Economist article: Trust me, I've got a licence

The Economist has an alternative medicine bashing article which describes osteopathy as a "therapy reckoned particularly likely to injure patients". Professor Ernst makes an appearance too!


Apr 17th 2008, The Economist

Regulating the quacks

IN THE 20th century medicine became a science; in the 21st it has become an industry. High demand and punishing performance targets mean that the modern GP spends fewer than 12 minutes with a patient. So it is no surprise that alternative medicine, which offers valuable support and sympathy along with treatments of less obvious efficacy, is big business. Britons spend £4.5 billion a year on it, up 50% on a decade ago. One in five adults are estimated to be regular users. But the market is fragmented and unregulated. Dozens of therapies—from reiki to reflexology—are sold by thousands of practitioners represented by a dizzying array of trade associations (homeopaths, for instance, have a choice of four groups to join).

Such chaos worries the government. Inspired by a report from the House of Lords Science and Technology Committee published in 2000, ministers are busily imposing order. Therapies reckoned particularly likely to injure patients are either already regulated by law (chiropractic and osteopathy) or soon will be (acupuncture, herbalism and Chinese medicine). For everything else, there will be a new Complementary and Natural Healthcare Council (CNHC), an independent regulator that is due to start work in the summer.

Instantly dubbed “Ofquack” by its critics, the CNHC has scrupulously avoided discussing whether the treatments it regulates actually work. Instead, says Maggie Dunn, one of the CNHC's two co-chairs, it will concern itself purely with public safety. “If there are quacks out there, all the more reason to regulate them,” she says. Those who want to join will have to show that they have insurance and proper training. A code of conduct will encourage them to be honest with patients and up to date with developments in their field. Only those therapies popular enough to have professional associations will be considered. Homeopaths and aromatherapists will be eligible; Hopi ear-candlers and Shamballa Multi-Dimensional Healing masters will not be, for now.

Not everyone is convinced that the CNHC is a good idea. Membership will be voluntary. Bristling at this invasion of their turf, several homeopathy organisations, for example, have said they will not co-operate, although Ms Dunn hopes that the allure of a trustworthy brand will bring the recalcitrant around. Others complain that much of the preparatory work for the new regulatory body was done by the Prince's Foundation for Integrated Health (with £900,000 of public money), a group that lobbies for alternative medicine. David Colquhoun, a professor of pharmacology at University College London, says that ignoring evidence (large-scale studies have shown homeopathy, for example, to be no more effective than a placebo) is ridiculous. “What can the idea of proper training in homeopathy actually mean?” he asks.

But the biggest worry is that what is supposed to be a simple certificate of safety will be interpreted as an official endorsement of efficacy. “When chiropractic was regulated, the amount of research activity trying to demonstrate that it worked actually decreased,” notes Edzard Ernst, a professor of complementary medicine at the Peninsular Medical School. “Nowadays, many call themselves doctors.” This may encourage people to seek ineffective treatments for serious illnesses. He points to a recent row in which a BBC reporter accused Neal's Yard, a high-street shop, of claiming that its homeopathic remedies could prevent malaria (Neal's Yard says the story was misleadingly edited).

Happily for sceptics, there is a countervailing trend. The NHS has paid for alternative treatments for years. No detailed figures are available, but there are a handful of publicly funded homeopathic hospitals and many doctors refer patients to alternative practitioners. But driven by hard-nosed considerations of cost-effectiveness, the NHS seems to be cooling on the idea. A survey published in January by Pulse, a magazine for doctors, found that over a quarter of health trusts had cut homeopathy funding over the past two years

Source: http://www.economist.com/world/britain/displaystory.cfm?story_id=11...