Introduction

Within the last 30 years, there has been a huge growth in usage of complementary and alternative therapies (CAM) both in the UK and world wide (Eisenberg et al., 1998). A report to the Department of Health estimated that up to 5 million patients in the UK may have consulted a CAM practitioner in the preceding year (Mills and Budd, 2000) and a recent Report by the House of Lords Select Committee on science and technology recognised that use of CAM in the UK is wide spread and growing (House of Lords, 2000).

Whereas in the past, orthodox medicine was hostile to wards CAM approaches, doctors are increasingly interested in the potential benefits CAM may offer their patients, particular those patients suffering from chronic, un differentiated diseases for which conventional medicine has little to offer. A 1995 study estimated that 39.5% of GP practices in England were providing access to CAM the rapists for their NHS patients (Thomas et al., 1995). A recent survey of UK GPs carried out by the BMA (BMA, 2000) found that 79% of those responding felt that acupuncture should be made available to patients on the NHS. The most popular therapies currently are the so-called ‘big five’, namely: acupuncture, homoeopathy, herbalism, osteopathy and chiropractic (the last two of which are subject to statutory regulation). Other popular therapies include aromatherapy, reflexology and healing. Most consultations with CAM practitioners occur in the private sector, with patients paying for sessions out of their own pockets. Most CAM practitioners are not medically qualified, although growing numbers of doctors, nurses, midwives and physiotherapists also utilise CAM techniques.