2,3 Several trials have revealed the beneficial effects on mood and mental health of simply observing nature, or even images of natural scenes. One group of holistic therapies that aim to treat the whole person and has been well researched through surveys and randomised trials is so-called green care, or therapy by exposure to plants and gardening. Can we do better for these people without using drugs?

Ten million of the UK population are defined as disabled, among them 6.9 million of working age. Such treatments could reduce the workload and financial pressure on the NHS, particularly in primary care, but they clearly must only be recommended by health professionals if there is good evidence that they are effective many are without merit. 1 In addition to improving the information given to patients and health professionals on the true efficacy of drugs and on their risks, and thus empowering choices for patients, there are opportunities to treat some physical and mental conditions with alternative or complementary therapies, and to encourage changes in lifestyle. Health depends on a range of social, economic and environmental factors, as is emphasised by the shaming disparity between the length of life in different areas of the country. Drugs are also prescribed at the cost of side effects, which are a leading cause of admissions to hospital, particularly for the elderly, who are poorly represented in trials. It is also realised that pharmaceutical drugs, transformative though they have been, are increasingly expensive and are not always as effective as they appear in the results of early, enthusiastically reported, clinical trials. There is anxiety that the NHS cannot cope now and in the future with the health needs of an increasing and ageing population.

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