THE LORDS' GUIDE TO THE COMPLEMENTARY MAZE
source: Jenny Hope, Daily Mail, Wednesday 29th November 2000
The Lords' report lists three groups of complementary and alternative therapies.
The big five professionally organised alternative therapies which have research evidence supporting their effectiveness.
Chiropractic - manipulation and massage techniques to treat musculo-skeletal complaints and back pain.
Homeopathy - treating 'like with like' by using dilute substances which in larger doses would bring on the symptoms of the illness being treated.
Osteopathy - treatment of musculo-skeletal problems by manipulation.
Acupuncture - the insertion of small needles into various points of the body to stimulate nerve impulses and treat pain.
Herbal medicine - use of plants and plant extracts to treat disorders and maintain good health.
Complementary therapies which 'complement' conventional medicine and should organise individual bodies of self-regulation. They include:
Alexander Technique - a method of standing, sitting and moving in a way that optimises health.
Aromatherapy - use of essential oils, which are inhaled, used as a massage oil or ingested to treat symptoms.
Body work therapies , including massage and shiatsu-therapies that use rubbing, kneading and pressure to alleviate aches, pains and musculo-skeletal problems.
Reflexology - foot massage based on the idea that each body organ is related to a region of the foot.
Hypnotherapy - hypnosis to treat various disorders.
Meditation - techniques used to relax a patient and clear the mind.
Yoga - system of adopting postures and exercise designed to promote spiritual and physical well-being.
Alternative disciplines for which there is no convincing research evidence that they work. Long-established and traditional systems of healthcare which include:
Ayurvedic medicine - ancient Indian discipline which uses natural herbs in treatment.
Chinese herbal medicine and traditional Chinese medicine - number of treatment methods used to diagnose and treat health problems.
Crystal therapies - using crystals to fine tune the body's energy.
Iridology - treatment of problems by studying the iris of the eye.
Dowsing - traditionally used to identify water sources underground but employed by therapists to answer questions through intuitive skills.
There was a considerable media response to the publication of the House of Lords Select Committee on Science and Technology report on complementary and alternative medicine, which was published on 28 November 2000.
Below are extracts from some of the press articles about the report.
HIT AND MISS MEDICINE
The Limits of Complementary Treatment
source: The Guardian 29th November 2000
Somebody needed to say it. A distinguished group of medics on the Lords select committee on science and technology obliged yesterday. A one-year study of complementary and alternative medicine (CAM) has produced a blunt conclusion. Most CAM training courses involve unacceptable variations in content, depth and duration; the regulation of the multiplying number of different specialities is fragmented and inadequate; and research on their effectiveness is virtually non-existent. But before sceptics respond with the Mandy Rice Davies reply ("they would, wouldn't they"), yesterday's report is not self-serving, protectionist defence of modern medicine. Far from wanting to suppress complementary and alternative therapies, the medics want to bring them under the National Health Service umbrella, but only where they can demonstrate their effectiveness. The committee rightly concludes that the public needs much better independent guidance on CAM therapies, and recommends the NHS should be given this responsibility. It calls for more government funding for CAM research, noting the success of the National Center for Complementary and Alternative Medicine in the US.
CAM therapists - now, at 50,000, out-numbering GPs by 10,000 - will rightly note that only 20% of modern medicine is evidence-based. But this proportion is growing exponentially. Modern medicines ensure that - 50% were unknown six years ago. A rational society should pursue evidence-based medicine, resisting populist calls for a retreat from science. The committee produced three useful categories: the 'big five' (acupuncture, chiropractic, herbal medicine, homeopathy, and osteopathy), which could qualify now for NHS inclusion; a group of complementary rather than alternative therapies giving comfort, not cures; and a third category with no evidence of effectiveness. It is time for complementary medicine to respond.
BMA BACKS TOUGHER REGULATION
Source: Nigel Hawkes, The Times, Wednesday 29th November 2000
Health organisations last night backed the report's call for greater control of the proliferating alternative medicine industry.
The Lords estimate that £1.6 billion a year is spent on complementary and alternative therapies, with 50,000 practitioners treating up to five million patients every year. But there is little regulation and not much evidence of the effectiveness of many treatments.
The British Medical Association supported the Lord's call for statutory regulation of acupuncture and herbal medicine. Vivienne Nathanson, head of policy at the BMA, said: "Only osteopathy and chiropractic are currently regulated by law and we want to see this extended. Acupuncture and herbal medicine are obvious candidates and we would want other areas to follow.
"People want to know what works and what doesn't. It is sensible if the NHS is going to share treatment and management of patients that there should be good information about therapies available for health care workers and patients. The BMA believes that only those therapies that are adequately regulated should be available on the NHS."
Paula Marie, vice-chair-woman of the British Complementary Medicine Association, said the report was excellent. "It supports everything that BCMA has been pushing for," she said. "We do need to establish governing bodies for the different therapies, and we have already been trying to do that.
"We also need access to research, so we can show the therapies are effective. We need all the help we can get from universities and other research organisations, and it's wonderful the Lords report is pushing for this."
Her only fear was that practitioners who use more than one technique might find
themselves having to register with more than one governing body, at considerable expense.
The Faculty of Homeopathy in London, which regulates the education, training and practice of homeopathy by doctors, said: "We welcome the report and believe it will be beneficial to patients. In particular, we welcome the recommendations about research - these are much needed and long overdue."
The Centre for the Study of Complementary Medicine at Southampton University Medical School agreed with the Lords call for better training and formal regulation, and the development of research to evaluate the effectiveness of treatments.
CHARLES CALLS FOR HEALTH SERVICE RESEARCH INTO ALTERNATIVE MEDICINES
source: Jenny Hope, Daily Mail, Wednesday 29th November 2000
The Prince of Wales is urging the Government to put millions of pounds of public money into researching alternative health remedies, it emerged last night. The revelation came after a House of Lords report cast doubt over a whole range of treatments such as crystal therapy, dowsing and Chinese medicine, saying there was "little credible evidence" for them. Others, such as homeopathy, acupuncture and herbal medicine, needed further research, said the committee of peers.
Charles, who has put integrated healthcare 'at the top of his agenda', is believed to have had a 'routine' meeting with Health Secretary Alan Milburn recently. His spokeswoman said last night he believed public money should be put into the research. She said the Prince set up the Foundation for Integrated Medicine, of which he is president, to raise the profile of alternative therapies.
"The Prince has been arguing for a long time that conventional medicine should look more closely at ways alternative therapies can help treatment," she said. "He is convinced that some treatments which are considered alternative can have benefits but he agrees there needs to be more research and more regulation."
She added: "The Prince can see benefits to the NHS and believes the service should help pay for the research."
Michael Fox, chief executive of the Prince's Foundation said the Government should commit £10 million over five years. He added: "That would be a drop in the ocean when you consider total spending on the NHS is more like £44 billion." He said a research programme could save the NHS money on drugs in the long run.
The report by the Lords Science and Technology committee said there must be tougher regulation of the booming complementary medicine business to protect consumers. It called for statutory controls on acupuncture and herbal medicine and insisted that therapists in other areas must put their house in order.
The 15-month inquiry highlighted the risks to patients from the lack of research or recognised training and the reliance on self-regulation throughout the complementary field.
Nevertheless the report accepted the growing popularity of such medicines and concluded that the 'Big Five' therapies with a proven track record of research - acupuncture, chiropractic, herbal medicine, homeopathy and osteopathy - should be available on the NHS. It said the health service was the "natural home" for reliable, non-promotional information on complementary medicine.
But Lord Walton, who led the inquiry, said he was concerned that healthcare reforms had caused a deterioration in the provision of such therapies by GPs. About five million Britons went to therapists offering treatments such as aromatherapy and homeopathy in the last year, and an estimated £1.6 billion was spent on alternative medicine. But the majority of the 40,000 therapists have no recognised training or system of regulation.