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Should the NHS Alliance be endorsing alternative medicine?

The NHS Alliance website informs us that the alliance, one of the UK's largest GP bodies, has a 'representational role' and 'helps primary care organisations exchange best practice'.

But there is no clear mission statement and, on browsing through the site, you might get the impression it is a lobby group for alternative and complementary medicine.

The site includes several speeches NHS Alliance chair Dr Michael Dixon has given promoting this type of healthcare and 10 press releases on the subject. This topic is controversial and we might expect a degree of critical assessment, but all the releases seem promotional. Here are quotes from a few:

o 'Complementary medicine is becoming increasingly popular with patients [and] has the potential to improve health and reduce demands on conventional services.'

o 'Complementary medicine… provides a holistic approach in line with primary care.'

o 'Conventional medicine risks becoming too mechanistic.'

o 'The NHS Alliance today backed ministers' support for alternative therapies to be available to NHS patients.'

o 'Three-quarters of the public believe complementary medicine should be available from the NHS.'

o 'It is time for orthodox medicine to embrace complementary therapies.'

Perhaps you will be surprised by all this material on alternative medicine, but still find the quotes acceptable.

I beg to differ. The total lack of critical assessment is disappointing and several statements are misleading or incorrect. Contrary to some of the releases, there is no good evidence the popularity of alternative medicine is increasing. The notion complementary medicine 'provides a holistic approach' implies primary care is no longer interested in whole individuals. And I would argue alternative therapies should not be 'embraced' and 'made available to NHS patients' - they should be scientifically tested and only those supported by sound evidence used. The vast majority of alternative therapies fail to fulfil this basic criterion1.

Dr Dixon seems to condone even less evidence-based practices. His endorsement appears on the cover of a book entitled Food is Better Medicine than Drugs - Your Prescription for Drug-Free Health2. In it, as an alternative to warfarin, aspirin and statins, patients are recommended 'several foods, nutrients and spices… [which] together… are likely to be far more effective'. There is, of course, no sound evidence for this claim.

What strikes me most with the NHS Alliance's promotion of alternative medicine is the absence of the term 'evidence'. The GMC demands of its members: 'You must provide effective treatments based on the best available evidence.' This raises the question of whether the NHS Alliance is not in conflict with the accepted ethical standards of the UK medical profession.

From Professor Edzard Ernst, professor of complementary medicine, Peninsula Medical School, Universities of Exeter and Plymouth

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