Should Muslims have faith based health services?

At a time when many government and public bodies are recognising the importance of engaging with faith communities, in BMJ two experts consider the case for faith based health services for Muslims.

Muslims have the poorest overall health services in Britain, says Professor Aziz Sheikh from the University of Edinburgh and their needs " in the short term at least " should be met by faith specific healthcare initiatives.

Professor Sheikh says that there is a lack of reliable data, but that the limited information available shows that Muslims are about twice as likely to self-report poor health and disability as the general population. He argues that a better picture of the health profile and experiences of British Muslims must be developed.

The first step to facilitate this is the recording of religious affiliation, not just ethnic background at primary and secondary care levels. He believes that whilst these data are collected, there are several faith services which should be introduced which could help improve the health of the Muslim population. These include the availability of male circumcision on the NHS, better access to prayer and ablution facilities in hospitals and more information on the derivation of drugs so that Muslims can avoid alcohol and porcine-derived pharmaceuticals.

"Change is unlikely to occur without adequate... representation of faith communities in positions of influence " be they government bodies, research charities, or NHS trusts" Professor Sheikh says. He concludes that the long-term goal must be "to mainstream the understanding of the importance of religious identity."

But Professor Aneez Esmail from Manchester University argues that whilst it is "reasonable [that] we try to plan and configure our services to take account of needs that may have their roots in particular beliefs... we cannot meet everyone's demands for special services based on their religious identity: it would not be practical." He goes on to argue that some faith groups might support practices which may be morally and ethically unacceptable to the majority " for example female circumcision and the refusal to accept blood transfusions in life saving situations.

Professor Esmail believes that going down the path of providing special services for defined groups risks stigmatisation and stereotyping. He concludes that "in an ideal world doctors... would ask about a patient's beliefs not so that they can be categorised but because it might be important for the patient in their illness."