2007 Message from Ron White,
Breakspear Hospital Trust Chairman

The well-publicised report by a House of Lords committee into allergy published at the end of September 2007 begins with the words “Allergy in the United Kingdom has now reached epidemic proportions” and goes on to say that “(United Kingdom) clinical services lag far behind those of many countries in Western Europe”. It acknowledges also that much allergic illness has a cause based on the environment in which sufferers, and by extension we all, live.

Breakspear Hospital Trust is a registered charity dedicated to helping those suffering from environmental illness, including allergy, and promoting awareness generally of allergy and related conditions. It is associated with Breakspear Hospital in Hemel Hempstead, a private day-case unit which specialises in treating people with allergy, CFS, IBS and other illnesses with an environmental cause.

There are simple things we can all do to reduce the detrimental effects of our own environment and the House of Lords report is right to recommend, for example, that we try to eliminate damp and mould from our living accommodation as these can be the source of problems. Other straightforward changes can be made to improve our health, but there are many others which are not so easy and in areas over which individuals have no control.

The report lists many suggestions as to how the severe shortcomings in care should be addressed. It mentions a number of treatments offered including immunotherapy, in other words the identifying of allergic triggers and then targeting the resulting responses with desensitising doses. One variation of this is low-dose immunotherapy,  sometimes known also as provocation/neutralisation, whereby once a trigger has been isolated the precise strength at which the allergen, be it a food, a chemical or some other substance, is established and the allergic response can then be “turned off” by administering a slightly weaker dose of that allergen by sub-cutaneous injection or sometimes by sub-lingual drops. This process, known as the Miller Technique, was developed in the United States nearly half a century ago and although it is used around the world there are still relatively few facilities using it. In the United Kingdom it is not used by the NHS and just two private clinics, Breakspear Hospital in Hemel Hempstead (under its medical director Dr Jean Monro) and Burgh Wood Clinic in Surrey (under Dr John Mansfield) use the technique to any degree; but they lack the resources to provide the high levels of complex evidence required to convince mainstream medicine of its efficacy or to expand its provision. Nevertheless in 2003 we commissioned the University of Hull to carry out a simple evaluation of “before and after” questionnaires completed by over one thousand patients at Breakspear Hospital, and were encouraged that statistically significant improvements were noted amongst post-treatment answers in a proper and expertly conducted exercise.

Low-dose immunotherapy is extremely effective and very safe because of the very low doses involved in comparison with other, sometimes discredited, immunotherapy regimes; also doctors are always on hand should an emergency such as anaphylactic shock arise, although we have no knowledge of that ever happening, and the facilities we are aware of are closely monitored by the relevant authorities to ensure they are equipped to handle any such eventuality. As practised by the two UK clinics mentioned this therapy is funded by a relatively small number of PCTs and our charity is able to help a few further patients who are unable to avail themselves of such funding and who cannot afford to pay for their treatment, eg. those unable to work; some have already undergone major, unnecessary, ineffective and financially wasteful interventions including surgery such as colostomy and hysterectomy.

There are other medical treatments available, for example Enzyme Potentiated Desensitisation (EPD), as well as some like Nambudripad’s Allergy Elimination Techniques (NAET) which might be regarded more as fringe medicine since practitioners do not have to be qualified doctors, thus reducing their credibility (you don’t need to be a doctor to practise homeopathy or acupuncture either but that does not mean that these have no value, although some would argue that they don’t). Whilst we make no claims in respect of any of these therapies, equally we do not dispute that some people derive tangible benefit from them and there are of course very many practitioners both in the United Kingdom and elsewhere.

As well as treatments it is vital to explore why some people suffer with allergy while others don’t, some environmental triggers such as organophosphates may cause problems even to the healthiest among us, but why are apparently harmless substances such a problem to some and not to others? The underlying reason is likely invariably to be some metabolic failure, everything we eat, drink and breathe in is potentially a poison to us in its raw form, it is only our digestive and immune systems which render it beneficial or at least harmless; as these processes involve just about every organ it’s not surprising that things can easily go wrong. Establishing exactly what has triggered the failure for the unfortunate sufferer must be a priority. For example a permeable gut (more commonly known as leaky gut) will absorb food through its lining and into the bloodstream before it has been fully digested so that the immune system cannot recognise or deal properly with it. Harmful gut flora combined with insufficient good flora can also produce what seem to be allergic reactions, as can deficiency of important vitamins, minerals and amino acids,  and in many cases appropriate supplementation can be of great benefit. Maybe there are  autonomic reasons for allergic symptoms, but while it is easier said than done many potential functional causes need to be investigated. Whether a patient is suffering from true allergy or an intolerance also needs to be established, the causes and therefore treatment may well be different.

The House of Lords report is right in many of its findings and recommendations, but we urge the Department of Health to take a wider view of what is going on. Of course more specialists are required and allergy should be regarded as a mainstream illness, but without a radical re-think of the whole NHS approach it is hard to imagine what these extra people would actually do to relieve the situation. At present the identification and avoidance, through diet, of trigger substances is the main thrust of mainstream advice, which is fine for those with one or two allergies but does not help those who react badly to many foods or unavoidable triggers such as petrol fumes and other airborne allergens. A lot of research is needed into the causes of often slightly irritating, sometimes debilitating, occasionally life-threatening and potentially fatal illness, because even the non-mainstream therapies mentioned concentrate largely on controlling allergy rather than curing it, rather like insulin controls diabetes but does not cure it, and over time the emphasis needs to change.

Of course our charity makes appeals for financial support from many quarters but the most rewarding thing would be for this not to be necessary. In the medium term we don’t expect that to happen but we do exhort the relevant medical bodies to take seriously the conditions we see every day and recognise that there are treatments which can provide relief, sometimes of the last resort, and improvements to the plight of many patients abandoned by the NHS.

It seems unlikely that the House of Lords report will cause the government to look more closely at what needs to be done for allergy sufferers. We predict that nothing will happen, just as nothing has happened in the past, despite the enormity of the problem. The government will not adopt a “back to square one” strategy to come up with solutions and that makes it even more important that what is already being done in this field is used as some sort of basis for moving forward. Effective treatment for allergy is available now, it’s not widely available but investment in the right direction could make it so. We strongly urge that if some of the improvements demanded by the House of Lords report are to be implemented then in the first instance the emphasis should be on development rather than invention. There are pockets of excellence and knowledge in the field of allergy treatment, albeit the results of private investment, which deserve to be seen and heard.