Friday, 13 October 2017

Homeopathy, the NHS, and Patient Choice

The conventional medical establishment is moving to ban all homeopathy from the NHS in England. They are doing so NOT because homeopathy is a danger to patients, like pharmaceutical drugs and vaccines; NOT because homeopathy cannot make patients better; NOT because patients do not want to use homeopathy for their illnesses. It is doing so purely and simply because the NHS, and the conventional medical establishment that controls it, has been captured by the pharmaceutical industry. They want to kill patient choice and health freedom.

To allow homeopathy on the NHS could lead to comparisons which conventional medicine has always found awkward. Why don't their drug treatments work? Why is the NHS in constant crisis? Why do homeopathic 'sugar pills' have such a wonderful effect? Why do patients continue to see homeopaths when they have to pay for the treatment?

It's not that homeopathy costs much, or that the NHS spends a lot of money on homeopathy. In a previous blog, Banning Homeopathy on the NHS, I calculated that homeopathy constituted just 0.001257% of the total NHS drugs budget.

This blog, written on 24th July 2017, outlined what the NHS were doing. It mentioned a petition to the government in support of homeopathy. In the blog I questioned whether homeopathy needed a place within the NHS. After all, it is not where most homeopathy is practiced in Britain. But the petition to government was well supported, and now the Department of Health has responded to it. I am reproducing that response here, commenting on what it says, and the government's position.

               "It is for local NHS organisations to decide on the commissioning and funding of these healthcare treatments. NHS England’s consultation on low value prescription items includes homeopathic treatments."

It would seem that Pontius Pilate rules within the Department of Health! It's nothing to do with us, guv'! We wash our hands of the whole thing! But can they do this without abandoning a key element of the government's policy on health? Read on.....

               "Information from NHS England (NHSE) shows that in 2015, the cost for all prescriptions dispensed in primary care, not including any dispensing costs or fees, was £9.27 billion, a 4.7% increase on the previous year. Due to the increasing cost, NHSE is leading a review of medicines which can be considered as being of low clinical value and develop new guidance for Clinical Commissioning Groups (CCGs). "

Yes, yes. The pharmaceutical drugs bill IS enormous, and the government does need to control it. But that has nothing to do with homeopathy, and the 0.001257% of that budget spent on homeopathy will not have gone up!

               "On 21 July, NHSE launched a three month consultation on the draft guidance on low value prescription items which is based on the latest clinical evidence, including that from the National Institute of Health and Care Excellence (NICE). Careful consideration has been given to ensure that particular groups of people are not disproportionately affected, and that principles of best practice on clinical prescribing are adhered to." 

The NHS regularly conducts these 'consultation' exercises when they are proposing to close down homeopathic treatment within the NHS. They did one prior to closing the homeopathy hospital in Lothian in 2014. A large number of patients, and former patients, spoke highly of the facility, and wanted it to continue. But NHS consultation is not about patients, it is about the vested interests of the conventional medical establishment, and their masters, the pharmaceutical industry! It was closed.

               "The commissioning guidance, upon which NHSE is consulting, will be addressed to CCGs to support them to fulfil their duties around the appropriate use of prescribing resources. This will need to be taken into account by CCGs in adopting or amending their own local guidance to their clinicians in primary care."

Most CCG's (Clinical Commissioning Groups) do not spend money on homeopathy, they have long since 'banned' it from the services they offer to patients in their area. This consultation is about preventing the remaining few CCG's from spending money on homeopathy.

               "The aim of this consultation is to provide individuals with information about the proposed national guidance and to seek people’s views about the proposals. NHSE welcomes the views of the public, patients, clinicians, commissioners and providers through this consultation process to help inform the final guidance. The consultation ends on 21 October. Links to the consultation can be found here: https://www.england.nhs.uk/2017/07/medicine-consultation/ and 
https://www.engage.england.nhs.uk/consultation/items-routinely-prescribed/

I am delighted that the Department of Health welcomes people's views! It is a question about whether minority views will be listened to, or whether instead the NHS will go further down the road of mono-medicine, that is, a 'one size fits all' health service, on the basis that if pharmaceutical drugs and vaccines are good enough for most people, they are good enough for everyone.

               "It is the responsibility of local NHS organisations to make decisions on the commissioning and funding of any healthcare treatments for NHS patients, such as homeopathy, taking account of issues to do with safety, clinical and cost-effectiveness and the availability of suitably qualified and regulated practitioners. "

Okay, well homeopathy complies with all that.

  • Homeopathy is safe (indeed, it is demonstrably safer than the conventional treatments that currently dominate the NHS). 
  • Homeopathy has been part of part of the clinical practice of the NHS since 1948, and to my knowledge its clinical practice has never been brought into question.
  • Homeopathy is cost-effective, consisting of a modest consultation fee, and the modest cost of homeopathic remedies.
  • Homeopaths, suitably qualified and regulated, are available throughout England, and the rest of the country (see the 'Find A Homeopath' website).

               "Complementary and alternative medicine (CAMs) treatments can, in principle, feature in a range of services offered by local NHS organisations. A treating clinician would take into account an individual’s circumstances and medical history in deciding what would be the most appropriate treatment for their condition. CCGs will have specific policies on the commissioning and funding of CAMs, and may have also developed local policies on priorities with regards to the funding of treatments. A GP would have to work within such policies in providing any treatments on the NHS."

Now, this is where government policy comes in, something that this Department of Health response seems to totally ignore. Note in the above response that treatments available to the patient are to be determined by the 'treating physician, who will decide "what would be the most appropriate treatment for their condition". Then cast you mind back to 2010, and the new government's White Paper. It made an important policy decision, easily reproduced here.

"No decision about me without me" 

Just a few simple words, but with massive meaning. They do NOT mean that the 'treating physician' will decide on 'the most appropriate treatment'. It puts the patient at the centre of treatment decisions. And many patients, including myself, will always choose homeopathic treatment rather than the pharmaceutical drugs and vaccines routinely handed out by the 'treating physicians' of the NHS.

So the government, and the Department of Health in particular, needs to decide what it's policy is, and if it seeks to place the patient at the centre of decision-making, central government cannot wash its hands of decisions that will only reduce and restrict patient choice. Not, at least, without admitting that it no longer believes in patient choice; or without making 'patient choice' part of the 'proposed national guidelines' which will inform CCG's in coming to their decision.

               "The Department of Health supports an approach to evidence-based prescribing which does not support the commissioning of services which are not clinically and cost effective. We are not aware of any evidence that demonstrates the therapeutic effectiveness of homeopathic products. The National Institute for Health and Care Excellence (NICE) does not currently recommend that homeopathy should be used in the treatment of any health condition, whilst primary care prescribing data shows that there has been a significant decline in the prescribing of homeopathic products over the last 10 years. Furthermore, a good number of NHS organisations are reviewing their funding of homeopathic treatments and some have already stopped funding such treatment altogether.

Here, at last, is the real position of the Department of Health.

Yet, look closely at all these people and organisations brought in by the Department of Health to decide what patients can, and cannot have in terms of medical treatment within the NHS.

  • the treating physician
  • CCG's
  • the evidence base of medical science
  • NICE

So is the patient in this brave new world of NHS reform? Are we moving, ever closer, towards "No decision about me without me"? Or is patient choice dead? Is the concept of health freedom something quite foreign to the Department of Health?

This response only reinforces my belief that patients are going to need an alternative health service, one that is populated by homeopaths, naturopaths, herbalists, acupuncturists, reflexologists, and other alternative therapists, one that is quite separate and distinct from the NHS. Why?

Conventional medicine is failing - fast. Doctors can no longer prescribe painkillers safely. There is an 'Antibiotic Apocalypse' on the way, according to the Chief Medical Officer. Benzodiazepine drugs are an ongoing disaster. Antidepressants and antipsychotic drugs are no better. So many pharmaceutical drugs are on the way to being withdrawn and no new drugs are coming through the pharmaceutical pipeline. The NHS is in constant crisis. It cannot recruit enough doctors, who cannot afford to pay their indemnity insurance for the damage their treatments cause to patients. And, on the other side, an ever-increasing number of patients are realising that the drugs and vaccines the NHS are handing out are harmful - patients are becoming resistant to them, and this will only get worse.

So let the NHS go. Let conventional medicine monopolise it, and allow it to fail alongside the pharmaceutical drugs industry. This particular patient may shed a quiet tear, the end of a socialist dream, making the best medicine freely available to all. But the NHS is no longer about patients, or patient choice, or health freedom, the things I care about. It operates for the drug companies that control it. So good riddance, and long live the medical therapies of the future.