An initiative launched in the North will investigate the benefits of GPs referring patients to a variety of alternative and complementary practitioners, writes Margaret Canning.
A new pilot scheme in parts of the North will see treatment by osteopaths, homeopaths, aromatherapists, chiropractors, acupuncturists and masseurs paid for by the National Health Service (NHS), the public body which provides healthcare in the UK.
The £200,000 scheme is run by a not-for-profit organisation called Get Well UK, which will liaise between the practitioners who are contracted to provide the work and the NHS.
Patients at the Community Treatment and Care Centre, in east Belfast, and Racecourse Medical, in Shantallow Health Centre, Derry, will be referred to the practitioners for musculo-skeletal problems and depression, stress and anxiety.
They will come into the surgery to treat patients "one or two days a week", according to a spokeswoman for the Department of Health in the North.
Northern Secretary Peter Hain launched the pilot scheme last Monday. A user of reflexology and homeopathy himself, he says the scheme has "the potential to improve health substantially".
If the pilot scheme is deemed a success next year, it could be rolled out across the North.
Homeopath Ken Mayne will treat patients suffering from stress and depression under the scheme.
"This is a very important step and the first of its kind in these islands," he says.
"CAM [complementary and alternative medicine] therapies are being accepted more and more, but it has tended to be piecemeal. This new scheme has come from high up, from the Secretary of State, and may well be the template for similar schemes in the rest of the UK and indeed, the Republic," says Mayne.
In England, NHS primary care health trusts may fund complementary and alternative medicine where a GP feels it is the only treatment that will work for a patient.
The main criticism of most forms of CAM is that, unlike orthodox drugs, they haven't been rigorously tested in double-blind trials and side effects are often unknown. Critics also point out that not all branches of complementary therapy are regulated.
Ken Mayne, who is also secretary of the Northern Ireland Association of Homeopaths, says the argument over lack of regulation stems from "a misconception".
"Since a report on CAM by a House of Lords Select Committee in 2000 [recommending statutory regulation], there have been great advances in regulation," he says. "The therapists on the pilot scheme have all been quality assured and all the boxes ticked for qualifications, insurance and competence."
Mayne is not a qualified doctor, but says anatomy, physiology and pathology were all part of his training. He also faces arguments from GPs who say the money shouldn't be given to alternative therapies when it's not readily available for breast cancer drug Herceptin and other expensive and potentially life-saving drugs.
"One of the main objectives is to show that there are more cost-effective ways of treating patients. If we show that money can be saved, then there will be more available for other drugs," Mayne says.
One NHS GP who works in Co Down says the scheme marks a change in NHS policy.
"It does make CAM more legitimate as it hasn't been approved or sanctioned from on high quite like this before," he says. But he says regulation is crucial.
Currently, there is no mechanism for GPs to refer to chiropractors though some guidelines do suggest chiropractors for back pain lasting more than six weeks.
A GP at a Belfast practice - not the one involved in the scheme - says she might refer a patient with back pain to a chiropractor if she had a list of recommended chiropractors whose credentials had been investigated and approved.
But she would draw the line at homeopathy and aromatherapy. "If patients want to go, they should go themselves."
The Co Down GP agrees that aromatherapy is appropriate for relaxation in palliative care or for someone who has just received a cancer diagnosis "but in general terms, I would not prescribe it, as there's no evidence it works on any illnesses".
However, she does not oppose the NHS spending £200,000 on the scheme: "It's not a huge amount of money in terms of the overall budget [£3.5 billion sterling]."
Anne O'Brien, a cardiac nurse and smoking cessation counsellor at Belfast's Royal Victoria Hospital, sometimes uses aromatherapy and arm massage to help people relax if they're struggling to kick the habit.
She welcomes the pilot scheme. "It's fantastic. Complementary therapies may not cure what people have, but it can help their quality of life and you can't always promise that otherwise," she says.
A spokeswoman for the British Medical Association in Northern Ireland said it would like to be assured that the £200,000 is not depriving other patients of resources.
"We would like to know that the money is new money and is not being taken from patient care," she says.
"In addition, any practitioners taking referrals from the practices involved in these schemes should be regulated and doctors should know to whom they are referring someone."