Emma Young, New Scientist, 28 November 2000 

Some complementary and alternative medicine (CAM) is effective, according to a 15-month inquiry in the UK, but governments should pay for rigorous research so that the beneficial and useless approaches can be separated. 

As much as £1.8 billion is spent each year on CAM in the UK alone, but the inquiry report notes that pharmaceutical companies have been reluctant to invest in testing, because they cannot patent products that are already available. 

The report's authors, the House of Lords Science and Technology Committee, conclude that the government should kick-start CAM research with "centres of excellence". Large-scale investment by the US National Institutes of Health has improved American CAM research "out of all recognition", says the committee chairman Lord Walton.

While there was good evidence that acupuncture and herbal medicine were effective, the report dismissed crystal therapy and iridology as lacking any credible evidence. More controversially, traditional Chinese medicine was also judged to have no merit. 

Placebo effect

Any therapy seeking official approval must show it is better than a placebo, Walton says. But proving exactly how a CAM product works may not be necessary.

"Evidence of safety and efficacy is paramount. If these exist, it is not always necessary to explain the mechanisms of action," he says.

The beneficial treatments should be regulated by law and available on the National Health Service, says the report. It criticises the NHS for failing to provide effective advice on alternative therapies. In France and Germany in particular, doctors routinely prescribe CAM remedies.

"British Doctors and nurses should at least be made familiar with CAM practices in undergraduate training," says Walton. "There is a clear need for more effective guidance for the public about what does and does not work."

Representatives of the UK's 40,000 CAM practitioners largely welcomed the report's conclusions. But many doubted the practicality of one of the key recommendations - that single regulatory organisations for each therapy should be established.

"The report seems very sensible," says Wendy Miller of the British Holistic Medical Association. "But getting over the difficulty of uniting the big complementary medicine associations will be crucial."

Side effects

At present, only osteopathy and chiropractic are regulated by British law. Anyone can practise alternative medicine in the UK, provided they have the consent of their patient. Anyone seeking an alternative therapy should do so through their GP, says the report.

CAM therapies often have fewer side effects and fewer apparent risks. But Lord Robert Winston of Hammersmith Hospital, London warned that "people might feel better with CAM therapy, when there is an underlying disease that is not being treated." 

A patient consulting only a CAM practitioner might miss out on effective treatments for life-threatening illnesses, the committee concluded. 

More at: House of Lords Science and Technology Reports: 
http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12301.htm