Has anybody noticed the pressure coming from economics? Courses seem to be getting shorter and shorter. The competition is fierce and many people just want the cheapest and shortest they can get.

Of course, whatever discipline we are talking about, you just can't maintain quality if you cut, cut, cut. I agree that it's not necessary to undertake degree courses in every context, something which those running degree courses are going to have to face one day. But there has to be a certain level of quality maintained that the public can recognise or treatments will become ineffective and unsafe.

A colleague recently got back from her annual Chinese hospital visit only to have to report of seeing a patient falling foul from an experienced practitioner. If experienced people can make mistakes (spinal acupuncture in this case) what hope is there that alternative practises can hold their credibility?

Many of us were relieved when Andrew Langley stopped short of imposing conditions on acupuncture, but that's because it would take people from the discipline to decide on what regulations make sense.

This doesn't mean the biggest players, it's a fact that there are no government recognised bodies - it is actually whether or not organisations can recommend people for insurance that counts. The biggest and the smallest have nothing to declare as an advantage in this respect.

I'm afraid that I personally cannot see how the march of economics can be slowed down. Bodies like the Acupuncture Stakeholder Group (ASG) should possibly be charged with some responsibility for shaping policy, after all, who else can be trusted?

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