Service (HWS).The HWS will provide occupational health advice and support for employees, employers and GPs to help individuals with a health condition to stay in or return to work.

The intention is to introduce the service by the end of 2014.

We do not target our employment programmes exclusively at individuals with particular conditions such as M.E. Chronic Fatigue Syndrome. The Department’s programmes, including its specialist disability employment programmes, aim to identify and meet the needs of the individual, including those with M.E. Chronic Fatigue Syndrome.

Access to Work provides additional support for individuals whose health or disability affects the way they do their job. It provides individuals and their employers with advice and support with extra costs which may arise because of an individual’s needs. Access to Work does not replace the duty an employer has under the Equality Act 2010 to make reasonable adjustments.

Work Choice is a specialist disability employment programme that provides tailored support to help disabled people who face the most complex barriers to employment, find and stay in work and ultimately help them progress into unsupported employment, where it is appropriate for the individual.

Jobcentre Plus Disability Employment Advisers can provide support and advice for disabled people who need help finding and retaining employment. They can refer individuals to specialist programmes, including Work Choice, and can use the professional expertise of Work Psychologists, who specialise in working with disabled people. Disability Employment Advisers can advocate with employers on the individual’s behalf and help employers to explore job solutions such as the restructuring of a job’s tasks/environment, or the provision/change of equipment.

The Government published ‘The disability and health employment strategy: the discussion so far’ on 17 December 2013. This paper sets out a range of proposals to further improve our employment support for disabled people and those with health conditions.

The Government recognises that getting the right support at the right time is particularly important for disabled people and those with a health condition so as part of our vision for future employment support we are developing a new Employment Gateway. This will be a light-touch process based on an individual's strengths and needs and will direct people to the most appropriate support.

In order to support individuals to stay in work where possible we are putting in place a new Health and Work Service (HWS).The HWS will provide occupational health advice and support for employees, employers and GPs to help individuals with a health condition to stay in or return to work.

The intention is to introduce the service by the end of 2014.

The Department requires the health professionals carrying out personal independence payment assessments to have a broad and thorough training in disability analysis, as well as training in specific conditions, including fluctuating conditions. Both organisations providing the assessment have to conform to a rigorous set of quality and recruitment standards which are closely monitored by the Department for Work and Pensions.

The Care Bill will require local authorities to provide information and advice on how to access care and support in their area including assessments.

The Bill will place local authorities under a duty to assess any adult who appears to have needs for care and support, whatever their level of need. The assessment will look at the person's needs and outcomes they want to achieve, and the person must be involved throughout the process. Authorities will have to ensure that anyone who is undertaking an assessment is appropriately trained to do so, and that where the assessor is not experienced in the condition of the person they are assessing, they must consult someone who is.

These measures will ensure that the person needing care has an effective assessment carried out by an appropriately trained assessor.

In 2007, the National Institute for Health and Care Excellence (NICE) produced the clinical guidance, ‘Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): Diagnosis and management of CFS/ME in adults and children’. This guidance set out best practice on the diagnosis, treatment care and support of children and adults with CFS/ME. Information on CFS/ME diagnosis and treatment can also be accessed via the NHS Evidence and NICE Clinical Knowledge summaries websites.

The content and standard of health care professional training is the responsibility of regulators, such as the General Medical Council, which are independent statutory bodies. They have the general function of promoting high standards of education, working with the Royal Colleges, and co-ordinating all stages of education to ensure that students and newly-qualified professionals are equipped with the knowledge, skills and attitudes essential for professional practice.

The Government has mandated Health Education England (HEE) to provide national leadership on education, training and work force development in the national health service. HEE is responsible for ensuring that the

future work force has the right numbers, skills, values and behaviours to meet patients’ needs today and tomorrow, and will work with stakeholders to influence training curricula as appropriate.

In 2007, the National Institute for Health and Care Excellence (NICE) produced the clinical guidance, ‘Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): Diagnosis and management of CFS/ME in adults and children’. This guidance set out best practice on the diagnosis, treatment care and support of children and adults with CFS/ME. Information on CFS/ME diagnosis and treatment can also be accessed via the NHS Evidence and NICE Clinical Knowledge summaries websites.

The content and standard of health care professional training is the responsibility of regulators, such as the General Medical Council, which are independent statutory bodies. They have the general function of promoting high standards of education, working with the Royal Colleges, and co-ordinating all stages of education to ensure that students and newly-qualified professionals are equipped with the knowledge, skills and attitudes essential for professional practice.

The Government has mandated Health Education England (HEE) to provide national leadership on education, training and work force development in the national health service. HEE is responsible for ensuring that the

future work force has the right numbers, skills, values and behaviours to meet patients’ needs today and tomorrow, and will work with stakeholders to influence training curricula as appropriate.

Local authorities are required to report annually on the numbers of children in need who have a disability (as defined by Section 6 of the Equality Act 2010) as part of the Children in Need Census data collection. These data are collected under Section 83 of the Children Act 1989 by the Department for Education. As part of this collection, local authorities report on the number of children with disabilities who are subject to child protection investigations under Section 47 of the Children Act 1989. However, it is not possible to separately identify those with chronic fatigue syndrome or myalgic encephalomyelitis.

The number of children in need with a disability is published in “Characteristics of Children in Need”, and can be found at:

https://www.gov.uk/government/publications/characteristics-of-children-in-need-in-england-2012-to-2013

The Department for Education does not hold the data requested.

Clinicians or clinical teams, supported by the latest available evidence and drawing on experience and judgment, are responsible for ensuring that the patients in their care get the treatment that is right for them.

There is range of guidance on the NHS Clinical Evidence website to support clinicians in the management

of patients who have either chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) fibromyalgia, or dysphagia. The National Institute for Health and Care Excellence has also produced a clinical guideline on CFS/ME that sets out best practice in the diagnosis, treatment care and support of this group of patients. However, there is no known pharmacological treatment or cure for either CFS/ME or fibromyalgia, and approaches to the management of patients with these conditions will vary, depending on the severity and type of symptoms. Regarding dysphagia this is usually a complication or symptom of another condition, rather than one that arises in isolation.

In terms of help with the cost of treatment, an extensive range of exemptions, based on age, income and medical condition are already in place to support those who may struggle to pay for their prescriptions. Around 90% of prescription items are dispensed free of charge. Prescription Prepayment Certificates (PPCs) are also available for those who have to pay national health service prescription charges and need multiple prescriptions. This is the fifth year the annual certificate, and the third year the three-month certificate have been frozen. Both certificates will remain at £104 and £29.10 respectively this year and next. There is no limit to the number of items that can be obtained through a PPC. The annual certificate benefits anyone needing more than 12 items a year, and the three-month certificate anyone needing more than three items in that three-month period. Through the Healthcare Travel Costs Scheme, those in receipt of qualifying benefits may also be eligible to claim assistance with travel to hospital or other NHS premises for NHS-funded treatment or diagnostic tests.

Regarding guidance on outstanding cases of maladministration surrounding the care of patients with CFS/ME, fibromyalgia or dysphagia, if a patient, carer or representative has concerns about the NHS care that they have received, they should first raise the matter with either the NHS organisation concerned or the NHS body that commissioned that care. The NHS Constitution makes it clear that patients have the legal right to:

make a complaint;

have that complaint investigated; and

be given a full and prompt reply.

Clinicians or clinical teams, supported by the latest available evidence and drawing on experience and judgment, are responsible for ensuring that the patients in their care get the treatment that is right for them.

There is range of guidance on the NHS Clinical Evidence website to support clinicians in the management

of patients who have either chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) fibromyalgia, or dysphagia. The National Institute for Health and Care Excellence has also produced a clinical guideline on CFS/ME that sets out best practice in the diagnosis, treatment care and support of this group of patients. However, there is no known pharmacological treatment or cure for either CFS/ME or fibromyalgia, and approaches to the management of patients with these conditions will vary, depending on the severity and type of symptoms. Regarding dysphagia this is usually a complication or symptom of another condition, rather than one that arises in isolation.

In terms of help with the cost of treatment, an extensive range of exemptions, based on age, income and medical condition are already in place to support those who may struggle to pay for their prescriptions. Around 90% of prescription items are dispensed free of charge. Prescription Prepayment Certificates (PPCs) are also available for those who have to pay national health service prescription charges and need multiple prescriptions. This is the fifth year the annual certificate, and the third year the three-month certificate have been frozen. Both certificates will remain at £104 and £29.10 respectively this year and next. There is no limit to the number of items that can be obtained through a PPC. The annual certificate benefits anyone needing more than 12 items a year, and the three-month certificate anyone needing more than three items in that three-month period. Through the Healthcare Travel Costs Scheme, those in receipt of qualifying benefits may also be eligible to claim assistance with travel to hospital or other NHS premises for NHS-funded treatment or diagnostic tests.

Regarding guidance on outstanding cases of maladministration surrounding the care of patients with CFS/ME, fibromyalgia or dysphagia, if a patient, carer or representative has concerns about the NHS care that they have received, they should first raise the matter with either the NHS organisation concerned or the NHS body that commissioned that care. The NHS Constitution makes it clear that patients have the legal right to:

make a complaint;

have that complaint investigated; and

be given a full and prompt reply.

What reports he has received on the possible reclassification of ME/CFS by the World Health Organisation.

I thank the Minister for her answer. Many people will be greatly relieved about that. As chair of the all-party group on myalgic encephalomyelitis, I receive many representations about GPs in this country still not necessarily recognising the condition. Will she look into that, and will she work with her counterparts in the DWP on the benefits side as well?

The World Health Organisation is currently developing the 11th version of the international classification of diseases, which it aims to publish in 2017. No discussions have taken place between the Department and the WHO on the reclassification of ME/CFS, but the WHO has publicly stated that there is no proposal to reclassify ME/CFS in ICD-11.

I am aware that this is a very difficult, complex and emotive area. I have heard before the point that the hon. Lady makes about GPs. I am very happy to take up her points and discuss them with her.

Will the Secretary of State join me in congratulating the UK Chronic Fatigue Syndrome/Myalgic Encephalopathy Research Collaborative for providing a mechanism for ME charities, researchers and clinicians to work together in a co-ordinated way? What support will his Department give research into the causes of and treatment for ME?

I am not the Secretary of State, but I would be very happy to join my hon. Friend in congratulating the collaborative, which is doing excellent work to generate more CFS/ME research. Spend by the National Institute for Health Research has already doubled in two years, and more funding applications are welcome. The NIHR has awarded nearly £0.9 million to the collaborative’s deputy chair for a senior fellowship studying paediatric CFS/ME.

Expenditure by the Department on research on chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) through research programmes, research centres and units, and research training awards is shown in the following table.

Total spend on CFS/ME research by the Department is higher than this because expenditure by the National Institute for Health Research (NIHR) Clinical Research Network (CRN) on CFS/ME research cannot be disaggregated from total CRN expenditure.

Total spend in future years by the NIHR on CFS/ME research depends on the volume and quality of scientific activity. The usual practice of the NIHR is not to ring-fence funds for expenditure on particular topics: research proposals in all areas compete for the funding available. The NIHR welcomes funding applications for research into any aspect of human health, including CFS/ME. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the scientific quality of the proposals made.

Over the period 2010-11 to 2012-13 the Medical Research Council (MRC) spent over £0.4 million on research into CFS/ME.

Research into CFS/ME is a priority area for the MRC. In 2011 £1.6 million was awarded to support five research grants following a call for proposals which aimed to improve understanding of the mechanisms of CFS/ME. A highlight notice identifying further areas where applications are encouraged is currently in place. The MRC does not normally allocate funds to particular topics and research proposals in all areas compete for the funding available. Awards are made according to their scientific quality and importance to human health.

Details of MRC research can be found on the RCUK Gateway to Research website at:

http://gtr.rcuk.ac.uk

and further information on MRC support for CFS/ME can be found on the MRC website at:

www.mrc.ac.uk/Ourresearch/ResearchInitiatives/CFSME/index.htm

The information requested is not held centrally. Clinical commissioning groups (CCGs) commission services for chronic fatigue syndrome/myalgic encephalopathy.

The information may be available from the National Health Service Birmingham South Central CCG.

Capita have produced the training material for their health professionals undertaking PIP assessments. It was developed in-house by qualified doctors, in line with current clinical guidelines, and includes some condition-specific information such as the material on chronic fatigue syndrome. This material forms part of an overall training package, approved by DWP, which builds on health professionals’ existing knowledge. This enables them to consider an individual's claim against the PIP assessment criteria and produce a holistic assessment of how their health condition or impairment impacts upon daily living and mobility.

The Department's National Institute for Health Research (NIHR) welcomes funding applications for research into any aspect of human health, including chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). These applications are subject to peer review and judged in open competition, with awards being made on the basis of the scientific quality of the proposals made.

The Medical Research Council (MRC), which is an independent body funded by the Department for Business, Innovation and Skills, has identified research into CFS/ME as a research priority and the Council has implemented a number of initiatives to stimulate high quality research in this area. The MRC's current priorities for this area are outlined in a highlight notice, which can be found on its website at:

www.mrc.ac.uk/Fundingopportunities/Highlightnotices/CFSME/MRC001747

Applications for research into all aspects of CFS/ME are welcomed by the MRC; this would include research on medically unexplained symptoms.

The MRC is independent in its choice of which research to support and the selection of projects for funding is determined through peer review.