Sir Alice Miles (“Happy, twaddle-free birthday to the NHS”, June 18) points out that the irony of an increasingly well-funded NHS ceasing to provide core services (“all medical, dental and nursing care”) against a background of proliferation of facetious peripheral ones. Woolly accompanying truisms include assertions that choices have to be made and that provision of effective but expensive treatments cannot be afforded. The first statement is true, the second not. The truth is that treatment is rationed to pay for politically motivated vanity schemes such as an ill-advised computer system (£12 billion), as well as management consultants (£30 billion) whose main discernible impact has been to destroy clinical priorities in decision-making.

C. J. Hawkey
Professor of Gastroenterology
Nottingham University

Sir, Alice Miles describes the report that I chaired on acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK as twaddle. She is entitled to her view but it is ill-informed.

Our conclusions echo those of the House of Lords’ Select Committee on Science and Technology’s Report on Complementary and Alternative Medicine (2000), the Government response (2001) and a Department of Health consultation on regulation of these professions (2004, 2005) all of which supported statutory regulation. Moreover, our recommendations have taken account of the most recent regulatory policy introduced to protect patients.

The NHS funds very little complementary and alternative medicine and NHS resources should only be used where there is evidence of efficacy, safety and quality assurance. Some of the therapies, including acupuncture, are used by orthodox healthcare professionals. Contrary to what is implied, neither the Prince of Wales nor the alternative health industry had any input into the report. There is honest recognition that the evidence base for many therapies is thin but, given the public demand for treatment, this should be addressed alongside the introduction of statutory regulation and not as a prerequisite.

Miles argues that the NHS should provide medical, dental and nursing care but absolutely nothing else. What about all the other health professionals such as radiographers, physiotherapists and occupational therapists ? I would be the first to admit that extreme views exist among some advocates of complementary medicine but clearly they are not alone.

Professor Mike Pittilo
Robert Gordon University, Aberdeen

Sir, As a retired NHS consultant, I find the continuing debate on restrictions on the use of NHS services for those cancer patients who use the private system to access life-saving drugs abhorrent. The situation as it stands is that many individuals who have contributed to the NHS for decades through taxes are being forced to pay for routine NHS services such as blood tests and scans, simply because they have been driven, through lack of NHS resources for cancer medicines, to buy these drugs through the UK private healthcare system. To force anyone to pay for life-saving treatment is inhumane and unjust; to add insult to injury by then charging them for routine NHS treatments for the cancer is beyond belief.

Dr Leyla Sanai
Glasgow

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