NHS Lothian’s decision to withdraw funding for homeopathy is a slap in the face for the patients who attended the public meetings during the health board’s “consultation” and who were overwhelmingly in favour of retaining the service.
The scant regard Professor Alex McMahon and his colleagues have given to the views of patients appears to be the antithesis of current thinking within the NHS on how to improve healthcare provision.
Don Berwick, the health quality expert brought in by the government to deal with problems following the Mid-Staffs debacle, has stated that the way to improve quality in health care is to put the patient, their family and their community at the absolute centre of all decision making. His simple suggestion – to ask the patient: “What can I do for you today?” Then quietly listen to what they have to say.
NHS Lothian, however, prefers to base its decisions on the results of an online survey, which by its own admission, anyone from anywhere could respond to and claim to live in Lothian.
On learning of the health board’s online survey, those opposed to homeopathy were exhorting their supporters, wherever they lived, to complete the questionnaire.
This led to the results being skewed and unrepresentative of the views of local people.
Is this putting patients and the local community at the centre of all decision making?
It is often stated by those opposed to complementary medicine that there is no evidence supporting the efficacy of homeopathy as a medical therapy. This simply is not true. The balance of evidence from clinical trials and patient reported outcome studies shows there is a therapeutic benefit from using homeopathy to treat certain conditions.
The BHA accepts this is not conclusive evidence of efficacy, but homeopathy is not the only medical therapy where this is the case. The BMJ has published an evidence check of 3000 therapies used in the NHS and found 50 per cent had “unknown effectiveness”. Will NHS Lothian be withdrawing funding for these therapies too?
To axe the homeopathic service on economic grounds makes no sense either, for patients currently receiving homeopathic treatment are not going to disappear. Many of them have chronic problems and have found help from homeopathy after undergoing a series of costly conventional treatments that have failed to provide relief from their symptoms.
Withdrawing funding for homeopathy will inevitably result in an increase in GP appointments, referrals to secondary care services and prescribing costs for conventional medicine – a strange approach to making the health service more cost effective.
To tell patients receiving homeopathic treatment that it has been decided that their choice of treatment, although prescribed by a medical doctor, is a bad one and will be denied them, is autocratic and not centred on the patient, their family or their community.
Is this the new NHS? Highly paid health service managers telling patients to give up their right to make decisions about their own health care choices, and instead defer that responsibility to opinion polls, the results of which have been influenced by people from outside the community.
If so, then it is not only homeopathy that is at risk in Lothian.
John Cook is chairman of the British Homeopathic Association