Dear Netters

 

Top Doctors and Scientists have urged the National Health Services Trust to abandon alternative medicine in the United Kingdom. Prince Charles, the future King of England, is in favour of  alternative medicine. As far my information goes, France has already taken a lead in the matter. This is a matter of global concern. I will comment later. For the present, I just post the following piece from today’s The Times. The letter also.

 

Bhuban

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The Times May 23, 2006

NHS told to abandon alternative medicine

By Mark Henderson, Science Editor

Top doctors say money should go to conventional treatment Full text of the letter to trust chief executives

A GROUP of Britain’s leading doctors has urged every NHS trust to stop paying for alternative medicine and to use the money for conventional treatments. Their appeal is a direct challenge to the Prince of Wales’s outspoken campaign to widen access to complementary therapies.
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Public funding of “unproven or disproved treatments” such as homoeopathy and reflexology, which are promoted by the Prince, is unacceptable while huge NHS deficits are forcing trusts to sack nurses and limit access to life-saving drugs, the doctors say.

The 13 scientists, who include some of the most eminent names in British medicine, have written to the chief executives of all 476 acute and primary care trusts to demand that only evidence-based therapies are provided free to patients.

Their letter, seen by The Times, has been sent as the Prince today steps up his crusade for increased provision of alternative treatments with a controversial speech to the World Health Organisation assembly in Geneva.

The Prince, who was yesterday given a lesson in crystal therapy while touring a complementary health unit in Merthyr Tydfil, will ask the WHO to embrace alternative therapies in the fight against serious disease. His views have outraged clinicians and researchers, who claim that many of the therapies that he advocates have been shown to be ineffective in trials or have never been properly tested.

The letter criticises two of his flagship initiatives on complementary medicine: a government-funded patient guide prepared by his Foundation for Integrated Medicine, and the Smallwood report last year, which he commissioned to make a financial case for increasing NHS provision.

Both documents, it is claimed, give misleading information about scientific support for therapies such as homoeo-pathy, described as “an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness”.

The letter’s signatories include Sir James Black, who won the Nobel Prize for Medicine in 1988, and Sir Keith Peters, president of the Academy of Medical Science, which represents Britain’s leading clinical researchers.

It was organised by Michael Baum, Emeritus Professor of Surgery at University College London, and other supporters include six Fellows of the Royal Society, Britain’s national academy of science, and Professor Edzard Ernst, of the Peninsula Medical School in Exeter, who holds the UK’s first chair in complementary medicine.

The doctors ask trust chief executives to review their policies so that patients are given accurate information, and not to waste scarce resources on therapies that have not been shown to work by rigorous clinical trials.

They conclude: “At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence.”

Professor Baum, a cancer specialist, said that he had organised the letter because of his “utter despair” at growing NHS acceptance of alternative treatments while drugs of proven effectiveness are being withheld. “At a time when we are struggling to gain access for our patients to Herceptin, which is absolutely proven to extend survival in breast cancer, I find it appalling that the NHS should be funding a therapy like homoeopathy that is utterly bogus,” he said.

He said that he was happy for the NHS to offer the treatments once research has proven them effective, such as acupuncture for pain relief, but that very few had reached the required standards.

“If people want to spend their own money on it, fine, but it shouldn’t be NHS money.”

The Department of Health does not keep figures on the total NHS spending on alternative medicine, but Britain’s total market is estimated at £1.6 billion.




Times Online May 23, 2006


Full letter: doctors' campaign against alternative therapies







From Professor Michael Baum and others


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Mr Peter Homa
Chief Executive
St George’s Healthcare NHS Trust
St George’s Hospital
Blackshaw Road
Tooting
London SW17 0QT


19th May 2006

Dear Mr Homa

Re Use of ‘alternative’ medicine in the NHS

We are a group of physicians and scientists who are concerned about ways in which unproven or disproved treatments are being encouraged for general use in the NHS. We would ask you to review practices in your own trust, and to join us in representing our concerns to the Department of Health because we want patients to benefit from the best treatments available.

There are two particular developments to which we would like to draw your attention. First, there is now overt promotion of homeopathy in parts of the NHS (including the NHS Direct website). It is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. Despite this, a recently-published patient guide, promoting use of homeopathy without making the lack of proven efficacy clear to patients, is being made available through government funding. Further suggestions about benefits of homeopathy in the treatment of asthma have been made in the ‘Smallwood Report’ and in another publication by the Department of Health designed to give primary care groups “a basic source of reference on complementary and alternative therapies.” A Cochrane review of all relevant studies, however, failed to confirm any benefits for asthma treatment.

Secondly, as you may know, there has been a concerted campaign to promote complementary and alternative medicine as a component of healthcare provision. Treatments covered by this definition include some which have not been tested as pharmaceutical products, but which are known to cause adverse effects, and others that have no demonstrable benefits. While medical practice must remain open to new discoveries for which there is convincing evidence, including any branded as ‘alternative’, it would be highly irresponsible to embrace any medicine as though it were a matter of principle. 

At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence. Furthermore, as someone in a position of accountability for resource distribution, you will be familiar with just how publicly emotive the decisions concerning which therapies to provide under the NHS can be; our ability to explain and justify to patients the selection of treatments, and to account for expenditure on them more widely, is  compromised if we abandon our reference to evidence. We are sensitive to the needs of patients for complementary care to enhance well-being and for spiritual support to deal with the fear of death at a time of critical illness, all of which can be supported through services already available within the NHS without resorting to false claims.

These are not trivial matters. We urge you to take an early opportunity to review practice in your own trust with a view to ensuring that patients do not receive misleading information about the effectiveness of alternative medicines. We would also ask you to write to the Department of Health requesting evidence-based information for trusts and for patients with respect to alternative medicine.

Yours sincerely

Professor Michael Baum
Emeritus Professor of Surgery, University College London

and
Professor Frances Ashcroft FRS
University Laboratory of Physiology, Oxford
Professor Sir Colin Berry
Emeritus Professor of Pathology, Queen Mary, London
Professor Gustav Born FRS
Emeritus Professor of Pharmacology, Kings College London
Professor Sir James Black FRS
Kings College London
Professor David Colquhoun FRS
University College London
Professor Peter Dawson
Clinical Director of Imaging, University College London
Professor Edzard Ernst
Peninsula Medical School, Exeter
Professor John Garrow
Emeritus Professor of Human Nutrition, London
Professor Sir Keith Peters FRS
President, The Academy of Medical Sciences
Mr Leslie Rose
Consultant Clinical Scientist
Professor Raymond Tallis
Emeritus Professor of Geriatric Medicine, University of Manchester
Professor Lewis Wolpert CBE FRS
University College London
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