This letter was sent to the chief executives of 476 NHS Trusts (acute and primary care trusts). It was the main headline in The Times, and the lead item on the BBC’s Today Programme.
|From Professor Michael Baum and others 19th May 2006
Re Use of ‘alternative’ medicine in the NHS
We are a group of physicians and scientists who are concerned about ways in which nproven 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.
and Professor Frances Ashcroft FRS
University Laboratory of Physiology, Oxford
Professor Sir Colin Berry
Professor Gustav Born FRS
Professor Sir James Black FRS
Professor David Colquhoun FRS
Professor Peter Dawson
Professor Edzard Ernst
Professor John Garrow
Professor Sir Keith Peters FRS
Mr Leslie Rose
Professor Raymond Tallis
Professor Lewis Wolpert CBE FRS
As soon as this appeared the phone started ringing.
Michael Baum did an excellent job on the Today Programme, and on BBC Birmingham, BBC55, BBC world service, ITN news (interviewed for 20 minutes outdoor in the rain), Sky News live, and as well as all that he saw patients, and missed lunch while in the operating theatre. Michael comments ” How was your day your Royal Highness? “.
Leslie Rose did BBC Breakfast TV interview and various radio stations.
I did interviews for BBC News24, BBC1 News, Chanel 5 News, Sky news, the Jeremy Vine Show (radio 2), BBC Radio Solent, and wrote something for the Scotsman. Today it’s Radio London at 10.35 pm and tomorrow, Radio Foyle (Derry).
Listen to the Today Programme 08.10 interview
John Humphrys, on the Today Programme, interviews Michael Baum (lead signatory on the letter), and Peter Fisher of the Royal London Homeopathic Hospital (For more on Peter Fisher, see here, and here, and here). Listen to the interview [mp3 file, 4.4 Mb]
Leslie Rose interviewed on BBC
Breakfast TV. Watch the interview (Realplayer file).
Interview for Sky News.
The Jeremy Vine show interview (Radio 2)
The Late Show on BBC Radio London (24 May), host Stephen
Rhodes, DC versus Gary Trainer: click to listen
Radio Foyle (N. Irelend) Talk show with Mark Patterson. The local health
food shop manager told me that ‘arthritis is a build up of toxins in the body’,
and that glucosamine and chondroitin are herbal! Click to listen
Michael Baum’s 2004 Open letter. “An open letter to the Prince of Wales: with respect, your highness, you’ve got it wrong”. Download pdf file.
Coverage in The Times, 23 May 2006. The front page headline.
New International has forced me to remove the pictures of the front page, but the front page headline was
NHS told to abandon alternative medicine
Top doctors say money should go to conventional treatment
Here is Mark Henderson’s article.
NHS told to abandon alternative medicine
By Mark Henderson, Science Editor
Top doctors say money should go to conventional treatment
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.
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.
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