BACKGROUND: Myalgic encephalomyelitis (ME) is a mysterious and
controversial condition. Debate has centred upon its
causation, and the purchasing question-which services to
commission for people with ME-has not been addressed.
METHODS: A health needs assessment was made of people with ME
in Wakefield, based upon published (including grey)
literature, and local informants.
RESULTS: Previous studies
have mostly reflected institutional outbreaks; local needs
will reflect community, sporadic cases but there is little
information about these. The very wide estimates of
prevalence (between zero and 57000 for a district the size of
Wakefield) indicate a fundamental problem over the validity of
the concept of ME. Four sets of health needs emerged from the
literature and from local informants: a medical diagnosis,
rest, specific treatments and social care. All four are
CONCLUSION: There are no proven services or
interventions which the health authority should purchase for
people with ME. Purchasing, being a blunt tool for service
change, is unlikely to improve health care given the
disagreements over the condition.