House of Lords

Session 1999-2000 Publications on the internet Science and Technology Committee Publications

Science and Technology - Sixth Report Here you can browse the report together with the Proceedings of the Committee. The published report was ordered by the House of Lords to be printed 21 November 2000. CONTENTS SUMMARY CHAPTER 1: INTRODUCTION What is Complementary and Alternative Medicine? Growing Use of CAM in the United Kingdom British Surveys Table 1: Use of CAM in the United Kingdom United States Surveys Table 2: Use of CAM in the USA Reasons for Accessing CAM Survey Data Table 3 :Reasons for Using CAM Other Possible Explanations Approach of This Report Conduct of this Inquiry CHAPTER 2: DISCIPLINES EXAMINED Definitions of the Various CAM Therapies Box 1: Short and Simplified Descriptions of CAM Disciplines Differing Philosophies CHAPTER 3: PATIENT SATISFACTION, THE ROLE OF THE THERAPIST AND THE PLACEBO RESPONSE Patient Satisfaction Patient Dissatisfaction The Role of the Therapist Placebo Effect CHAPTER 4: EVIDENCE Evidence for Efficacy? Evidence for Safety Patient Satisfaction As Evidence For Efficacy Evidence About Mechanisms of Action CHAPTER 5: REGULATION Current Regulatory Status of CAM Professions Box 2: Status of Some CAM Voluntary Professional Bodies in the United Kingdom. Box 3 : General Statutory Regulation of CAM Weaknesses of the Current Situation Features of an Effective Regulatory System Box 4: Modern Principles of Statutory Self-Regulation in the Health Field Regulatory Options Voluntary Self-Regulation Box 5: Features of an Effective Voluntary Self-Regulatory Body Statutory Regulation Routes To Statutory Regulation Own Act Health Act 1999 Box 6 : Criteria for petitioning to come under the Council for Professions Supplementary to Medicine or its successor Box 7 : Criteria for a Group to be Considered a Profession Which Therapies Would Benefit From Statutory Regulation? Acupuncture Herbal Medicine Homeopathy Single Umbrella Regulatory Body? Regulation of Conventional Healthcare Professionals Practising CAM Regulation of Herbal Products CHAPTER 6: PROFESSIONAL TRAINING AND EDUCATION Standards of CAM Training Courses Training in Statutorily Regulated CAM Therapies Training in Non-Statutorily Regulated CAM Therapies Current Status of Training General Conclusions Continuing Professional Development Validation of Training What Should CAM Training Courses Include? Basics of Biomedical Science Research Methods Limits of Competence Familiarisation With Other CAM Therapies A Core Curriculum? National Occupational Standards Training Conventional Medical Practitioners in CAM Familiarisation for Medical Students Box 8 : Extracts from Reports of GMC Visits to United Kingdom Medical Schools 1998-99 Postgraduate Familiarisation for Doctors Training for Medical Practitioners Nurses, Midwives and Health Visitors Familiarisation Training Conclusion CHAPTER 7: RESEARCH AND DEVELOPMENT Priority Areas For Research Should Specific Therapies be Prioritised? Research Methods Randomised Controlled Trials (RCTs) Box 9: Issues to Consider When Designing RCTs for CAM Therapies Qualitative Research Box 10: Some Forms of Qualitative Research: Their Advantages and Disadvantages for CAM Research Research Outcome Measures Which Research Method to Use and When Expertise on Grant-Awarding Boards Environment and Infrastructure for Research Research Education Attracting Mainstream Investigators Research Funding Sources The Government Box 11: Government Funding Options The Medical Research Charities Commercial and Industrial Companies Pump-Priming and Ring-Fencing The Lessons of NCCAM Attitude of UK Research Funding Bodies Co-ordinating the Development of CAM Research CHAPTER 8: INFORMATION Information for Healthcare Professionals The Dissemination of Research Findings Information for Patients Media Coverage of CAM The Internet Advertising CAM Table 4: Complaints Against Advertisements An Overarching Information Body? CHAPTER 9: DELIVERY Current Patterns of Delivery Methods of Delivery Box 12: Methods of Delivery Within the NHS Integrated Healthcare Primary and Secondary Care Primary Care Groups Gatekeeper Role of GPs Criteria for NHS Provision Figure 1: Factors Affecting PCG Decision Making on CAM Provision SUMMARY OF RECOMMENDATIONS APPENDIX 1 Difficulties of Randomised Controlled Trials APPENDIX 2 Features of the General Osteopathic Council and the General Chiropractic Council APPENDIX 3 Visit to Mr Simon Mills' CAM Practice, Department of Complementary Medicine, University of Exeter; and the Centre for Complementary Health Studies, University of Exeter On 22/23 March 2000 APPENDIX 4 Visit to the Marylebone Health Centre, 12 April 2000 APPENDIX 5 Visit to the University of Southampton Medical School and the Centre for the Study of Complementary Medicine, Southampton, on 9 June 2000 APPENDIX 6 Special visit to the Glasgow Homeopathic Hospital by two members of the Sub-Committee on 24 August 2000 APPENDIX 7 Sub-Committee 1 APPENDIX 8 List of Witnesses APPENDIX 9 Acronyms Note Written and oral evidence received by the Committee is published in two separate volumes (HL Paper 48 and HL Paper 118). In the text of the Report: Q refers to a question in oral evidence; p refers to a page of written evidence printed in HL Paper 118; and P refers to a page of written evidence printed in HL Paper 48.