Complementary and alternative therapies

There has long been debate about the degree to which conventional health professionals should work closely with complementary and alternative medicine (CAM) practitioners, if patients choose treatment from both. Some doctors are trained in conventional and alternative therapies but often, liaison depends on the type of therapy, whether it is regulated by law and whether it supplements conventional methods of diagnosis and treatment or claims to provide an alternative to them. Among the therapies often used by patients to supplement conventional medicine, but which do not claim to have a diagnostic purpose, are aromatherapy, massage, stress therapy, reflexology and hypnotherapy. Chinese medicine and homoeopathy are among those which are not statutorily regulated but claim to provide diagnosis and treatment. Practitioners of conventional medicine are often wary of unregulated treatments that supplant evidence-based therapy—even though not all conventional medicine has been proven by randomised controlled trials.

The role of complementary and alternative therapies came under scrutiny in England in February 2010 when the Parliamentary Science and Technology Committee published a critical report on NHS funding for homoeopathy.1 Focusing on whether government policy on homoeopathy was evidence-based, the Committee found a mismatch between the evidence and policy. Its main conclusion was that the evidence indicates that homoeopathy is not efficacious and does not produce results beyond the placebo effect. The Committee said that explanations for why homoeopathy was thought to work were implausible and that further homoeopathic clinical trials could not be justified. The amount that the NHS actually spends on homoeopathic therapies was left unclear and was subject to varying claims from the Society of Homoeopaths (estimating £4 million annually) and the Health Minister (estimating £152 000 annually).2 The Parliamentary report recommended that there should be a clear policy on prescribing placebos, including homoeopathic medicines, but the government has been …