Health: The NHS is getting complementary

Many GPs are prescribing osteopathy and other `alternative' remedies.

THE RECENT news that Britain now boasts more alternative therapists than conventional GPs was greeted, as you may expect, with more than a little cynicism from conventional doctors. "My main concern is the dogma surrounding this type of medicine," said Eric Rose, a GP and member of the BMA's GPs' Committee. "You see some ridiculous claims - that if you eat six tins of stewed rhubarb you will get better."

A survey carried out by Exeter University's Centre for Complementary Health Studies found that the general public has a different view. There at least 40,000 complementary therapists in the UK, compared to 36,200 family doctors, and an estimated 3 million-plus patients a year visit them. In this light, are we, like Cherie Booth, turning into a nation who would rather trust a "healing" pendant than a qualified NHS doctor?

Although it may be a long time before crystal healing is available on the NHS, massage, osteopathy, homeopathy and acupuncture already are - depending on where you live. For conditions such as asthma, skin complaints, back pain and digestive disorders, complementary medicine ("alternative" is now considered too antagonistic a word) may be able to offer hope when all else has failed. Even the Health Secretary, Frank Dobson, at a complementary health conference in May, said: "I believe that what works is what counts and what counts is what works. With so many threats to our health, we can't afford to ignore anything that works and is safe."

Yet conventional doctors' concern is understandable. Lack of research into the effectiveness of treatment, poor information about the standard of training within each specialty and a lack of proper regulation are all valid criticisms.

Slowly, though, scepticism is fading as many doctors acknowledge the possibilities of complementary techniques working alongside orthodox medicine. A recent survey by Sheffield University found that as many as 40 per cent of GP practices in England now provide access to complementary treatment for NHS patients. "In the last 10 years or so we have seen a change in attitude," says Dr Sosie Kassab, a GP working with the Royal London Homoeopathic Hospital. "More and more GPs are interested. I find it increasingly useful if I come across something I can't prescribe for, such as someone with arthritis who has contra-indications to using anti-inflammatory drugs."

The Foundation for Integrated Medicine, supported by the Prince of Wales, is funding more research into the effectiveness of various therapies in an attempt to encourage their use alongside conventional medicine. "The NHS is relatively cautious," said a spokeswoman. "After all, it is spending taxpayers' money."

So your chances of being able to get osteopathy, acupuncture or aromatherapy through the NHS depend entirely on whether your GP's practice has taken a particular interest in that area. Some health authorities will pay for you to be referred elsewhere for treatment, but many have refused, arguing that there is no proof that complementary medicine is effective.

Marylebone Health Centre in London, for example, pioneered on-site massage, osteopathy, homeopathy and acupuncture clinics, an idea that has been developed in other surgeries as well. Elsewhere, there are pockets of interest. Leicester has an international aromatherapy school. All over the country, nurses, midwives and physiotherapists who have trained in massage or acupuncture are incorporating these therapies into their work. Often cancer patients are offered complementary treatments, such as reflexology and aromatherapy, in addition to radio- or chemotherapy.

"We are not going to cure them of their cancer, " explains Lucy Bell, who leads the complementary therapy team at Hammersmith Hospital NHS Trust. "The reason we do it is for relaxation and support. We help them deal with the stress of having a life-threatening illness."

Four years ago, Lewisham Hospital in south London led the way in integrating complementary therapies within the NHS. It opened an outpatient clinic that offered acupuncture, homeopathy and osteopathy free to patients who had been referred by local GPs. It was extremely popular, seeing 1,500 patients in three years.

"We presented the health authority with some good outcome evidence," says Janet Richardson, manager of the research and evaluation unit, "but they argued that wasn't sufficient. "The health authority had a pounds 19m deficit and were making cutbacks all over the place."

It is hard to defend homoeopathy when your patients need hip replacements. The centre was forced to close on 27 March 1997.

"There are still quite a few GPs who have complementary therapists working with them," says Ms Richardson. "Had the decision been made this year about the clinic's future, I think the money might have been there."

British Acupuncture Council: 0181-964 0222. Society of Teachers of the Alexander Technique: 0171-351 0828. Guild of Complementary Practitioners (for Aromatherapists): 0118 9735757. British Chiropractic Association: 0118 950 5950. Natural Federation of Spiritual Healers: 01932 783164. National Institute of Medical Herbalists: 01392 426022. Society of Homoeopaths: 01604 621400. London and Counties Society of Physiologists (for Massage): 01253 408443. General Osteopathic Council: 0171-799 2442. Association of Reflexologists: 01903 212345. Shiatsu Society: 01733 758341