The Other Medicine: Programme Five

Transcript: Fit To Practise

First broadcast on BBC Radio 4
Tuesday 19/10/04 2100-2130

PRESENTER:
ANNA FORD

CONTRIBUTORS:
DAVID CANN
RALF PIKE
SUE CROFT
DAVID ADAMS
JULIE STONE
NIGEL CLARKE
KEITH BOUGHTON
SCOTT MIDDLETON
BRIAN ISBELL
VIVIENNE LO
MIKE O’FARRELL
JOHN LANDALE
KATHERINE ARMITAGE
MELANIE OXLEY
BOB LECKRIDGE

PRODUCER:
RAMI TZABAR


MONTAGE
Nobody can treat an animal unless they have a veterinary licence but anybody can treat the animal’s owner without any kind of licence whatsoever.

Statutory regulation is not a panacea, you can’t protect, for example, unqualified practitioners from practising, even if you have a statutory scheme.

Here we’re trying to bring together Western medical treatments, so orthodox medicine, complementary medical practitioners, the Chinese community, the nursing profession and somehow we’re trying to find a way of all working together.

FORD
Complementary and alternative medicine is such a vast and varied field, it doesn’t easily lend itself to regulation. At the moment apart from chiropractors and osteopaths, practitioners don’t have to join any official register or take any course of training before they start to practise. But with so many of us using this form of healthcare today, the government is planning to take action, both to regulate the practitioners and the thousands of products for sale.

ACTUALITY - TRADE FAIR
CANN
My name’s David Cann, I’m the managing director of Target Publishing and the Natural Trade Show and we’re standing on the gallery at the Brighton Metropole looking down on 130 exhibitors. This trade show that we have developed is for wholly independent retailers and practitioners within the natural product, organic and complementary industry.

FORD
That trade is currently worth about £800 million a year. Independent retailers and individual herbalists are very concerned at what the regulation may mean.

ACTUALITY - TRADE FAIR
PIKE
My name’s Ralf Pike, I’m the director of the National Association of Health Stores. It’s the biggest issue that we’ve had in this country for a long time because it comes down to freedom of choice, how you look after yourself, what you want to do with your own health - whether you want to have no alternative to drugs, that choice is being taken away from us essentially by a raft of European directives, the first ones are already in place now called the Food Supplements Directive and that’s going to take around 5,000 products off the marketplace on the 1st August 2005.

CROFT
My name is Sue Croft and I’m a director of Consumers for Health Choice. I’ve come to Brighton today because I’m very concerned that our supporters - the consumers out there of these products - are going to lose out and lose a great many of their most popular supplements. Now these are not just any vitamin and mineral product, they are specialist formulations, they are high dose levels, many of them have been on the market for possibly up to 50 years but Brussels says we can’t have them, therefore they will either be removed from the market completely or will have to be reformulated but also the dose levels will be substantially reduced.

ADAMS
Well I’m David Adams, I’m director of the Health Food Manufacturers’ Association. My association has joined with another in actually taking legal action and trying to have one particular directive anulled.  We would much prefer to actually have common-sense discussions with the government and with the EU and actually arrive at solutions that both preserve consumer choice but also obviously give them a guaranteee of continued safety.

FORD
The body charged in part with implementing the EU regulation in this area is the MHRA, part of the Department of Health.  They couldn't give us an interview but they sent us this statement:

SPOKESMAN
"There is wide agreement across almost the entire herbal sector that the current regulatory arrangement for unlicensed herbal remedies is unsatisfactory.  Whilst there are many responsible producers out there, the Medicines and Healthcare Products Regulatory Agency has also come across repeated examples in UK of unsafe and poor quality unlicensed products, containing illegal ingredients, the wrong herb or poor labelling. We want to protect public health, enhance the status of herbal medicine and maintain wide consumer choice."

So regulating products is proving controversial, but the government hopes it will safeguard the public’s interests: just as in the future we can expect statutory regulation of practitioners and their therapies to be tightened up too. But how might that benefit patients?

BOUGHTON
My name is Keith Boughton and I live in Bournemouth in Dorset. I suffer with asthma, a specific type of asthma called brittle asthma. What makes brittle asthma different to normal asthma is that it’s generally very, very severe and it comes on very, very quickly.

FORD
After a decade struggling to manage his asthma with steroids, Keith decided that he would look for an alternative and chose acupuncture. But finding a reputable therapist was far from easy.

BOUGHTON
I was very concerned initially about the aspect of cleanliness. I’m not averse to needles but I felt that sterility or cleanliness had to be paramount. I looked through yellow pages, I had no other referral points, and the qualifications varied so much and I became quite confused about who had what level of understanding or qualification or training. But I was a little bit concerned with one particular acupuncturist that I spoke to. I was concerned because firstly he said yes it always worked for asthmatics, so that tended to make me a little bit sort of cautious about what else he was going to say. And the other thing was he told me that I needed treatment at least three times a week, well everyone else said that once a week or twice a week was the most that I would ever need. I recall thinking that he was talking in a different light to other people and he could see me immediately and so I just got that feeling that I didn’t quite know who I was speaking to or what training he’d got.

STONE
Historically healthcare professions have always been regulated. That said complementary and alternative therapies until relatively recently have been outside the statutory regulation framework. That changed in 1993 when the osteopaths became the first CAM therapy to be statutory regulated, followed by the chiropractors a year later.

FORD
Julie Stone is a lawyer with many years experience of tackling thorny issues in complementary medicine such as ethics and regulation. She’s also the deputy director of the Council for Healthcare Regulatory Excellence - a new government body set up in the wake of the Shipman inquiry - which in effect, regulates the regulators. CHRE oversees organisations like the General Medical Council and the General Osteopathic Council.

STONE
Regulation has two sides to it. By becoming statutory regulated there’s no doubt that it confers a certain status and legitimacy on a therapy. That said that is very much the secondary aim of professional self-regulation, professionally led regulation, which is of course to protect the public. Now it’s arguable that the higher the professional status the easier it is for public protection to be assured but public protection has to be the driving force behind regulation.

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