DOROTHY-GRACE Elder (“Unhealthy trends that brush aside the views of patients”, The Herald, January 27) has done us a great service by pointing out how opaque commissioning is in health boards and how some issues (Glasgow’s Centre for Integrated Care is just one example) are too country-wide and important to be left up to individual health boards and their stretched budgets. The Scottish Government needs to take a grip.
Regarding the Centre for Integrated Care (CIC), it is the case that the kind of medicine usually called “conventional”, which is taught in medical schools and which most of us have come to rely on, does not have all the answers to all clinical questions doctors and the health system can be asked by sufferers. Even the British Medical Association (BMA) on its website (clinical evidence.bmj.com) estimates that only about 13 per cent of all treatments commonly used in medicine are fully supported by conventionally acceptable evidence. It is not surprising that patients and doctors who want to lessen suffering are drawn towards non-conventional options. It reduces risks to patients if these are appropriately provided by trained medical staff within the NHS. From this perspective, the CIC looks like a real blessing whose services should be available to all the people of Scotland and should not be confined to the lucky few who happen to live in the right areas.
It seems that there is much confusion between what the CIC does and homeopathy. Integrative medicine is a specialty in its own right and includes many practisces. It can include homeopathy. The current fashionable blacklisting of homeopathy seems to me to be based on a lack of serious reading of the (very considerable) evidence, or a simple lack of knowledge of what is available, concluding “it can't work, so it doesn't”, sort of prejudice-based medicine rather than evidence-based-medicine.
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Dr Tom Whitmarsh,
31 Hyndland Road, Glasgow.
I GREATLY appreciated Dorothy-Grace Elder’s excellent article on the threat to Glasgow’s Centre for Integrative Care (CIC).
The CIC offers a diverse range of treatments for patients who have not responded to standard treatment or who do not wish to continue with allopathic treatment because the side-effects are having a negative effect on their quality of life. If the CIC closes existing and future patients will lose their hope of managing their lives successfully. About 20 per cent of patients at GP surgeries are there because of long-term pain; chronic and complex conditions increase with advances in medicine and life expectancy.
I have worked as a registered nurse and midwife in the NHS before developing my own practice as an acupuncturist with an integrative approach to healthcare. I became interested in the management of chronic pain and completed a two-year research programme with the Scottish Intercollegiate Guideline Network. Acupuncture was endorsed in this guideline as an effective treatment for lower back pain and osteoarthritis.
After completing this research I was encouraged by another GP to approach Grampian Service Improvement Group (SIG) for chronic pain to be considered as a member to represent the views of complementary medicine. But my letters were either ignored or responses were delayed by nine months.
In my view, the SIG group became too big to be effective, and there was also a lacked diversity in professional capabilities. This results in blind spots being reinforced as everyone’s experiences are similar. There seems to be a reluctance to reach out and respond to research, financed by the NHS, and set up a bold, new imaginative way to tackle the waiting lists for chronic pain sufferers. The NHS chronic pain clinics provide specialist advice and most importantly relieve pressure on GP surgeries. The reality is that patients face the indignity of an unacceptable waiting lists because clinics are understaffed. In the last two years, boards have had an extra £200 million between them each year to spend but there is no sign of any new investment in chronic pain, despite the huge patient numbers.
Thank goodness Ms Elder's critical thinking continues to ask awkward questions. It is now time to openly look at the figures and focus on providing treatment, as the priority.
The CIC needs to be upheld as a centre of excellence to inspire a more ambitious healthcare programme throughout Scotland. We must not under-estimate the seriousness of the points raised in Dorothy Grace Elder’s article if we want to strive for a healthy and successful Nation.
Member of the British Acupuncture Council.,
64 Craigton Road, Aberdeen.
IN times of straitened budgets the days of homeopathy on the NHS must be numbered (Letters, 28 January).
One criterion for banning or withdrawing a drug is the existence of a cheaper alternative. With homeopathic treatments we know such an option exists: doing nothing.
Tavistock Drive, Newlands, Glasgow.