Sylvia Thompson examines the changing role of complementary healthcare as a new report is delivered to Mary Harney
The complementary or alternative medicine sector is coming of age in Ireland. For years, practitioners with varying levels of qualifications and clinical experience treated patients in a cultural context that was suspicious of alternatives to orthodox medicine yet willing to try anything once conventional approaches failed.
In the past five years or so, homeopaths, medical herbalists, acupuncturists and even yoga teachers have realised the importance of forming professional associations with minimum training requirements, codes of ethics and disciplinary procedures. In tandem with this, the public has become better informed about the diversity of complementary and alternative therapies available, their strengths and their weaknesses.
However, the most significant development of all has been the willingness of the Department of Health to deal with the sector and a new report on the regulation of complementary therapists has just been delivered to the Minister for Health, Mary Harney.
Compiled by a national working group with representatives from various therapies, the Consumer Association of Ireland and chaired by broadcast journalist, Teri Garvey, this report - the first of its kind in Ireland - includes recommendations on education and training of complementary/alternative medicine practitioners, the role and function of professional associations and the need for a public information campaign on complementary therapists.
"The public needs to know who's properly qualified," says Garvey, adding that the sector will continue to develop its self-regulatory mechanisms (ie with powers to strike off members who fail to meet standards of practice or abide by code of ethics). Internationally, the thrust of regulation is towards voluntary self-regulation rather than statutory regulation, according to Garvey.
"Statutory regulation won't stop people going to spiritual healers or others who don't have any qualifications whatsoever.
"Members of the public also have to take responsibility for their own health and ask questions such as is the therapist trained, qualified, registered and insured to practise, whether they are attending a conventional or complementary medicine practitioner. It's not just in the complementary health sector that things go wrong," says Garvey.
However, it is when things go wrong that complementary/alternative medicine practitioners are all tarred with the same brush.
The tragic case of the 49-year-old Mayo man, Paul Howie, who died of suffocation caused by a cancerous tumour in his throat, highlighted yet again how vulnerable people can make bad decisions about their treatment.
Howie's widow, Michelle, told the inquest into his death earlier this year that Mulrany-based natural health therapist Mineke Kamper had repeatedly told them that if Paul got other medical treatment, he would die. A trained nurse, Kamper is believed to have been practising homeopathy although she is not a member of the Irish Society of Homeopaths, the professional register of homeopaths in Ireland.
The first third-level degree course in herbal science, which took in its first students in October, was welcomed by the Irish Institute of Medical Herbalists (IIMH). According to Emmet Walsh, medical herbalist and chairman of the IIMH, the course will provide a research-base for the emerging herbal science industry in Ireland. "Such evidence-based medicine is the prerequisite for public confidence in medicine. It is our intention to end the days of self-appointed gurus and charlatans which have given herbal medicine a bad name."
Dr Brian Kennedy, a medically trained doctor who practises homeopathy, suggests a five-point charter on best practice in complementary medicine.
He believes this would help consumers to be better informed. It would, according to Dr Kennedy, also put the onus on therapists to explain how their therapeutic skills complement the diagnostic expertise of conventional doctors and also to give patients clear written information about medicines prescribed (side effects and possible interactions with any other medicines).
Such a charter, he says, could be prominently displayed in clinics and a copy given to patients on their first visit.
"This charter could be administered by an independent consumer association on behalf of a series of professional associations which were committed to this as a gold standard of consumer protection," says Dr Kennedy, who is a member of the national working group on the regulation of complementary therapists.
Many practitioners of complementary/alternative medicine suggest an integrative system where medical herbalists, homeopaths and osteopaths practise alongside conventional doctors is the best way forward.
Dr David Reilly, consultant physician at the Centre for Integrative Care at Glasgow Homeopathic Hospital (GHH), espoused this view in a talk at the RDS in Dublin in April.
"All our team - doctors, nurses, physiotherapists and occupational therapists - are medically trained but they have expanded their skills through a range of complementary medical approaches," says Dr Reilly.
At the GHH, patients can be treated using orthodox medicine, homeopathy, acupuncture, herbalism and physical therapies such as massage, the Alexander Technique and pilates.
Good nutrition and self-help approaches such as meditation are also available.
According to Dr Reilly, there is no conflict between the therapies and the team members because "they don't hold to the traditional mind/body divisions of orthodox medicine".
While in Dublin, Dr Reilly gave a workshop to health professionals on the "therapeutic encounter".
"I believe many [ orthodox] healthcare practitioners study complementary therapies as a response to the dehumanisation of medicine and because these therapies legitimise the value of the human encounter," he says.
In Ireland, the integration of complementary/alternative medicine and orthodox medicine is developing slowly with a small number of medical herbalists and acupuncturists working part-time in GP practices. The new Village Nursing Care Centre in Craughwell, Co Galway is closer to the integrative model.
The brainchild of Dr Hussain Bhatti, a medical doctor turned naturopath, the private residential and day care centre for convalescence and short and long-term stay patients offers a range of therapies (acupuncture, massage, reflexology and reiki) alongside conventional medicine.
All in all, the sector is maturing as its clients continue to be enthusiastic about the benefits of many complementary therapies but more aware of their limitations. Dr Brian Kennedy sums it up with the following comment: "Complementary therapists are keen to play their role as part of an integrated team of health professionals so that patients can get the best of what conventional and complementary medicine has to offer."
Sylvia Thompson is an Irish Times journalist and the author of Test Driving Complementary Therapies (Newleaf, 2002) sthompson@irish-times.ie