Zeno's Blog

David Colquhoun’s frustration — and indeed anger — is palpable. And understandably so.

He brilliantly covered Monday’s announcement by the Department of Health (DoH) of their consultation into the regulation of “acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems”.

This consultation is the DoH’s response to the infamous Pittilo Report, which saw the light of day just over a year ago.

I won’t go into the report or the consultation at the moment, but urge you to read what David says about it. Suffice to say I agree with David when he urges:

It is very important that as many people as possible respond to it. It’s easy to say that the consultation is sham. It will be if it is left only to acupuncturists and Chinese medicine people to respond to it. Please write to them before the closing date, November 2nd 2009.

In his conclusion, David says:

But if the government were to accept the recommendations of the Pitilo report it would be seen, quite rightly, as being anti-scientific and of posing a danger to the public.

…and he quotes from the blog on the FT by GP Margaret McCartney:

This report would, if implemented, create lots more nonsense exam papers funded by a lot more public money – and would produce practitioners without the absolutely crucial skill of how to assess evidence and reject or use it appropriately.

I never thought I’d quote The Sun, but their piece today says:

HERBAL medicine and acupuncture face new Government controls, health minister Ann Keen announced earlier this week.

“Patient safety is paramount,” she says adding that the Government wants to introduce safeguards to ensure anyone offering the alternative remedies meets “professional standards of care and safety”.

It sounds sensible but it’s actually a charter for licensed quackery.

Unlike doctors, herbalists and acupuncturists won’t have to provide proof their treatments work.

Anything that gives an official seal of approval to alternative medicine is bound to increase its credibility and popularity. And that is why regulation is far from sensible.

As Britain’s leading expert on alternative medicine, Professor Edzard Ernst points out: “If you regulate nonsense, it is still nonsense.”

Says it all, really, in nice simple language everyone can understand.

However, I want to mention the announcement of this consultation on the website of the Prince’s Foundation for Integrated Health. Their release on this was titled: Regulating complementary therapies: a critical consultation. Of course, Prince Charles’ lot think this is the best thing since sliced organic bread (available from all upper class supermarkets — other, more affordable, alternatives are also available).

It quoted their medical director, Dr Michael Dixon:

There is good evidence for herbal medicine, acupuncture and Chinese medicine in the treatment of some conditions but, as in all healthcare, these therapies require properly trained practitioners.

Strange wording: “There is good evidence for… …in the treatment of…” The Advertising Standards Authority is not so keen on such woolly weasel wording and no doubt would take that to be a claim of efficacy. They would require decent scientific evidence for any such claims.

However, Dixon appears to think there is more than a jot of evidence for these woo treatments. Of course, some herbal potions are pharmacologically active — sometimes a tad more than you might have expected, but let’s not forget the the NICE fiasco on — amongst other AltMed therapies — acupuncture. (More information on acupuncture can be found on the excellent evidence-based medicine website, EBM-First.)

Dixon states that: “these therapies require properly trained practitioners.” But how do you train someone in nonsense? No, the answer isn’t to teach gobbledegook in our Universities, doling out Bachelor of Science degrees in woo.

He goes on to say:

Statutory regulation will demand high standards of practice. It will enable the public to identify qualified practitioners, and to feel confident of good quality, safe treatment.

Well, that’s debatable. The consultation report certainly talks about the problems with adulterated herbal potions and the difficulties that gives regulation but note that it doesn’t say anything about evidence of efficacy for any of these woo therapies. Heaven forbid that they should have to provide scientific evidence — plethora or otherwise. Although I’ve not yet read through all of the DoH’s consultation (there’s a lot of it!), willingness to enter into a discussion on the efficacy of these treatments would appear not to be on the agenda.

However, that will not stop many of us from giving the thorny topic of efficacy at least passing mention when we submit our considered responses…

What statutory regulation of yet more quackery will do is enhance its perceived standing in the eyes of the public: “if it’s regulated by the Government, it must be OK”. What we don’t need are more quacks calling themselves “a primary health-care profession“. That does not protect the public.

AltMeds — including the FIH — talk incessantly about increasing consumer ‘choice’; but the public’s choices are reduced when quackery is covered in a veneer of statutory respectability.

The FIH subtitled their release: “a critical consultation”. A critical response to the consultation is certainly something they can rely on.