OK, then, what about the use of cannabis to alleviate the symptoms of multiple sclerosis and other illnesses? “There are better ways to alleviate pain and nausea, so anyone who takes it probably likes the cannabis effect.”
Prof Ernst’s soft voice and teddy-bear appearance give the impression of a charming, elderly academic who is happy to be spending more time in his Suffolk garden since he retired in May. It is a false impression borne, he says, of German being his first language. “I don’t shout because I can’t express myself in English as I should like to. I may appear calm, but I get terrifically angry.”
In the past 18 years, while he has been running the complementary medicine research group at the Peninsula Medical School in Devon (a partnership between Exeter and Plymouth Universities and the NHS), he has often been angry. He has had public run-ins with many alternative therapists – homoeopaths, chiropractors, herbalists and acupuncturists. But the juiciest chapter in the autobiography he is currently writing will cover his feud with the Prince of Wales.
It began in 2005 when he rubbished a report, sponsored by the Prince, which supported the idea that the NHS would save up to ?3.5?billion a year if it spent more on alternative therapies. “I knew the facts extremely well as I had done a similar report for the World Health Organisation, and didn’t mince my words.”
Sir Michael Peat, the Prince of Wales’s private secretary, complained that Prof Ernst had breached confidentiality by speaking to a newspaper. “There was a 13-month investigation and I was shown to be innocent, but all fund-raising stopped. After that, I was persona non grata.” This, he believes, led to the funding crisis that forced him into early retirement, aged 63.
“Both the vice-chancellor of Exeter University and the dean of the Peninsula Medical School were knighted.” For taking the Prince’s side? “Cause and effect are not proven.”
Last month, Prof Ernst told a conference in London that he considered the Prince “a snake-oil salesman” for supporting “unproven and disproved” remedies and for selling a ?10 Duchy Herbals Detox Tincture. The range, he said, should be renamed “Dodgy Originals”.
The battle between the two men is one of principle, he says. “We urgently need to focus on the safety of alternative treatments, of which there are about 400.
People think natural equals safe, but it is a misconception. If there is an adverse reaction to medication, a doctor fills out a yellow card, sending a signal that can be investigated. There is no such system for herbal medicines. I also know of 30 to 40 cases of serious neurological damage after spinal manipulation, none of them formally reported.”
Fortunately for those who share his concern, the arrival of a new dean of the Peninsula Medical School, Professor Steve Thornton, has led to a reprieve for his research group. Prof Ernst still had to go, but he is helping to appoint his successor. The advertisements for the post of professor of complementary medicine call for “a rigorous scientist”. If this requirement is not stated clearly, he fears, the job could attract promoters of alternative therapies.
The British, who spend around ?2 billion a year on unproved therapies, need sceptics to investigate on their behalf, he believes. Individuals can then decide whether to waste their money.
He is, unequivocally opposed to the NHS funding alternative therapies at a time when money is tight and patients are being denied treatments of proven worth.
“I have an advertisement on my desk from an NHS hospital looking for a reiki healer. I’m sure the money could be better spent. Recently, the National Institute for Health and Clinical Excellence (Nice) decided that acupuncture and chiropractic are good treatments for recurring back pain. They have underestimated the risks.”
Those two alternative therapies were among those assessed in Trick or Treatment?, the 2008 book that he co-authored with the eminent science writer, Simon Singh. Ironically dedicated to the Prince of Wales, it examines the case for the safety and effectiveness of various therapies, and finds them mostly wanting.
“There are some positive conclusions about acupuncture, nothing on homoeopathy, almost nothing on chiropractic (a type of manipulation), and some positive findings on herbal medicine. The therapies for which there are strong evidence are supportive rather than curative: hypnotherapy, massage, autogenic training and other relaxation therapies.”
Prof Ernst seems almost surprised that he has become known as the scourge of the alternative medical world because in southern Germany, where he was brought up, it was part of normal life.
“My father practised homoeopathy. I was exposed to herbal remedies, acupuncture and massage, as everyone in Germany is. My first job on qualifying as a doctor was in a homoeopathic hospital.”
Initially he was impressed by how patients recovered after homoeopathy. Now he believes that is because of the placebo effect and the psychotherapeutic benefits of an hour’s consultation. By 1993, he held a professorship in recuperative medicine at the University of Vienna, but later seized an offer from the University of Exeter to set up the world’s first department dedicated to research into complementary medicine. At its peak, Prof Ernst was running 20 research projects. It will take time for his successor to build back up to that level, but he believes it must be done to prevent quackery.
His own health regime is simple. “I eat oily fish rich in omega-3 fatty acids and lots of salad. I drink green tea, which reduces the risk of gastric cancer, lots of water, and rather more red wine than I should because I like it.” He and his French wife, Danielle, keep fit by walking their Welsh terrier.
If he were diagnosed with cancer, what would he do? “I wouldn’t take aspirin [thought to prevent cancer].
I might have a look at selenium [supposedly a tumour suppressor] but, most importantly I would find a good health care team and trust them. You can’t go around torturing yourself with believing every nonsense on the internet.”
I am sure he is right, but I might just finish the papaya leaf extract first.
‘Trick or Treatment? Alternative Medicine on Trial’ by Simon Singh and Edzard Ernst (Corgi, ?8.99)
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