The Other Medicine: Programme Five

LO
It’s been presented to us that Chinese medical practice is dangerous and needs to be controlled. Actually I would take issue with that. Of course there are instances where it’s dangerous, where people improperly prescribe substances that are very fierce but I think there is very little evidence that it’s intrinsically dangerous if people are properly trained.

FORD
Dr Vivienne Lo practises acupuncture and is also a research fellow at the Wellcome Trust Department of the History of Medicine at University College, London. She echoes the concerns of the Chinese practitioner community who say that Chinese medicine is often misunderstood in the West and might be marginalised by new laws.

LO
The beauty of most traditional medical practice is that it’s an art and if an environment can be created whereby practitioners are nurtured in their art then that’s a good thing. In the end there will be a board that registers the new practitioners and that could fall down on the side of a group of European practitioners who don’t want to register the Chinese, who don’t respect Chinese knowledge and who want to - who have their agendas about their own tradition and how they believe their own tradition is.

O’FARRELL
One of the things that I’ve been doing is to chair meetings between the Department of Health and the Chinese bodies to try and build some bridges and bring us all closer together because in the end the public have got to be able to feel that wherever the individual comes from, wherever they were trained, they are to a particular standard and that standard is reflected in the fact that they’ve been allowed to appear on the register.

FORD
Regulation is by no means universally popular amongst the practitioner community though opposition is dwindling. Apart from a dislike of bureaucracy, and issues of cost, there is a deeper concern that regulation will attempt to control the therapies rather than just the therapists.

In Hebden Bridge in Yorkshire, I met John Landale who's been in practice for 35 years. He was a member of the British Acupuncture Council but left after refusing to alter the way he works to fit in with their new rules. He describes himself as a neuro-acupuncturist.

LANDALE
I wanted to really find out what was really making acupuncture tick, why did it work in some people and perhaps didn’t work in others? And so I started looking for different points and I’ve come up with a whole class of new acupuncture points that do a better job.

FORD
That’s very interesting because the Chinese were doing this for 2,000 years and you’ve said not all of what they did was right, so you found a new way of doing acupuncture which you call neuro-acupuncture.

LANDALE
That’s correct but I’m not trying to say they were wrong. Acupuncture works whatever the name you give it, it’s just that some points are more powerful than others. So I’ve merely found other points to give me a stronger effect and I use them in my own manner, I don’t think in terms of fire, earth, metal, water and wood as a traditional acupuncturist would, I don’t look for chi energies because I don’t believe there are any. But it is your body’s own nervous energy that produces the changes.

FORD
Now this change in your thought process and in your practice led to a bit of a fall out with the British Acupuncture Council didn’t it?

LANDALE
Only in my method of description. The British Acupuncture Council wanted me to write my notes in a traditional manner and I didn’t want to do that - and in fact they gave me two weeks to do it in and I refused, and so I gave my resignation in because of that.

FORD
And has that had any implications for you, I mean has it meant that you can’t practise in this sphere?

LANDALE
Oh not at all, no. The British Acupuncture Council has no - has no authority as to whether anyone can practise - this is one of the thorns in the side of the acupuncturists at the moment because a lot of acupuncturists are masquerading as acupuncturists when really they’re not. There’s a lot of shops that’s grown up - I won’t name them - but the shops in almost every shopping centre but the people inside them are not qualified and so this is why the government through the British Acupuncture Council are now looking to register all acupuncturists and I strongly agree with that, I don’t agree with people doing acupuncture that are not capable.

ARMITAGE
I’m Katherine Armitage. I work as a homeopath from Health Foods, Fulham Road. I use flower essences and homeopathy as my main therapies, I also work as a healer. I’m not a member of the Society of Homeopaths, I’m actually not a member of any of the registering bodies for homeopaths, I’m a member of my college of homeopathy - which is the Lakeland College. Statutory regulation is a good thing and there are lots of people who are doing fantastic work to move towards that. My own personal feeling is that if I’m statutorily registered and I have to limit my practice of homeopathy to a certain way I would rather change the name of what I do - for example call myself a resonance therapist - and continue to be able to practise in the way that I practise now.

STONE
It’s important to remember that statutory regulation unless it protects function, as well as title, cannot stop people from practising in that particular area. It would stop me, for example, holding myself out or calling myself an osteopath, indeed it would be a criminal offence. That said there coexists a common law - freedom to practise - whereby anyone can practise provided they don’t use that title. Ultimately whether or not to seek a registered practitioner has to be a matter of public choice. Now personally I don’t buy into the idea that all patients are vulnerable but people have to exercise a level of choice and responsibility about the therapies which they access.

FORD
Though help is at hand because increasingly therapy bodies are unifying to create single registers with clear operating guidelines for practitioners, on a voluntary basis. A recent example of this is the Society of Homeopaths - the largest single body for non-medical practitioners. Melanie Oxley is a director of the society and a registered homeopath.

OXLEY
The first thing they must do is find out how the homeopath was trained and if they’re regulated by an existing registering body, such as our own. We have robust complaints procedure, we have our own professional conduct department. So we protect the rights of the patients and we support our members. So if they look for the letters after the name that say the homeopath belongs to - the Society of Homeopaths for instance - they know that all that has gone before.

FORD
Would you welcome a more statutory regulatory process?

OXLEY
This is a discussion that’s really only just beginning within the homeopathic profession. At this point we have to really heed what the Department of Health is advising us which is to get our own house in order first, in other words to pursue a route of voluntary self-regulation, to get a robust system up and running and then that will be the time to see what greater benefit can be afforded by statutory regulation.

FORD
The government is suggesting that there isn’t going to be a homeopathic council but they would like to see a general CAM council, do you think that’s a move in the right direction?

OXLEY
We have reservations about that and we wrote to the Department of Health to say that we did not think a joint CAM council was a very good idea. Logistically it would seem to be something that was destined to be enormous if it were to reflect all of those interests and let’s face it within acupuncture there are four or five different disciplines. If all of those practitioners could be represented on a council it would be huge and I think it would be unwieldy and probably very expensive.

FORD
Not surprisingly not all homeopaths agree on how best to regulate CAM. Dr Bob Leckridge is president of the Faculty of Homeopathy which represents medical homeopaths. Leckridge thinks that the opposition to the single council is misguided.

LECKRIDGE
That thinking is coming from believing that a council has to represent a whole bunch of individual unique and different therapists. That’s not what we do. For example, the GMC regulates me in an identical way to a colleague who is a surgeon or a psychiatrist and yet on a day-to-day basis the three of us - psychiatrist, surgeon and homeopath - are using an extremely different skill set and working in very different clinical contexts. That works because it works on a basis of the core shared professional skills. Why can that not be applied in the world of complementary therapy?

FORD
This animated debate over single or multiple councils will come to a head when the Department of Health reveal their plans for CAM regulation, which they say they’ll do by the end of 2004.

But the regulation issue is just part of a more profound debate, one that has yet to be fully tackled either by CAM or by those in orthodox medicine. And that’s the question of whether complementary medicine with all its diversity of styles and views, will finally be able to make the transition from the fringes, to become an integrated part of the National Health Service.

And integration is the subject of our final programme in this series, next week.

LECKRIDGE
Do they want to be accepted truly as healthcare professionals or not? And it’s not a matter of trying to defend their therapy or trying to defend their cause, but it is a matter of trying to say to the public that they are prepared to work on a day-to-day basis with the same standards as a doctor or a nurse or a pharmacist. And what that’s likely to lead to in terms of a pay-back is that the therapy itself becomes more legitimate, more understood and more accepted. And if we really want to be patient-centred and we want to pitch up each day and do a job on behalf of patients rather than on behalf of ourselves then I think it’s no good to stand and fight our own corners anymore.

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