Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Friday, October 07, 2005

NHS should pin hopes on alternative remedies

The Prince of Quacks is still at it......

NHS should pin hopes on alternative remedies


COMPLEMENTARY therapies should be much more widely available on the NHS, according to a controversial report commissioned by the Prince of Wales.

The independent study, ordered by Prince Charles nine months ago, called for therapies such as acupuncture and herbal remedies such as echinacea to be made widely available on the NHS, saying that to do so could bring widespread benefits to the nation's health and the wider economy.

But a leading scientist has slammed the study as "purely political" and politicians called for the prince to take part in a public debate on the issue.

The report, led by economist Christopher Smallwood, investigated the "big five" complementary and alternative therapies: osteopathy and chiropractic, acupuncture, homeopathy and herbal medicine.

Based on case studies from three health centres - in Newcastle, Glastonbury and north London - and a comprehensive literature review, it found many patients derived significant benefits from accessing the complementary and alternative medicine (CAM) therapies, while prescription costs were halved and there was a 30 per cent drop in GP consultations.

The report found that osteopathy, chiropractic and acupuncture can aid those with conditions such as back pain, while herbal medicines helped to ease arthritis, colds, depression and heart and circulatory problems.

However, it said that, while homeopathy was reported as being beneficial for certain conditions including stress and menstrual problems, its overall effectiveness was inconclusive.

Mr Smallwood said: "The weight of evidence we have examined suggests that complementary and alternative medicines could play a much larger role in the delivery of healthcare and help to fill recognised effectiveness gaps in healthcare provision.

"Illnesses such as anxiety, stress and depression and a number of chronic complaints can often be more effectively dealt with by complementary therapies."

The study found some therapies offered the possibility of savings in direct health costs, while others, which were just as expensive as conventional treatments, could still improve patients' health in a cost-effective way.

However, Professor Edzard Ernst, of the University of Exeter, a leading expert in homeopathic medicine, claimed the report was "totally unscientific".

The professor, who was interviewed for the study, but asked for his contribution to be withdrawn, said: "There is just no benefit to this, and no new science here. It seems to be a purely political move, and certainly should not be treated as anything that advances our knowledge."

He said the prince's report could actually be detrimental to patients.

"Nowhere is the safety of these treatments mentioned, and that is a major oversight. It could lead to unproved treatments being integrated into the NHS at the expense of other therapies. Potentially, that could be quite detrimental to the NHS."

Evan Harris, the Liberal Democrat science spokesman, said: "If Prince Charles is going to seek to influence healthcare or science policy - especially without going through the normal peer review process - he must allow himself to be challenged in debate or interview, something that he has never done."

The 200-page report, which includes a foreword from the head of the General Medical Council backing its findings, calls on health ministers to lobby for a government study into complementary therapies.

According to the report, the use of alternative treatments to treat chronic conditions could have considerable benefits for the economy. Back pain alone accounts for 200 million days lost from work per year, costing £11 billion in productivity.

The report highlighted a shortage of treatments in poor areas. However, a Scottish Executive spokeswoman pointed to the Homeopathic Hospital in Glasgow, the only such institution in the UK, as evidence of the NHS support of alternative treatments in Scotland.

She added: "NHS boards have discretionary powers to provide complementary therapies."

But MSPs called for more therapies to be made available on the NHS and more research into their effectiveness.

Shona Robison, the SNP health spokeswoman, said: "We would favour complementary therapies being available on the NHS, but they have to have been tested to show they are effective so we need more research."

Users of complementary health services in Scotland backed the report's call for a greater provision on the NHS.

Helen MacGregor, a dancer in Glasgow who was told she would be unable to work for six months after injuring her shins, returned to dancing just one month after receiving acupuncture at her local health clinic.

"They told me I wouldn't be able to work for six months, but they offered me treatment such as massage and ultrasound.

"I asked them about acupuncture which I'd had privately for another injury when I was working in America. I received an hour's treatment twice a week for about five or six weeks and was then able to go back to work. I would not have been able to afford that treatment privately because I was not earning because of my injuries.

"But I don't think it was a particularly expensive service for the health centre to provide. It didn't require expensive drugs or physio equipment and the effects were incredible."

A Clarence House spokeswoman said the prince's motivation has been seeing people over the past 20 years who believed these therapies had helped. The prince advocates a more holistic approach to looking at the causes of diseases, she said.

Acupuncture: encouraging energy

ACUPUNCTURE, based on ancient Chinese medicine, involves puncturing the skin with needles in order to treat disease by encouraging the flow of energy (Qi) around the body's channels (meridians).

The procedure typically involves the insertion of four to ten needles into the skin, from half a centimetre to several centimetres in depth, which are left in for ten to 30 minutes.

The report found that acupuncture was most effective for musculoskeletal conditions, such as back pain, osteoarthritis of the knee, and post-operative pain and nausea. However, practitioners focus on improving the overall well-being of the patient, rather than the isolated treatment of specific symptoms.

The treatment has a good safety record when carried out by a qualified practitioner. However, according to some critics, acupuncture is not effective in itself and pain is suppressed as a result of psychological suggestion, rather than the actual treatment.

Homeopathy: fighting fire with fire

HOMEOPATHY is a complementary therapy that treats illnesses with preparations, called remedies, made from plant, mineral, metal and insect sources which have been diluted.

The treatment works on the theory that "like cures like" and remedies for a specific condition are based on substances that produce similar effects in a patient as the illness they are suffering from. The report found that homeopathic treatments were associated with improvements in stress and depression, menstrual problems and pain, though the study was inconclusive as to whether homeopathic remedies were superior to placebos.

It is not known scientifically how homeopathy works, and there is not a conclusive body of evidence that it does.

Critics claim that as the substances on which remedies are based are often so diluted that there are no traceable elements of them left, they cannot be scientifically effective.

Herbal remedies: harnessing nature's healers

HERBAL medicine uses plants or plant extracts to treat illness.

According to the report, herbal medicine was found to help arthritis, heart and circulatory problems, the common cold and some prostate problems.

Herbal medicine has been used in Britain for centuries and like many complementary therapies aims to help the body to heal itself.

Risks associated with herbal medicines include side-effects and possible interaction with other drugs. There have even been reports of fatal toxic effects with some herbal products, although this is rare with products that originate in the UK.

New European regulations have restricted the use of certain treatments and uncertainty remains about exactly how the new rules will affect the use of herbal treatments in the future.

Chiropractice: manipulative medicine

CHIROPRACTIC therapy involves the diagnosis, treatment and management of conditions affecting joints, ligaments, tendons and nerves, particularly those of the spine.

The report found it to be helpful for back, shoulder and neck pain.

Treatment - which does not involve the use of drugs or surgery - consists of a wide range of manipulative techniques aimed at improving the function of the joints, relieving pain and muscle spasm.

The most serious potential risks of chiropractic therapy are spinal cord injury or stroke after manipulation of the neck. These are rare, though there have been calls for research to establish how significant the risks are.

The treatment is dangerous for pregnant women and people with osteoarthritis of the neck or spine.

Osteopathy: stretching away the pain

OSTEOPATHY is a way of detecting and treating damaged parts of the body such as muscles, ligaments, nerves and joints.

Practitioners use their hands to identify abnormalities within the bodies structure and function. They then use a variety of stretching, mobilising and manipulative techniques to encourage healing.

Osteopaths also offer exercise and general health advice to help patients reduce their symptoms.

The report found osteopathy to be effective for back, shoulder and neck pain. The treatment carries risk of spinal damage and stroke. However, there is a wide consensus that osteopathy is less risky in terms of spinal injury than chiropractic treatment because osteopaths usually use less forceful manipulation techniques on the spine.

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