Vol. 25 No. 1 February 2005

A joint Australia-New Zealand therapeutic products agency has been in the planning stage for three years or so now, and looks likely to become a functioning reality later this year. In 2002 a draft document on the regulations such a body might administer was circulated for comment, and the Homœopathic Society made submissions, with proposals for sensible rules about homœopathic medicines. These submissions were printed in Homœopathica, September 2002.

Now a very thoroughly revamped version of these proposals is being circulated, and the Society will again comment. I think it can be said that the proposed controls on homœopathic medicines are far more rational and less onerous than anyone in the homœopathic world had imagined would be created; in fact the repeal of the particularly silly rules found now in Australia that the document proposes will be very welcome to homœopaths there. Misunderstandings about some aspects of homœopathy are still to be found in the draft, but considering the good response to our earlier submissions I am hopeful these can be corrected. The Society’s submissions will be composed after a meeting with representatives of Medsafe, the New Zealand side of the project; in Australia the Therapeutic Goods Administration is the counterpart.

On 16 December last year the Minister of Health, Annette King, released her response to the report of the Ministerial Advisory Committee on Complementary and Alternative Health. Her remarks, as they appear at www.Beehive.govt.nz are very superficial and put in question the merit of forming the advisory committee – which some people say was set up merely as a sop to the Green Party, with never any belief it would produce a significant result.

The committee made 14 recommendations; the fourth one is: “Practitioners . . . who practise one or more CAM [complementary or alternative medicine] modalities should undertake training and monitoring that is appropriate to the risk of each CAM modality.” The committee explains that it made this suggestion for these reasons.

“Many practitioners practise several CAM modalities. The risk is that consumers may not be able to identify the level of competency a practitioner has in each modality. MACCAH suggests therefore that all practitioners be required to complete minimum standards of training specific to each of the modalities they practise.

“This approach would need to accommodate the possibility of cross-crediting for training that is general to all health care practice (for example, dealing with emergencies, referral practices and so on) or where there is a common philosophical base to the modalities practised (for example, acupuncture and Chinese herbal medicine).

“Biomedical practitioners of CAM refers, in this instance, to health professionals including doctors, physiotherapists, nurses (and soon midwives) who are already regulated by statute under the Health Practitioners Competency Assurance Act 2003 (HPCA 2003).

“The risk is that consumers might well assume that, because a practitioner is regulated by statute, they are competent in the practice of the CAM they offer.

This is not necessarily the case. They may, for example, have only attended an introductory training session on the modality. “Again, MACCAH suggests that dual practitioners be required to complete minimum standards of training specific to each of the modalities they practise.” To which the Minister gave the one-sentence retort: “Training requirements and monitoring of these is the responsibility of the relevant statutory council or professional body.” Does this mean she thinks this is the situation that obtains now, or that one day, of their own free will, the bodies that control doctors, midwives, chiropractors, physiotherapists, etc, (and why not veterinarians too?) will tell their members they must have a good level of training and understanding of homœopathy, acupuncture, etc, before they apply them to their patients?

I look forward to the day the dabblers in homœopathy we know exist in the world of “orthodox” medicine are denied the right to practise their pygmy skills on patients who deserve better. The Homœopathic Society raised exactly this issue when, on 30 May 2004, in response to an appeal for submissions on the New Zealand Medical Association’s Draft Statement on Complementary Medicine we said: “The Society would like it incumbent on doctors using homœopathy, or describing themselves as homœopaths, to be able to produce proof that they have adequate training in the discipline, preferably, also, that they belong to a professional body which has a standard of knowledge and skill as a membership requirement.”

Subsequent correspondence shows, surprisingly, that the Medical Association may have taken notice of this suggestion, stimulated also by comments made by the Medical Disciplinary Tribunal which heard the charges against Richard Warwick Gorringe early last year. The relevant comments by that body are:

“The Tribunal was of the view that where a registered medical practitioner practises ‘alternative’ or ‘complementary’ medicine, there is an onus on that practitioner to inform the patient not only of the nature of the alternative treatment offered but also the extent to which that is consistent with conventional theories of medicine and has, or does not have, the support of the majority of practitioners.

“The Tribunal recognises that persons who suffer from chronic complaints or conditions for which no simple cure is available are often willing to undergo any treatment which is proffered as a cure. As such, they are more readily exploited. The faith which such persons place in practitioners offering alternative remedies largely depends on the credibility with which such practitioners present themselves.

“Where such remedies are offered by a registered medical practitioner, it is difficult to escape the conclusion that the patient derives considerable assurance from the fact that the practitioner is so registered. It follows, therefore, that a registered medical practitioner cannot discharge his or her obligation to treat the patient to the acceptable and recognised standard simply by claiming the particular treatment was ‘alternative’ or ‘complementary medicine’.

“It was satisfied that medical practitioners who practise both conventional and alternative medicine must be well aware of the possibility that patients consult them to get ‘the best of both worlds’ and to avoid those aspects of alternative medicine which are extreme or incredible.”

The next step, of course, is the putting in place of a mechanism whereby it is possible to complain that a practitioner is claiming to be a homœopath, or even prescribing homœopathic medicines, without adequate credentials. When, if, this is done, I personally will be first in line to start proceedings that will stop such charlatans from sullying the status of homœopathy.

Bruce Barwell