We Should All Be Free to Consider the Alternatives Why Are Thousands of Pregnant Women Having Acupuncture? It's Just One Example of How Integrated Medicine Is Working, Says Barbara Lantin

Imagine - you are suffering from blinding migraines, so you visit your GP. She suggests you try homoeopathy first - she took a course in the subject at medical school - before moving on to pharmaceuticals, if necessary. She refers you to the surgery's chiropractor, who will ease the tension in your neck, and to the nutritional therapist, to see if modifying your diet might help. Then she recommends some useful reading from the practice library.

This fantasy scenario is closer than we think. At the Royal Festival Hall in London this week, the Prince of Wales presented this year's Awards for Good Practice in Integrated Healthcare to a GP practice in Kent where patients with chronic illness can take part in art, music and movement therapy, and to an acupuncture service established in the maternity department of a Devon hospital.

Both are outstanding examples of the way complementary and conventional medicine can be practised side by side, bringing "the best of both worlds" to National Health Service patients. Projects such as these are still unusual, but they are part of an exciting trend. The Integrated Healthcare awards attracted more than 40 entries and selecting a winner from the shortlist of 11 was no easy task - I was one of the judges, in my capacity as chairman of the Guild of Health Writers - and, in the end, we chose two.

It is hardly news that complementary and alternative medicine is big in Britain. There are thought to be about 50,000 practitioners in this country, carrying out more than 90 different therapies between them. One person in five had such a consultation last year and pounds 1.5 billion was spent in the process.

But unlike conventional medicine, complementary therapies are not available to all. Most consultations are private and - at anything from pounds 30 an hour - beyond the reach of many. The field is poorly regulated, making it difficult for patients to distinguish between reputable practitioners and quacks. And the therapies are not generally integrated with conventional medicine, so people have to choose which route to follow.

"There is a major issue about access to complementary medicine," says Michael Fox, chief executive of the Foundation for Integrated Medicine, which runs the awards. "It should not be an add-on for the well-heeled, but available to everybody who needs it." Even the British Medical Journal acknowledges that conventional medicine does not have all the answers. As Prof Lesley Rees, director of education at the Royal College of Physicians, wrote in a BMJ editorial earlier this year: "Conventional medicine has become dependent on expensive technological solutions to health problems, even when they are not particularly effective It has turned its back on holism and simple methods of intervention."

In integrated medicine, the focus is on "health and healing, rather than disease and treatment. It views patients as whole people with minds and spirits as well as bodies and includes these dimensions in diagnosis and treatment."

Things are improving. Although some doctors remain sceptical and a few hostile, more than 40 per cent of general medical practices in Britain now provide some access to complementary medicine services, and the benefits of complementary medicine in cancer care and treatment of the terminally ill are well recognised.

This autumn saw the launch of Healthy Bristol, the first city- wide integrated medicine project in the country. The local health authority has given moral - though not financial - support. Funding is from a Japanese charity.

"At the moment, services tend to be built up around charismatic individuals who have a passion for their subject and have found ways of making things happen," says Dr Rosy Daniel, former medical director of the Bristol Cancer Help Centre, who dreamed up the idea of Healthy Bristol. "It should not be like that."

That was the case in several of the shortlisted projects and in one of the winners, the maternity acupuncture service at Derriford Hospital in Plymouth. Its founder, midwife Sarah Budd, trained as an acupuncturist in her spare time and saw patients after hours, before being appointed the country's first full-time midwife acupuncturist. "I saw that there was very little choice in terms of pain relief for labour and nothing that was not drug-oriented," she says. "Women wanted more control and acupuncture seemed a great way to give pain relief."

There are now three midwife acupuncturists dealing not only with labour, but with pregnancy-related problems such as sickness and backache. More than 4,000 women have been treated and there is a three-week waiting list.

In Scotland, the Borders Primary Care Trust, which uses essential oils to treat people with mental health problems and learning disabilities, has found that one or two drops of lavender oil can replace sleeping tablets, at a fraction of the cost and without the side effects. Another short-listed candidate, the Integrated Footcare Clinic at the Royal London Homoeopathic Hospital, uses poultices made of crushed marigolds to treat bunions, avoiding the need for an expensive operation with only a moderate success rate. If this work were extended countrywide, the cost savings could be enormous.

Apart from finance, three other factors prevent complementary medicine from being more widely available within the NHS - inadequate regulation of practitioners, insufficient research about which treatments really work, and lack of knowledge among GPs.

The Complete Guide to Integrated Medicine, by Dr David Peters and Anne Woodham, Dorling Kindersley, is available from Telegraph Books Direct for pounds 12.99 plus pounds 1.99 p&p on 0870 155 7222

　　From Healthy.net