Having worked at SourcePoint Community Acupuncture on Dartmoor in the South-West of the UK last year, I’m currently in the process of setting up my own clinic in a town nearby.
Community/multibed acupuncture, if you are not familiar with it, is a new model of acupuncture provision based on the multibed model common in China and Japan. Costs are lower because multiple patients can be treated at the same time, in the same space (in the US, reclining garden chairs are commonly used to keep equipment costs even lower, as in the picture above). This is possible because this style of acupuncture mostly uses distal points on the arms and legs (no undressing required) and, after insertion and manipulation, the needles are left in to continue working for 20 minutes while the next patient is seen.
[And if you are unfamiliar (or dubious) about what traditional acupuncture can treat, here are some research summaries from the British Acupuncture Council.]
This area of the UK has a lot of rural poverty. The town in question used to be a centre of the textiles industry and still has associated businesses, but now is mostly well-known for being poor, backward and depressed in comparison to nearby Exeter or Taunton. A walk down the high street reals the unholy trifecta of economic malaise, high levels of obesity, ill-health and disability, and that indefinable loss of spirit in a town that convinces every young person of passion or ambition to leave the area at the earliest opportunity.
The main message is that Community Multibed Acupuncture can be an incredibly powerful intervention in an area like this. The effect seems to come from a combination of:
Effective health care - I’ve lost count of the number of patients who have come in with stories of months or years of expensive National Health Service treatments that made no difference to their conditions, who then see a large reduction in their symptoms after only one or two acupuncture treatments. (Moves to provide acupuncture on the NHS over the last decades have been faltering and half-hearted, and are now suffering from a pushback against anything considered ‘alternative’ or ‘optional’ - which is a shame, as it could save the NHS millions).
Humane treatment - unlike the increasingly isolating and interventionist treatments common in industrial healthcare, the effectiveness of traditional acupuncture shows patients that good health can often be achieved through minimal intervention, through working with the body rather than against it, through self-help, and lifestyle and dietary changes. Demonstrating that a more humane approach to health is possible starts people thinking about what else they need to question.
Collective treatment - something about the nature of receiving shared treatment with other people seems to have an effect on people. Perhaps it cuts through the common Western idea of illness as something private, secret and shameful - whatever it is, sharing one’s vulnerability and the act of seeking support and help with other community members seems to have a profound psychological charge.
Affordability - although health care is free (‘at the point of use’) in the UK, it is, in effect, rationed; waiting lists are getting longer again, and many NHS trusts are effectively bankrupt. C&MACs offer a form of healthcare without the expensive pharmaceuticals, electronics and salaried consultants. Most either offer a reduced rate (e.g. £20) or a sliding scale (e.g. £10-30, where you pay what you want). [I’ve found problems with both models - resistance to the idea of a sliding scale is very common, and often leads users to undervalue what is being offered. Given that it has taken the District Council 2 months (at this time of counting) to respond to what should be a simple request for licensing, and given that the licence terms for this district are insanely onerous, I have found a degree of freedom and enjoyment in simply offering treatments for free and explaining to patients what sort of average donation is necessary to keep the clinic open.] If all kinds of healthcare were funded equally, acupuncture would prove massively more cost-effective than many ‘mainstream’ modalities - not to mention less energy-intensive and ecologically-damaging.
Knock-on effects - people who come to the clinic see flyers and posters for other events while they are there. They buy a coffee in the cafe upstairs and bump into other people they know. They go into other shops seeing as they are in town already. People who had given up on the town are excited that something like this would happen there. Maybe some people even wonder whether there is something they could do to get things happening in the local area. These are effects that are common to any community venture, many of which other ERs have mentioned elsewhere. As with education, art, reskilling, etc, the fact that users of the service are making positive changes in their lives, and are already feeling the benefit of being involved, seems to snowball this effect even more strongly.