Whenever asked about the use of Complementary and Alternative Medicine (CAM) in the Scottish NHS, the Scottish Government quote the ‘Guidance HDL (2005) 37’, issued to NHS Boards in August 2005. This document was issued as a consequence of my meetings with Andy Kerr, the Scottish Health Secretary at that time.
In essence the ‘Guidance’ states that:
- The Executive recognises that CAM may offer relief to some people suffering from a wide variety of conditions
- There is no legislative bar to prevent practitioners from offering their services
- a GP or hospital clinician may refer a patient for alternative treatment
- The GP or hospital clinician would require to be satisfied of the value of the treatment and the competence of the practitioner, and would remain responsible for the patient’s medical care
- If an NHS Board sees a need for the provision of a particular type of CAM in its area it is open to that Board to provide that therapy, at the Board’s discretion
- There was a consensus of opinion that there should be a single regulatory council for both disciplines [acupuncture and herbal medicine], and strong support for the proposition that there should be a single UK council
- The Executive will work with the UK Government and the other devolved administrations to introduce legislation to establish such a council
- Complementary and Alternative Medicine is an area in which there is increasing public interest. Chief Executives are asked to take this into account in the planning of services
This is great on paper but there is absolutely nothing in place to support the statements above and offer patients the chance to use Complementary And Alternative Medicines (CAM) if they chose to.
In February 2012, I submitted the following questions to the Directorate for Health and Healthcare Improvement – long Term Conditions Unit:
The Government has often quoted the Guidance issued to NHS Boards in August 2005 which makes clear that, “if they choose to refer a patient for alternative treatment, the GP or hospital clinician would require to be satisfied of the value of the treatment and the competence of the practitioner, and would remain responsible for the patient’s care” (Shona Robison to Andy Kerr, Nicola Sturgeon to Mary Scanlon both in March 2011 and others).
QUESTION 1: Assuming that all conditions above are met and a GP would like to refer a patient for alternative or complementary therapy today, how is payment made i.e. who pays for the patient’s alternative therapy treatment and what is the payment process? Answer 1: “Clinicians in NHS Scotland can only refer a patient for complementary therapy where their NHS Board agrees to the referral. In such instances the treatment is provided free of charge”. So, basically, only patients who can afford drug-free therapies can use them. Other patients will have to use either physiotherapy (not effective for ALL types of pain), psychology (to help COPE with pain or medication (which can have extreme adverse effects, some times leading to death).
QUESTION 2: What mechanisms are there in place to allow a GP to be satisfied with the competence of any given practitioner? Answer 2: “I can confirm that there are no mechanisms in place to implement the statements of the Guidance.”
QUESTION 3: What is the referral pathway for such referral? Answer 3: “It is up to the Boards to establish the appropriate referral pathways”. So, the answer is ‘No’, there is no referral pathway
Similar questions have also been asked by Mary Scanlon MSP and Jackie Baillie MSP
So, the question remains – why isn’t the Government doing more to put their statements into practice?