British Homceopathic Journal April 1988. Vol. 77. pp. 138-139

Book review

The Heal th Crisis . Chris Thomson and Denis MacEoin. Birmingham: Natural Medicines Society 1987. Pp. 40. s

Accountability, cost efficiency, quality control and proof of efficacy are not in themselves unreasonable demands when made by scientists or governments seeking the best value for money and a fair deal for their tax-paying cus- tomers. The inevitable bureaucratic corollary is to wish to see all things neatly categorized and pigeon-holed. There is no real proof of efficacy that is acceptable either to the profession as a whole or to the government, and the need for the existence of such proofs is therefore questioned. The advent of the EEC and the desire to have uniform regulations throughout its member states provides another impetus to control that which has always existed freely and relatively unlegislated in society.

The Natural Medicines Society was born out of the customers' desire to maintain freedom of choice with reference to natural medicines. Faced with the government 's impending and

poss ib ly damaging legislation every effort is required of both practitioners and patients to maintain the freedoms we currently enjoy. The Society seeks recognition and acceptance for the major natural medicines, including homoeo- pathy, by political, educational and research ini- tiatives. It deserves our support.

The authors of this booklet , Chris Thomson, PhD, and Denis MacEoin, MA, MA, PhD, are enthusiastic and able academicians who take a leading role in the work of the Natural Medi- cines Society and chair its Medical Research Advisory Committee and Social Science Research Committee respectively. From this position they get a better perspective of the impact of conventional medicine on society as a whole than we who work among the trees, as it were, and never see the whole wood.

Thirty-five of the forty pages are devoted to a summary of the evidence, quite considerable evidence at that, which demonstrates the uselessness of modern medicine when viewed in these overall terms. They draw heavily on the published evidence for this, as their bibligraphy

shows. To summarize: - -T he re may even be a negative correlation

between the provision of medical services and health.

- - M o s t infectious diseases such as tuberculosis, typhoid and diphtheria were declining well before any appropriate antibiotic treatment was available, and the advent of antibiotics has made no significant difference to the graph of mortality due to these conditions.

- -Ser ious illness is on the increase, e.g. lung and breast cancer and heart disease. The latest WHO figures show that Britain has the worst death rate in the world from these diseases and that our expectation of life at 45 is among the worst in the world. Chronic disease is showing a steep rise.

- - M r Average consumes far too many drugs- - half the adults take a drug every other day in industrialized countries. Twenty-eigh t per cent of women are on constant medication.

- - T h e National Health Service was supposed to improve the health of the population, and indeed its midwives had no reason to suppose otherwise. It has become very much a treat- ment service rather than a health servicel

- - I t is a myth to suppose that drugs and surgery are effective or generally necessary when pre- scribed. A number of situations are quoted in which treatment is given and operations are performed in the absence of reasonable proof of their efficacy.

- - T h e level of illness caused by drug therapy, iatrogenesis, is unacceptably great. Six quota- tions serve to demonstrate this. Two out of five people receiving clinical drugs have side effects which 'in many cases' are much more serious than the condition that is being treated. The USA spend an estimated three billion dollars on treating side effects. The treatment of arthritis is quoted to illustrate the point. In the remaining five rather scattered pages a

positive holistic approach is advocated and the use of less orthodox therapies is discussed. A fourteen-point Blueprint for Future Health Policy which was hammered out at NMS Board Meetings from a draft which the authors had

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produced, seems to me totally acceptable. It recommends that health remain a top national priority, that orthodox and other approaches be integrated, that positive health measures are taken and that alternative treatment is made available through the National Health Service and private health insurance. It advocates uni- versity training with appropriate standards for all the major alternative medical systems, their introduction into schools and medical colleges, funding for the establishment of appropriately staffed holistic medical centres and for research. It advises that research be directed towards the illnesses that are currently difficult to treat by conventional methods, including multiple scle- rosis, AIDS, cancer, and coronary heart disease. It also recommends a restructuring of the Medi- cines Commission to allow representatives from experts in homoeopathic, herbal, anthropo- sophical and biochemic medicine, possibly on the Dutch or West German models.

It is this last point which concerns us most immediately. The Medicines Commission at present does not include experts of this kind. The inappropriateness of legislation not based on expert advice is a point that the Faculty has also made - -and must continue to make - - to government until the situation is altered.

The laid-back perspective open to the non- medical scientist observing the scientific scene is a salutary one for us all. My own reaction is defensive of conventional medicine. What do you do when faced with an ill patient who wants treatment? It is all very well to quote the inef- ficacy of intervention applied to whole popula- tions, but it is equally the case that individuals do sometimes respond both to conventional and to unconventional t rea tment - -and they are the ones sitting in front of us, for whom we have to act.

I cannot help wondering what the effect of reading literature such as this will be on a government already determined to limit the expense of the National Health Service. To expand initiatives in public education, to encourage good dietary habits, relaxation and a healthy lifestyle is wholly laudable. But where health authorities have to choose between doing this, with uncertain, distant rewards, and providing enough beds for its acute services it is difficult to see how they can do more than pay lip service to the preventive approach from current budget levels. A patient with acute appendicitis, a young mother with breast cancer, a 42-year-old

with triple coronary disease exist, and their needs must be met, too. More specific studies show that appropriate treatment at the right time for people in these categories is indeed effective in reducing mortality and improving quality of life over periods of years. While it is good to remind us of the limitations of medicine, and the need for a readjustment of balance between treatment and prevention, we do not want to encourage government to reduce its acute services any further or to make the public unduly anxious or suspicious about the efficacy or motives of those engaged in orthodox and unorthodox medicine who are both expert and genuine in their desire to help individuals.

The authors, in condemning the failures of modern medicine, do not argue the case for their laudable Blueprint conclusions. If the purpose of the booklet is to inform lay people as to how to argue the case to government or informed government representatives, it might have been better balanced if the 40 pages had been divided differently, say 20 for demonstrating the inade- quacies of the existing position and the remainder for developing the reasons behind the Blueprint. These could have included the acknowledged weaknesses of the case, which are only included by inference in the Blueprint. There is no real proof of efficacy of any of these forms of t reatment--who shall pract ise--what qualifications--what protection for the public against charlatans--what quality control of med- ications. In homoeopathy at least we can assert that our treatments appear to be totally safe; there is no real evidence to the contrary, although we should always be on the look-out for harmful effects.

Government officials have demanded that complementary and alternative medicines speak. with one voice. Although we as a Faculty may negotiate with government officials, the lobby would be that much more powerful if it included all the major alternative and complementary therapies, those represented by the Natural Medicines Commission and those which do not rely on drugs of any kind. It is clear that there are many points of difference between individual therapies, and it will be sad if any of these are considered more important than what appears to be the main need of this decade: to establish a sound legislative base within which a practice of any legitimate therapy is secure within the EEC, and all that this implies with regard to the train- ing of professionals, quality control, and so on.

J O H N E N G L I S H