Doctors’ Campaign Against Alternative Therapies UK

Discussion in 'Fibromyalgia Main Forum' started by tansy, Aug 11, 2006.

  1. tansy

    tansy New Member

    Response to Doctors’ Campaign Against Alternative Therapies

    Eileen Marshall Margaret Williams
    24th May 2006

    Members of the ME community may have read a letter that was published in The Times on 23rd May 2006 from a group of eminent (ie. so-called “establishment”) physicians and scientists who are strongly opposed to what they call “unproven or disproved treatments” that are now being encouraged for general use in the NHS.

    According to the BBC, this letter was sent to the head of every single Primary Healthcare Trust in the UK – almost 500 of them -- urging them 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 ask you to write to the Department of Health requesting evidence-based information for trusts and for patients with respect to alternative medicine”.

    The letter asked the recipients “to join us in representing our concerns to the Department of Health” and stated: “There are two particular developments to which we would like to draw your attention. First, there is now overt promotion of homeopathy (sic) in parts of the NHS (including the NHS Direct website). A recently-published patient guide, promoting the use of homeopathy (sic) is being made available through Government funding”.

    The letter continues: “Secondly, 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”.

    It goes on: “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. Our ability to justify to patients the selection of treatments is compromised if we abandon our reference to evidence”.

    The timing of this letter was significant, because it appeared on the very day the HRH The Prince of Wales was to address the World Health Assembly (and his support for alternative and complementary medicine is well-known, as is the fact that members of the Royal Family have used such interventions for many years: indeed, it is said that the Queen never travels without a homoeopathic medicine chest).

    Apart from the signatories’ notable lack of rejoicing about the fact that in many instances homoeopathy actually works -- which means that patients benefit from it – even if the way in which it works remains undetermined (and something that is of benefit to patients ought surely to be the raison d’etre of such eminent medical and scientific persons), the argument promoted for the non-use of therapies that work requires scrutiny.

    The letter makes it clear that in the delivery of healthcare, the signatories urge reliance on nothing but “evidence-based” interventions and that they believe such interventions are those that use “pharmaceutical products”.

    Here, once again, seems to be the voice of HealthWatch, a campaigning organisation that was set up to serve the interests of the pharmaceutical industry and which has an established track record of militant opposition to alternative and complementary medicine and to the extermination of its practitioners (see for example Hansard (Lords) 28th April 1993:364-382 and Hansard (Lords) 10th May 1995:66-68). Despite furious denials from one of its founders (the President of HealthWatch, Nick Ross of CrimeWatch fame), its own early literature is very clear about its objectives, and it is an irrefutable fact that it has in the past accepted money from both the pharmaceutical and health insurance industries.

    Some of the signatories to the letter to The Times are, or certainly were, members of HealthWatch, whose other members of relevance to the ME community include Professor Simon Wessely and Dr Charles Shepherd. Professor Michael Baum, the lead author of the letter, was a major player from its foundation in 1985, while Professor John Garrow was a member of its Committee and held the post of Hon Secretary, whilst Professor Lewis Wolpert could fairly be described as an adherent of the “Wessely School”.

    If “acceptable” therapeutic interventions must be based on “solid evidence”, why does this concept not apply in ME/CFS, where the only interventions that are offered (sometimes under duress) and indeed permitted are antidepressants and behavioural modification programmes, including graded exercise regimes, which have been shown to be ineffective and sometimes dangerous.

    In this case, the very limited and equivocal “solid evidence” consists of only five RCTs and it is unknown how many participants actually had ME or in fact had some other form of “medically unexplained” fatigue. These RCTs delivered only modest and time-limited benefit, yet the UK Government has been happy to pour at least £11.1 million into these unsuitable interventions that cannot credibly be described as “evidence-based”, since ‘double-blind’ psychotherapy is impossible (ref: Clinical trials in psychiatry: background and statistical perspective. Tony Johnson (MRC Biostatistics Unit, Cambridge, UK): Statistical Methods in Medical Research 1998:7:209-234).

    It will be recalled that this is the same Tony Johnson who is currently assisting Simon Wessely with the MRC PACE trials.

    It is alternative and complementary interventions which are the very ones that often deliver benefit to the unfortunate and much-abused ME/CFS patients, yet here we have yet more confirmation of the influence of powerful vested interest groups whose aim seems to be to deny and prevent such benefit.

    Since doctors no longer swear the Hippocratic oath, some of them seem to have forgotten that the aim of medicine is to prevent, not compound, suffering.

  2. tansy

    tansy New Member

    Times online May 23, 2006

    Full letter: doctors' campaign against alternative therapies

    From Professor Michael Baum and others
    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 BerryEmeritus Professor of Pathology, Queen Mary, London
    Professor Gustav Born FRSEmeritus Professor of Pharmacology, Kings College London
    Professor Sir James Black FRSKings College LondonProfessor David Colquhoun FRSUniversity College London
    Professor Peter DawsonClinical Director of Imaging, University College London
    Professor Edzard ErnstPeninsula Medical School, Exeter
    Professor John GarrowEmeritus Professor of Human Nutrition, London
    Professor Sir Keith Peters FRSPresident, The Academy of Medical Sciences
    Mr Leslie RoseConsultant Clinical Scientist
    Professor Raymond Tallis
    Emeritus Professor of Geriatric Medicine, University of Manchester
    Professor Lewis Wolpert CBE FRSUniversity College London[This Message was Edited on 08/11/2006]
  3. tansy

    tansy New Member

    The Times May 24, 2006

    "Physician, heal thyself"
    BY JEROME BURNE

    PROFESSOR Michael Baum, who laid into alternative medicine yesterday, is right to be concerned about wasting scarce NHS funds on “unproven or disproved” treatments. But he has the wrong target in his sights. If he wants to root out hype dressed up as science, he would do far better to focus on conventional drugs.

    Far too many prescription drugs are marginally effective and carry risks out of proportion to the conditions they are designed to treat. Drug side- effects kill around 10,000 people a year in the UK — three times the number killed on the roads — and cost the NHS more than £4 billion. Patients are being perfectly rational in seeking alternatives and it is simply outdated medical arrogance to condemn them for it.

    Only last week it emerged that one of the antidepressant SSRI drugs increased the risk of young adults committing suicide — a possibility that the companies had always strenuously denied even though in 2003 doctors had been advised not to give these drugs to anyone under 18 because of a suicide link. The evidence for that official ruling dated to 1996 but had never been published. During the intervening years British doctors were prescribing more SSRIs to children than any other country in Europe and yet there was no proper evidence base for this at all. Treating those children by changing their diet or with acupuncture seems sane by comparison.

    The scandal surrounding the anti-inflammatory drug Vioxx — withdrawn from the market in 2004 because it doubled the risk of developing heart disease — is another example of a heavily hyped drug prescribed to millions for whom it was not appropriate. Evidence that there was a danger was once again downplayed or ignored; one expert estimate puts the number of Americans killed or harmed by a drug they took to ease aching joints at 140,000.

    Professor Baum demonstrates no understanding of why people are searching for alternatives to his remedies. In any other business, blaming your customers for deserting you would be regarded as self-defeating. If he’s serious about safety and cutting costs, he could start by demanding that drug disasters are followed by an official inquiry and that testing of promising non-drug therapies is properly funded.

    Jerome Burne is author of the forthcoming book Food is Better Medicine than Drugs
  4. UnicornK

    UnicornK New Member

    How dare they! If it works, let us have it! Pooh on "solid evidence". There isn't "solid evidence" that doctors work! (Sorry...I couldn't resist that! LOL)

    Anyway, I guess they are talking about accupuncture, holistic/homeopathic remedies, etc. All they have to do is talk to some of us to get their solid evidence.

    I'm outraged that someone could do this to us...and others who are benefiting from "alternative" solutions.

    Just my humble opinion.

    God Bless.
  5. Tantallon

    Tantallon New Member

    If some doctors are so 'against' the use of alternative therapies why don't they come up with an effective treatment then.

    God I get so annoyed with attitudes like this. If some people find that they work for them, then why shouldn't they continue to use them.

    It just seems to me that some attitudes of UK doctors are "Yes you've got ME/FMS and at the moment their is no treatment for it. Join a support group".
  6. tansy

    tansy New Member

    as the Campaign Against Health Fraud. A leading figure in this was Caroline Richmond (journalist) who seemed to have a particular dislike for PWME; her writings were particularly vitrioloc and insulting.

    The CAHF's earliest targets were doctors who treated ME, MCS, and who gave cancer patients advice on non pharmaceutical ways to enhance their recovery. Their targets included the Breakespear Hospital (Dr Jean Munroe), the Bristol Cancer Centre, and many more.

    Dr Charles Shepherd and Prof Simon Wessely, who have been actively involved in Healthwatch (CAHF), remain adamantly opposed to most alternatives. You would have thought that as "specialists" they would be keen to promote anything that helped when neither has come up with Tx that cure or bring about a 100% remission. Reports on the Wessely School's conferences confirm their dislike of non psychiatric protocols for the illnesses they describe as functional somatic disorders.

    As you know there was a lot of campaigning going on last year to preserve our right to access supps, herbs etc. Members of Healthwatch clearly have a problem with this freedom of choice and the large numbers who benefit from Tx that have not been aproved by the doctors whose attitude to all Tx is ultra orthodox and tunnel visioned.

    Tansy[This Message was Edited on 08/12/2006]