Monday, 24 July 2017

Banning Homeopathy on the NHS

There is (yet another) move to ban doctors prescribing homeopathy on the NHS in England. For many of us who appreciate the effectiveness of alternative medical therapies, and homeopathy in particular, and know about its safety, such attacks will not come as no surprise! The NHS has, over the years, become the mouthpiece of the pharmaceutical industry. The NHS is Big Pharma's preferred contact with patients. It serves as their retail outlet, par excellence, the source of their mighty profits in Britain.

The news was extensively covered in the mainstream news media throughout the weekend of 22nd-23rd July 2017. The doctor's e-magazine Pulse announced it with this headline, and discussed the possibility with no great regret!

So what should our response be? The growing homeopathic community is gearing itself up for another battle with the conventional medical establishment. Yet, I am going to raise an important question - is it really worth it? One radical response might be just to go along with the suggestion, and decide to withdraw homeopathic services from the NHS! 

              One advantage would be that it would help the public understand that the NHS has positioned itself as a monopoly supplier of conventional medicine, and it would ditch the pretence that an important NHS objective is to provide patients with the 'best medicine available'! 

               Another would be to end the pretence that homeopathy had anything more than a tiny, minuscule presence within the NHS in any case!

               Another would be to disabuse those patients who currently believe that if homeopathy could help them their doctor would recommend it and refer them on. The reality is that they don't, they won't, and the can't!

So perhaps the time has come for alternative medicine to establish itself as an alternative source of medical assistance, with alternative outlets, and to demonstrate that it is something quite different and separate to what is available on the NHS.

The thousands of patients who have benefitted from homeopathy might disagree vehemently with such a suggestion, especially those who would be unable to afford treatment outside the publicly-funded NHS. But the reality is that very few people, in very few areas of England, have any access to NHS homeopathy whatsoever. In London and Bristol there are small homeopathic hospitals. If someone is lucky, very lucky, they might have a doctor in a local surgery who practices homeopathy alongside conventional medicine. But most patients (like myself) live in areas where there is absolutely no access to homeopathy whatsoever, or to any other kind of alternative therapy. And if we ask the NHS for anything other than conventional treatment, it is routinely refused.

Another reason to withdraw homeopathy from the NHS, for me, would be that no reasonable or rational argument will ever suffice to persuade the conventional medical establishment of the case for homeopathy. This becomes clear if we look at the reasons NHS England is putting forward to ban homeopathy. This is contained in an NHS England consultation paper. The question it seeks to ask and answer is this:

               "Approve formal public consultation on products which are considered to be relatively ineffective, unnecessary, inappropriate or unsafe for prescription on the NHS."

Initially this question was asked because of the large number of pharmaceutical treatments that conventional medicine itself know to be ineffective, including drugs like paracetamol, tramadol, co-proxamol, dosulepin, prolonged-release Doxazosin, immediate-release Fentanyl, Glucosamine and Chondroitin, travel vaccines, and several others. Yet these treatments are still being prescribed by doctors. The reason for the consultation exercise is outlined in the NHS paper.

               "Last year, 1.1 billion prescription items were dispensed in primary care at a cost of £9.2billion. Over 90% of prescriptions currently issued are exempt from a prescription charge. It is vital that the NHS achieves the greatest value from the money that it spends, and we know that across England there is significant variation on what is being prescribed and to whom. Often patients are receiving medicines which have been proven to be ineffective or for which there are other more effective and/or cheaper alternatives, and products which it may no longer be appropriate to prescribe on the NHS."

This appears to be a perfectly reasonable thing to do! It is quite right that NHS England should not be spending public money on ineffective (leave along harmful) pharmaceutical drugs. They are the drugs that conventional doctors have been prescribing for decades, at great cost, and belatedly found to be ineffective and useless for patients.

Homeopathy, and herbal treatments too, were added as an after-thought! The NHS knows little about these therapies, as they demonstrate with the two reasons given for their inclusion: homeopathy is ineffective - and homeopathy costs the NHS a lot of money.

               "NHS England’s view is that, at best, homeopathy is a placebo and a misuse of scarce NHS funds which could better be devoted to treatments that work."

Let's examine both reasons. First, what evidence does NHS England use to demonstrate that homeopathy is 'ineffective'? They provide none, other than 'their view', stated in the sentence above, that homeopathy is 'placebo'. Is it just me, or is anyone else fed up with this particular mantra?
There will almost certainly be a vigorous response from the homeopathic community to the new attack by NHS England, no doubt the most forthright coming from ARH itself. The responses will repeat all the evidence we have used, time and time again, to demonstrate that homeopathy is a safe and effective medical therapy. But will our response have any effect on our detractors, or the conventional medical establishment generally? Or in a few years hence will we be faced with another attack that states, without any supporting evidence, that homeopathy is 'just placebo'?

And so to cost. We are now told that homeopathy costs the NHS a lot of money, which is better spent on 'treatments that work'! So how much money is this exactly? The NHS paper is able to tell us, at least vaguely and tentatively!

               "Data on the residual use and cost of homeopathy on the NHS are hard to come by. A recent Freedom of Information request by a third party suggested that at least £578,000 has been spent on prescribed homeopathy over the past five years, with the total cost being higher than that when the cost of consultations was factored in."

If these figures are anywhere near correct, it means that NHS England is spending about £115,600 each year on homeopathy! Let me remind you about the figures (already quoted above from the consultation document) about the money NHS England wastes on 'ineffective' treatments!

               "Last year, 1.1 billion prescription items were dispensed in primary care at a cost of £9.2 billion." 

Of course, I assume (to use their own words) that this total cost will "be higher than that when the cost of consultations are factored in"! So, ignoring the issue of consultation costs, NHS England is concerned that homeopathy is costing them 0.001257% of their total drugs budget. (Now, is this right, I have struggled with these figures, one being so high, the other so minuscule! Anyone who wants to correct this, please do contact me!)

On the other hand, the NHS England consultation document is 9 pages long, and one entire page is devoted to its dismissal of homeopathy; that is, it takes up 11.11111% of the document!

So after these two considerations, the fundamental question is this - is there really any point in engaging such people in discussion? Is it not a waste of time and energy? Will they listen to anything we have to say? Is their stance so rigid, so dominated by the self-interests of their failing medical system that whatever we say will be ignored? 

Call me irascible, call me intolerant if you will, but I have long since ceased engaging with medical fundamentalists, so-called skeptics, who are not prepared to say anything beyond what the pharmaceutical industry wants them to say!

Does the homeopathic community not have better ways of spending their time? Homeopaths are treating so many more patients now who have been damaged by conventional, drug-dominated, NHS medicine. At the same time conventional doctors are having a bad time finding anything that is safe, or effective, to prescribe to their sick patients. The NHS itself is in constant crisis, with patients who do not get better, with a wide variety of chronic diseases now at epidemic levels, and paying for treatments that are slowly bankrupting it.

So my question is - why do we not let them get on with it? Let the NHS fail, as it inevitably will, alongside their painkillers which are now accepted as too dangerous to prescribe, their antibiotics which no long work, and all their other drugs that are causing epidemic levels of chronic disease with which they cannot cope!

Homeopathy will survive without the NHS. But the NHS will not survive without homeopathy, or indeed without other safe and effective alternative therapies.

So my suggestion is that homeopathy leaves the NHS. It is not a silly idea. Indeed, it is an eminently practical one. It will mean that we will need to develop our organisational structure. In each city and town, in every area of the country, we will have to ensure that there are alternative medical clinics, quite separate and distinct from conventional doctor's surgeries. Each clinic will have important tasks to undertake.
  • Each one will need to show they are offering something different, at a time when many more people are looking for alternative treatments for their chronic illness. 
  • Each one will need to demonstrate that they are effective in treating all kinds of illness, at a time the NHS failing to do so, and is therefore quite unable to cope with patient demand. 
  • Each one will need to demonstrate that they are offering safe medical therapies, when so may patients are currently suffering the chronic side effects of pharmaceutical drugs and vaccines.
Initially, those people who cannot afford to pay for alternative treatment will be excluded as alternative medical centres will not be publicly funded. Sadly, the safest and most effective treatments will be available only to those who can afford to pay, something I would personally regret (but it is not far from the current situation anyway). Perhaps for a time 'low-cost' clinics can be set up to ameliorate the situation. Perhaps we could look into starting up some kind of alternative insurance scheme. 

Yet this is likely to be a temporary problem. As the NHS runs out of viable treatments; and public money to pay for these treatments; and as more and more patients are empowered to insist on having patient choice, the demand for safer and more effective treatment will ensure that the demand for homeopathy, and other alternative treatments, will increase. When this happens, the NHS will not be able to avoid referring sick patients, for whom they have not treatment, to alternative clinics, and paying for doing so.

So perhaps it is time that homeopathy decided to stand alone. Instead of waiting to be banned, we should withdraw. We have survived for decades without the support of any appreciable public funding, and what is more, we have done so when conventional medicine has been given to patients, free at the point of need, and during the decades drug companies have been telling us that they had 'wonder drugs', the 'miracle cures', that would end illness and disease forever.

Well, why don't we just let them get on with it?