The Ministerial
Advisory Committee on Complementary and Alternative Health (MACCAH)
was set up in June 2001 and is funded to run until 2004. MACCAH
is
responsible for providing the Minister of Health with information
and advice on complementary and alternative health care in New
Zealand. MACCAH's terms of reference are outlined in Appendix
1. A list of MACCAH's members is given in Appendix 2.
This discussion document aims to provide background and comparative information on complementary and alternative medicine (CAM) in New Zealand and overseas, and to identify policy issues of particular concern here in New Zealand.
The first part of the document, the 'Review of Complementary and Alternative Medicine n New Zealand and Abroad', gives an overview of current policies on CAM in the following countries:
These countries were selected to give a balance between Western and Eastern perspectives. The English-speaking countries were chosen because they have similar judicial and governmental systems. China is included because biomedicine and CAM, in the form of traditional Chinese medicine, are integrated within the Chinese health system. Within each country the relevant policies are discussed under four headings:
These four policy areas are in line with MACCAH's terms of reference (see Appendix 1).
The second part of the document, 'Policy Issues Surrounding CAM', identifies and examines some of the questions and areas of uncertainty that arise from the survey of CAM in New Zealand and overseas. These are some of the issues that MACCAH believes policy-makers, practitioners and consumers here in New Zealand need to consider.
The definition of CAM used in this document is as follows:
Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being (O'Connor et al 1997). [This definition does not encompass a definable group of methods. More important, it suggests that the defining characteristic should be political dominance (whatever that is) rather than scientific validity or scientific acceptance.]
The term is also understood to include those modalities that are perceived as forming part of the CAM spectrum in the countries under discussion. ["CAM" is a marketing term, not a definable group of theories methods. In examining how these modalities are "perceived" in other countries, the MACCAH does not appear to have examined any of the writings of "CAM" critics. Meaningful discussion of "CAM" regulation should take scientific plausibility of each into account. Practices that are completely nonsensical should be regulated differently from those that have some validity. Most "CAM" methods would be more appropriately classified as quack methods.] A fuller explanation of the terminology used by MACCAH is given in our terminology paper (MACCAH 2002). [The references in the terminology paper do not include a single publication by a "CAM" critic.]
The CAM modalities most commonly available in New Zealand are listed in Appendix 3.
Under the Treaty of Waitangi, the Government has an obligation
to protect and support Mäori systems of knowledge. Development
of policy advice with respect to traditional Mäori healing
should be led by Mäori to be consistent with the principle
of rangatiratanga, or self-determination. In light of this, MACCAH
will not be considering traditional Mäori healing within
the scope of its policy advice to the Minister of Health. Advice
in this area will instead be led by the Ministry of Health's Mäori
Health Directorate in the context of implementing He Korowai Oranga,
the Mäori Health Strategy. [The
MACCAH physician members work in the area of Maori and Pacific
health systems. If the committee is not going to deal with this
area, why are they on the committee? And why doesn't the committee
have a single mainstream medical expert?]