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Letters to the Editor Issue 39

by Letters(more info)

listed in letters to the editor, originally published in issue 39 - April 1999

Will Wilson’s Comments re. Editorial, Issue 37

In Positive Health Issue 37, Sandra Goodman’s editorial focussed on the problems of Diagnosis and Complementary/Alternative practitioners. She visits her GP to get a diagnosis and then selects an appropriate complementary/ Alternative Practitioner to treat the diagnosed condition. My own and my family’s experience of GPs’ diagnosis has been little short of catastrophic, and it has only been my own 17 years experience of working in NHS Pathology departments that has saved the day. In my own case, one hopelessly wrong diagnosis was followed by a correct diagnosis (when my partner called the emergency doctor), but a hopelessly wrong treatment plan. He left, leaving a prescription for penicillin. In my by then state of delirium I realised this would not help, and managed to get myself taken to hospital for the emergency operation I needed, otherwise I probably wouldn’t be writing this now.

Hospital doctors fare little better. As a Scientific head of Department working behind the scenes in hospital pathology laboratories, I often had the experience of what we called “Fishing”. This consisted of doctors requesting as many pathology tests as they could possibly get on the request form in the hope that something would show up and give them a diagnostic clue. To question this approach would be to be challenging their “clinical freedom”. In the old days doctors would make their diagnosis, then request tests to confirm this.

Of course there are good and bad in any profession, and I do agree with Sandra Goodman that appallingly bad diagnosis exists in the Alternative/Complementary field too. One reason for this is the poor basic biological, medical and anatomical knowledge that many practitioners have. Often there is almost an assumption that this isn’t needed because we’re “working with the energy” or “following the process”. And often Training Schools are just “sausage machines”, more interested in pushing through large numbers at high profit than turning out competent practitioners, often taking on students unsuited for the work that will be demanded of them.

Also diagnosis depends on your viewpoint. The medical diagnosis “Pyrexia (fever) of unknown origin” isn’t really a diagnosis, neither is “imbalance in the fire element”. The whole question of diagnosis is a veritable minefield. Non-medics are effectively forbidden to make a “medical diagnosis” so even if I knew from my experience it was likely a client had, say, tuberculosis, I would have to just suggest strongly they saw a doctor soon. It seems that the consumer of “Healthcare” has to be aware, be very aware.

Will Wilson

• Positive Health will be publishing an article by Will Wilson re. Craniosacral Therapy in Issue 42 (July 1999).

Open letter to the Medicines Control Agency from the BHMA

Re: MLX 249 - Proposed amendments to the Medicines for Human Use (Marketing Authorisations etc.) Regulations 1994

Thank you for the above consultation letter and details of the proposed amendments to SI 3144 1994.

The BHMA understands that the MCA feels obliged to amend the above Act, due to circumstances which have arisen during the past five years since the introduction of SI 3144 on January 1st 1995. We note the European Court ruling that "it is for national authorities to determine, subject to review by the Courts, whether or not a product should be controlled as a medicine" and recognise that the MCA is charged with this responsibility.

The BHMA's Position

The BHMA by articles of association and declared objectives are:-

* To defend the right of the public to choose herbal remedies and to be able to obtain them freely;
* To encourage wider knowledge and recognition of the value of herbal medicine;
* To advance the science and practice of herbal medicine by modern techniques;
* To promote high standards of quality and safety in herbal remedies;
* To foster research in herbal medicine, exploring the vast potential of medicinal plants.

All these objectives the BHMA has striven to achieve over its 35 year history, and when appropriate has mounted political campaigns to defend the status quo. Occasions have been rare when this has been necessary as we prefer dialogue rather than confrontation, and we welcome this opportunity to comment on the above proposals and trust that our comments will be helpful, measured and responsible.

The Proposals

The BHMA does not propose to challenge the decision of the Department of Health to introduce the amending regulations as a matter of principle because we are aware of the broad demands of the E.C. that national authorities must determine whether or not a product should be controlled as a medicine. We are aware that measures are necessary to address the current trends which are affecting the supply of borderline products, and in particular the supply of herbal medicinal products which are our principle concern.

The Board of the BHMA recognises the need to clarify the regulations and sees the necessity for a clear transparent procedure for dealing with the borderline issues, and subject to the necessary checks and balances the new measures could be a very positive piece of legislation. It is obvious that without clear criteria there is a possibility of continued current market confusion, at the expense of responsible manufacturers but, above all, the possible detriment to the public. We are also aware that unless there is a clear policy for addressing the borderline issues, then pressure to act from the European authorities will be inexorable.

The Procedure

Annex 2 of your proposals sets out a system for determining whether a product is medicinal or not, and we recognise that it follows the general principles as laid down on the MAL 8 guideline. We are of the opinion that the procedure could be improved by setting up an independent tribunal which could be the final arbiter, but acknowledge that this may not be possible if legal constraints apply. Nevertheless, we would ask the MCA to review this proposal to see if ways and means could be found to seek advice from outside interests before the final determination takes place.

In view of all the issues addressed above, the BHMA will support the introduction of the Statutory Instrument as outlined in MLX 249 subject to the following assurances:-

1. There is no threat to the continued existence of Section 12 exemptions as detailed in SI 3144 1994;
2. There is no threat to the herbal practitioner and the right to practise and prescribe herbal medicines, providing they are not restricted in any other way;
3. There is no threat to the free sale of herbal medicinal products, subject to Section 12 2 of the exemption, via health food stores and other non pharmacy current retail outlets;
4. That the procedures of the review committee are detailed and discussed with the BHMA before implementation.

We trust that our comments will receive serious consideration and hope they will be helpful in your deliberations.

Victor Perfitt,
Chairman, British Herbal Medicine Association (BHMA)

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