It seems extraordinary to me that despite a recent poll indicating that 75% of people want complementary medicine available to all on the NHS, there are still only a handful of clinics offering integrated healthcare for free. Indeed, 90% of complementary medicine is only available to those who can afford to pay for it.
Correcting this imbalance, between the services which are being provided and those which people want, need not mean huge additional expenditure. Complementary medicine emphasises preventative care, and encourages individuals to undertake a greater degree of self-management.
Greater access to integrated healthcare would also help tackle some of the worst obstacles to creating a healthier population, one of the most notable being the increasing problem of allergies, which are at epidemic levels in the UK. As the Guardian made clear recently, Britain faces something of an allergy explosion, with predictions that half of us will suffer one by 2015.
There is accumulating evidence that the rise in allergies could be directly linked to the way in which we live and the environment which we inhabit. Sir Tom Blundell, Chairman of the the Royal Commission on Environmental Pollution, argues that "given our understanding of the way chemicals interact with the environment, you could say we are running a gigantic experiment with humans and all other living things as the subject". The evidence so far appears disturbing: the thinning of seabird‘s egg shells, sex changes in fish and shellfish, reduced human male fertility and a rise in certain cancers linked to chemicals that have found their way into our environment and food chain.
A study by scientists at the University of Lancaster has shown that organophosphorus pesticides that were banned some 15-20 years ago are still detectable in the blood. The fact that flame retardants, plasticizers, pesticides and dioxins can cross from the mother to her suckling infant in breast milk is also a cause for concern.
Our disregard for the delicate web that sustains our environment is leading to its degradation and threats to health. There are in excess of 30,000 chemicals in products that we use and dispose of which have never been tested. The application of modern computational techniques coupled with improved environmental and health monitoring would go a long way towards rectifying this situation.
A recent report from the Royal College of Physicians indicated that 18 million people in this country have an allergy, with a staggering 12 million suffering at any one time. Allergies are also increasing in severity and complexity. While asthma and hayfever have increased two-to-threefold over 20 years, hospital admissions for anaphylaxis - a systemic form of allergy that can be fatal - have increased sevenfold over 10 years.
In the UK, 34% of 13- to-14-year-olds now have active asthma, the highest prevalence in the world. I am told that the high figures are most likely to be explained by lifestyle factors including diet, exercise, smoking in parents, exposure to chemicals and a lack of protective factors in early childhood (exposure to bacteria and other micro-organisms that boost immunity) and overuse of antibiotics.
Peanut allergy, the most common form of food allergy to cause fatal reactions, has trebled in incidence over four years. One in 70 children are now affected. Drug allergies and allergies at work are all on the increase too; 8% of nurses are now allergic to latex in rubber gloves yet, in 1979, only two cases had been described.
Clearly, something dramatic is happening. The rising trends in allergy seen in developing countries, as they adopt our Western habits, point strongly to factors in the way we live. We spend up to 80% of our time indoors, and the sealing of our houses to conserve heat and energy, the increase in soft furnishings and the rising numbers of pets all increase the chance of those genetically at risk becoming sensitized to domestic allergens such as dust mites, moulds, cats and dogs. Similarly, at work, increasing allergies give rise to the ‘sick building‘ syndrome. But increased exposure to allergens cannot be the whole answer because we are also becoming allergic to outdoor allergens such as pollens, and to certain foods, especially fish, fresh fruits and vegetables.
Children raised on livestock farms have only one third of the incidence of allergy when compared to their non-farming rural peers. In Africa and Asia, allergy is much higher in urban than in rural populations. It seems that exposure to higher levels of bacteria, viruses and fungi stimulates the immune response away from allergy. A similar effect has been suggested for the beneficial effect of fresh farm produce in helping "good" bacteria live in the gut of young children. Clearly, there is a balance to be struck between exposure to infectious agents, thereby reducing allergy, and exposure causing serious infection. The recent concerns over "super bugs" in hospitals and the emergence of resistant tuberculosis are examples of where micro-organisms have successfully got round our attempts to eliminate them.
Factors associated with our Western society, such as over-eating, lack of exercise and an obsession with hygiene, as well as our exposure to a myriad of chemicals from products whose effects we are only just learning about, are conspiring to weaken our defence against the environment. Our children are paying the price.
So, what do we do? In the short-term, it would seem vital to recognise the importance of allergy and to improve its management. While encouraging a healthy, balanced diet and a focus on physical and mental fitness will undoubtedly help, we need to take allergy more seriously. The UK has a minimal specialist allergy service. Our frontline GPs and nurses need greater support in helping to advise and treat patients with serious and increasingly complex allergy problems. But in the many countries that I have visited, it is clear that more traditional, "natural" approaches are helpful too.
Clinical trials of acupuncture, homeopathy, herbal medicine and controlled breathing have shown benefit in asthma treatment. An area of great interest to my Foundation for Integrated Health is how to capitalize on this wealth of experience and to ensure that we can provide people with the best of complementary approaches alongside orthodox medicine.
All this needs to be part of a well thought-out and coordinated approach which links a more effective and focused specialist service with frontline doctors and nurses to the needs of patients. Allergy is about our lifestyle - what we eat, what we touch and what we breathe. There are some things that we do individually, but collectively we need to create an environment that causes less allergy in the first place. My Foundation is hoping to lead some work with the Royal College of Physicians and others looking at what can be done by adopting an integrated approach.
It is time that all of us took allergy more seriously, particularly those engaged in public health who have the resources to improve things, and the British public who will continue to fall victim to the epidemic if we do not.