Dr. Paul McKeown:

I should clarify for Deputy Doherty that when I spoke about chronic Lyme disease I meant that there are chronic conditions. In terms of chronic seronegative Lyme disease, the human body is designed to fight off alien substances, including infections. One of the ways it does this is through antibodies. My feeling is that if somebody has an infection, they must mount an antibody response. If the antibodies are not there, it means the person has a desperately damaged immune system and is open to all sorts of infections or that the diagnosis would be something else.

In terms of guidance, it is extremely important that we produced our consensus statement and highlighted a number of guidance documents. Whenever we develop guidance, we look for confluence and a majority of evidence pointing in one direction. To do that, we have access to a vast amount of evidence through various repositories of information that are made freely available to us. It is a wonderful resource. We look for confluence of evidence which does not mean that we discard other evidence. All the evidence in terms of diagnostics and treatment very much point in a particular direction, and that is the basis upon which we have developed guidance.

I note to Deputy Griffin that it is shocking to hear of someone who is placed in that awful position. I would be very concerned that if that person got a diagnosis outside the country, he or she was given the wrong diagnosis. Quality assurance in our labs is very high and extremely important because our medics - my microbiological colleagues - are here to protect people. That is why across all developed countries the laboratories operate to a very high quality assurance standard. That is necessary to ensure that people get the correct diagnosis in order that they do not go down a road of being given inappropriate antibiotics that could damage them or having an inappropriate lumbar puncture, which very occasionally has complications.