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A question of health or wealth?

This article is more than 22 years old
If your New Year's resolution is to improve your wellbeing, be sure to check any practitioner's credentials, says Mary O'Hara

You have resolved to give up smoking, stop eating chocolate and join a gym. But in the annual January dash to find the holy grail of health, you could be handing over more than you bargained for - especially if the chosen route is complementary and alternative medicine (CAM).

The variety of treatments and remedies in this field stretch as far as the imagination. And although many practitioners are competent, many people do not check their credentials and will hand over cash to someone with meaningless letters after their name who is unqualified to practice, but who is still legally entitled to do so.

The cost of following a course of treatment, or even buying over-the-counter products, can be sky high and getting this type of therapy on the NHS is rare.

A Which? magazine survey on complementary therapies in December found that 90% of CAM users were paying for treatments out of their own pocket. Only 5% were treated on the NHS, and the remaining 5% paid for all or part of their treatments with private health insurance.

Whether the patient has chosen homeopathy, acupuncture, osteopathy, or an obscure course of herbal remedies from the Australian outback, they will have few guarantees of a cure. The only guarantee they will have is that it will dig a sizeable hole in their wallet.

The British Homeopathic Association (BHA) which registers and regulates GPs who have qualified in homeo-pathy - one of the most popular forms of complementary medicine - acknowledges the cost of private consultation can be prohibitively high.

A one-hour visit to a homeopath starts at around £35 but can be as high as £150, it says. Depending on where you live the costs vary widely, with people in London generally paying more than those outside the capital.

"Not everyone can afford to go private," a spokesman said. "Some practices offer special rates for those on lower incomes but most do not.

"There are five homeopathic NHS hospitals and a number of clinics around the country but the treatment is not available in all postcodes and a GP referral is usually necessary."

Pinning down usage figures for the cocktail of CAM therapies is almost impossible, but research by Mintel and Exeter University's department of complementary medicine have concluded that around 20% of the UK population use some form of complementary therapy each year.

In some parts of Europe the figure is as high as 70%. CAM is anything from a £350m to a £1.6bn industry, depending on which estimates you believe.

In addition to the explosion of therapy centres and independent health shops stocking a plethora of bottled remedies since the early 90s, the big mainstream pharmacies have also been competing for a slice of the action.

Boots was one of the first to recognise the business potential, prompting it to enter the market in 1991. Its consultants estimate that 47% of CAM users become "lifetime users."

"Boots recognise alternative health can be confusing sometimes and has invested millions in a new brand called Boots Alternatives in a bid to simplify them," a spokesman says.

The company recently set up health and beauty services in some larger stores offering treatments such as homeopathy, aromatherapy and herbalism. A single, one-hour consultation can cost as much as £55.

Other big players in the pharmaceutical retail market include Alliance, which owns the Moss Chemist chain, while supermarket giants Tesco and Sainsbury have invested significantly in devel oping and marketing alternative medicine ranges.

Established health food shops such as Holland and Barrett and Neal's Yard Remedies, have been capitalising on growing demand for years. But as outlets proliferate, product ranges are rendered even more confusing and, significantly, competition has not brought down the prices of either consultations or bottled remedies.

The UK's only professor of complementary medicine, Edzard Ernst of Exeter University, says: "Consultations can be long and treatments can often require many visits over a long period of time. This means many cannot afford it. And then there are the medicines to buy as well."

He warns people to be wary of using over-the-counter products as a substitute for consultations with qualified homeopathic practitioners - preferably both medically and homeopathically qualified.

Professor Ernst also cautions: "The system invites problems. It is largely unregulated. Anyone could register as a practitioner and charge for treatment. Because of this, there is no impetus for change or tighter regulation, but more concerning is that people could be paying lots of money to people who are not competent to practice."

Boots says it only uses homeopaths who are also registered GPs and its herbalists are registered with the National Institute of Medical Herbalists.

Private practices are under no obligation to use medically qualified consultants.

The BHA says consumers should check the qualifications of any practitioner carefully, and if possible, use a therapist recommended by someone they know and trust.

"The faculty of homeopathy is a statutory regulatory body which regulates GPs trained as homeopaths. We do not endorse practitioners who do not have medical qualifications," a spokesman says.

"Whilst many homeopaths may be good, we advise people to check the credentials before handing over any money, especially when the subsequent treatment could actually harm them if they are treated by a non-competent person who could mis-diagnose and mis-prescribe."

Consumers should look out for the right accreditation, MFHom or FFom, after a practitioner's name, he says. "And always check with a GP before undergoing any treatment."

A House of Lords select committee report earlier this year warned of the dangers of the lack of regulation. And there is a growing lobby of MPs, medical professionals and consumer groups campaigning for regulation.

There are numerous qualified, respected and highly professional therapists who say they offer value for money - many of whom are available on the NHS. But in a dauntingly complex industry with little, and in some cases no, regulation, the need to do research before parting with cash, is more critical than ever.

With a GP's compliments

Dr Mike Rusling is typical of a new breed of GPs willing to embrace and practice complementary medicine. He has been a GP for more than 17 years and a qualified homeopath for 11 and runs both a general and private GP's surgery in Hull.

A passionate advocate of homeopathy, he says he was convinced of its worth after seeing "remarkable" results during his early consultations. He is halfway through running a three-year pilot homeopathic clinic funded by the British Homeopathic Association and is lobbying for permanent NHS support.

"I initially looked at complementary medicine out of curiosity and frustration that I was not able to treat some of my patients' conditions very well with conventional medicine," he says.

"If you can show it works and there is an effect, and you can explain it in scientific terms, that's great."

His homeopathic clinic - based at his Hull practice - is open four to five hours a week and caters for both consultations and NHS referred patients. Dr Rusling admits that non-NHS treatments are not cheap but says: "I think they are reasonably charged if you compare them with, for example, a tradesman. You could pay £100 for parts and labour to fix a washing machine but for some reason, people don't seem to value their health the same way."

What you will pay

Therapies at Boots Health and Beauty centres in London, Reading, Milton Keynes, Leeds, Manchester, Oxford, Tunbridge Wells, Cambridge and Birmingham (First consultation/Follow-ups)

Homeopathy: £55 for 45 minutes/£38 for 30 minutes
Aromatherapy: £45 for 60 minutes/£39 for 45 minutes
Herbalism: £43 for 45 minutes/£36 for 30 minutes

Hale Clinic, London

Homeopathy: Consultations range from £45 to £130
Aromatherapy: Consultations range from £50-£60 for one hour
Herbalism: £130 for two hours £70 per hour

Manchester Therapy Centre

Homeopathy: £35 £15
Aromatherapy: £25 per hour or £15 for 30 minutes

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