Tuesday, May 26, 2009

Insane: NHS practices quack medicine but denies patients drugs that do work

There have been several well-controlled studies which show that acupuncture has placebo effects only

Acupuncture is to be made available on the NHS at a cost of ?1.4bn a year despite little scientific evidence that the 'mumbo jumbo' medicine works. The Government's rationing watchdog NICE will also announce on Wednesday that patients can demand other unproven treatments like osteopathy and chiropracty. This is despite the fact that NICE has turned down drugs for people with cancer and dementia, describing them as 'not cost effective'.

Experts have slammed the new ruling as tantamount to the official endorsement of 'mumbo jumbo' medicine which works no better than a placebo. It is the first time the rationing body has backed the use of alternative therapies on the NHS. Their guidance comes just weeks after a large scientific study found that the traditional Chinese practice of acupuncture was no better at relieving pain than simply sticking toothpicks in different parts of the body.

The research, by the Centre for Health Studies, in Seattle, found that 60 per cent of patients given acupuncture for back pain felt better a year after treatment, compared with 40 per cent of those who were not given the treatment. But the trial found that a third group of patients given 'simulated acupuncture' using toothpicks which did not penetrate the skin, was just as effective as when needles were used. Professor David Colquhoun, pharmacologist at University College London, said this indicated that all acupuncture did was create a 'theatrical placebo', which fooled recipients into believing their condition had improved.

He said of the new guidance: 'This is an official endorsement of mumbo jumbo and the implications of that are terrible, for the NHS, and for the taxpayer. 'We will not only be subsidising an industry of acupuncturists and chiropractors, but worse still spending money on standards and regulation of something which I do not believe the evidence supports.'

On Wednesday, NICE will tell GPs to offer patients with back pain courses of complementary therapies costing the NHS at least 400 pounds a time, as an alternative to exercises they can carry out on their own or in class. The draft guidance says up to 10 sessions of acupuncture, worth between 35 and 50 pounds a session, or nine visits to an expert in 'spinal manipulation' - osteopaths, chiropractors and physiotherapists - should be offered.

Four million people consult their GP about back pain every year and if all of them took up acupuncture or chiropracty, it would land the NHS with an annual bill of more than 1.4 billion.

The guidance says anyone whose pain persists for more than six weeks should be given a choice of several treatments, because the evidence of what works best is so uncertain. There were no randomised controlled trials which showed the benefit of exercise, while on complementary therapies the evidence was mixed, with some showing small benefits. Therefore, any decision on which treatment to try should be left with the patient. NICE say that no one should be referred for X rays or MRI scans until other treatments have been tried.

Supporters of acupuncture say it works because needles are inserted into points in the body identified as 'meridians' through which 'energy' flows. But there is no anatomical basis for belief in 'meridians', and acupuncturists cannot state what the 'energy' they claim to be harnessing actually is.

Paul Robin, chairman of the Acupuncture Society, said the therapy worked 'fantastically well' in relieving back pain. He said the mystery about how acupuncture worked made it difficult for trials to demonstrate that its results were not caused by a placebo effect. Mr Robin said: 'There have not really been enough studies into acupuncture. For example, we know that it works even when the needles are not in the right places, which could be because the needles themselves create an endorphin effect, which gives pain relief. 'That doesn't mean acupuncture doesn't work.'

Chiropracty, invented in the late nineteenth century, works on the unscientific principle that diseases are caused by faulty alignment of the bones. Practitioners manipulate the spine in an attempt to relieve pain.

NICE's green light for alternative medicine comes despite the fact that two years ago it turned down drugs for people with moderate Alzheimer's disease, costing just 2.50 a day. It also turned down bowel cancer drugs Avastin and Erbitux. Ian Beaumont, campaigns director of Bowel Cancer UK, said: 'We hope NICE is not funding complementary therapy at the expense of mainstream drugs which have a more proven benefit - but often are not made available to patients on the NHS.'

Neil Hunt, chief executive of the Alzheimer's Society, said: 'We have consistently stated that NICE's decision to deny people with dementia access to drugs in the moderate stages of the condition is unethical and based on flawed calculations. NICE must tackle these flaws to ensure people with dementia can get access to effective treatments.'

SOURCE

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