DOH Email On CAM

July 31, 2008 at 3:27 pm (Alternative Medicine, Bad Science, government, Woo) (, , , )

Via Improbable Science, I was made aware of a piece in the Times where Alice Miles recommended writing to Ben Bradshaw regarding an NHS consultation:

The Government responded on Monday – with a three-month consultation. So join in. Write to the Health Minister Ben Bradshaw at Richmond House, 79 Whitehall, SW1A 2NS. Write, on behalf of the NHS: “What I want for my 60th birthday is… the chance to provide medical, dental, and nursing care to all. And absolutely nothing else.”

So I did. I’m quite suggestible you see, and it doesn’t take much prompting for me to fire off a missive asking the government to spend our tax dollars wisely – or drop the ridiculous ID card idea. The government response to my email is below:

Thank you for your email of 30 June to the Department of Health about complementary and alternative medicines. I have been asked to reply and I am sorry for the delay in doing so.

The Department recognises that many people find complementary and alternative medicine helpful in alleviating the symptoms of certain illnesses, especially those illnesses for which orthodox medicine does not appear to offer a complete answer. We also appreciate the fact that the public is increasingly making use of complementary and alternative treatments and products, including homeopathy.

Decision-making on individual clinical interventions, whether orthodox or complementary treatments, is a matter for local NHS service providers and practitioners as they are best placed to know their community’s needs. In making such decisions, they have to take into account evidence for the safety, clinical and cost-effectiveness of any treatments, the availability of suitably qualified practitioners, and the needs of the individual patient. Clinical responsibility rests with the NHS professional who makes the decision to refer and who must therefore be able to justify any treatment they recommend.

Practice Based Commissioning enables the delegation of indicative budgets to practices for commissioning of services that best meet the needs of patients, including complementary and alternative health therapies. Primary Care Trusts (PCTs) are responsible for ensuring that all services commissioned are of the required quality. PCTs often have specific policies on the extent to which patients can be given access to complementary and alternative therapies and, within these policies, it is open to GPs to give access to specific therapies, including homeopathy, where they consider it in the interests of the individual patient.

I hope this reply clarifies the Department’s position on this matter.
Yours sincerely,

It looks to be roughly the same format as the email response I got when I contacted the DoH to complain about homeopathy on the NHS a while back (blogged here: D’oh!).

Incidentally, the 92nd Sceptics’ Circle is here at Lay Science: Sceptics’ Circle.

ETA: iscador

1 Comment

  1. draust said,

    The most interesting phrase here is:

    “Clinical responsibility rests with the NHS professional who makes the decision to refer and who must therefore be able to justify any treatment they recommend.

    Among other things, what this means is that the REFERRING doctor is responsible for what any CAM practitioner they might refer to is doing. Thus, if the CAM person they refer to is practising deception, or unsafe nonsense, then the REFERRING CONVENTIONAL DOCTOR is legally and professionally responsible and could be called to account at a fitness to practise / misconduct hearing.

    This is one of the hidden points to all the efforts made by people like Edzard Ernst to assess systematically the evidence for and against CAM interventions and “therapies” .

    To take an example, suppose that there is absolutely no credible evidence that applied kinesiology can “diagnose” allergies and intolerances (which there isn’t), some evidence that it is utterly useless (which there is), and no even vaguely plausible rationale for it (which there isn’t).

    Hence, any GP “referring” someone to an applied kinesiologist is arguably guilty of substandard practise and breach of professional ethics, as he is subjecting the patient to deception. The time is coming when the standard out of “Oh well, but in my experience I have found this useful for some of my patients” will not wash if this view is contradicted by all the evidence ( not to mention by reality). This is why folk like Dr John Briffa are getting a bit nervous.

    It will probably get fudged, of course. It is widely suspected that part of the reason why consumer companies are interested in moving into GP care and setting up Polyclinics is that they could set up clinics with a few GPs and a load of CAM therapists, with the GPs “refererring” in-house to the CAM therapist (much better profit margins on CAM). Cynically one might suspect the interests of business will trump those of value for money for the patient and taxpayer, not to mention medical ethics. But there is at least a chance that a lot of CAM nonsense could be ruled out by it simply being judged unprofessional and unethical for doctors to refer people for utterly useless fake “therapy”.

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