MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The task of UK Clinical Commissioning Groups (CCGs) is to ensure NHS funds are spent as effectively and responsibly as possible. This is particularly important in the current financial climate, as NHS budgets are under enormous pressure. For that reason, The Good Thinking Society (GTS, a pro-science charity) invited Liverpool CCG to reconsider whether the money (~ £ 30,000 pa) they spend on homeopathy represents good service to the public. Recently the CCG agreed to make a fresh decision on this contentious issue.

The GTS would prefer to see limited NHS resources spent on evidence-based medicine rather than on continued funding of homeopathy which, as readers of this blog will know, has repeatedly failed to demonstrate that it is doing more good than harm. It is encouraging to see Liverpool CCG take a first step in the right direction by agreeing to properly consider the best evidence and expertise on this issue.

Supporters of homeopathy frequently cite the concept of patient choice and claim that, if patients want homeopathy, they should have it free on the NHS. The principle is obviously important, but it is crucial that this choice is an informed one. The best evidence has conclusively shown that homeopathy is not an effective treatment, and to continue to offer ineffective treatments under the guise of patient choice raises troubling questions about the important concept of informed choice, and indeed of informed consent as well as medical ethics.

The GTS were represented by Salima Budhani and Jamie Potter of Bindmans LLP. Salima said: “This case underlines the necessity of transparent and accountable decision making by the controllers of health budgets, particularly in the light of the current financial climate in the NHS. CCGs have legal obligations to properly consider relevant evidence, as well as the views of experts and residents, in deciding how precious NHS resources are to be spent. It is essential that commissioning decisions are rational and evidence-based. Liverpool CCG’s decision to reconsider its position on the funding of homeopathy in these circumstances is to be welcomed.

“Our client has also called upon the Secretary of State for Health to issue guidance on the funding of homeopathy on the NHS. Public statements by the Secretary of State indicate that he does not support ongoing funding, yet he has so far declined to ask NICE to do any work on this issue. The provision of such guidance would be of significant benefit to CCGs in justifying decisions to terminate funding.”

Commenting on their decision, a Liverpool CCG spokesperson said: “Liverpool CCG currently resources a small homeopathy contract to the value of £30,000 per year that benefits a small number of patients in the city who choose to access NHS homeopathy care and treatment services. The CCG has agreed with the Good Thinking Society to carry out further engagement with patients and the general public to inform our future commissioning intentions for this service.”

Over the last two decades, prescriptions fulfilled in community pharmacies for homeopathy on the NHS in England have fallen  by over 94% and homeopathic hospitals have seen their funding reallocated. This reduction indicates that the majority of doctors and commissioning bodies have acted responsibly by terminating funding for homeopathic treatments.

The GTS are currently fundraising in order to fund further legal challenges – donate now to support our campaign at justgiving.com/Good-Thinking-Society-Appeal/.

23 Responses to Homeopathy on the NHS: the first legal challenge

  • There are two elements to ‘homeopathy’ which should be considered separately:
    (i) The practitioner and the practice. Style and substance.
    No doubt time spent in a therapeutic relationship with an empathic practitioner helps many patients ‘feel better’.
    They might also feel better if NHS funds were spent on them having a new hairdo, a perfume, a ticket to visit the gardens of Highgrove House. The list is endless, as would be the cost of satisfying these desires.
    These are type I effects due to placebo.
    (ii) The issue for CCGs is whether homeopathic remedies have any type II effects on specific pathological conditions.
    So far there is no evidence they do which is why Dame Sally Davies and others have opposed NHS funding for homeopathic remedies.
    That is also BMA policy, ‘unless and until NICE reports on the cost-benefit’. (Which would require some type II benefit being demonstrated).
    It does not matter how much is spent – no NHS funds should be used without good reason.
    The financial situation may focus attention, but that basic principle is always there.

  • How many other countries fund homeopathy publicly at present? A very brief Google came up with the UK only. Is this true?

    • I know a bit about the situations in Germany, Austria, France, and the US. in all of these countries, the patient would not normally pay for homeopathy out of her own pocket [provided she is adequately insured].

      • In Thailand . Public health ministry has CAM department
        Some research conduct on kindergarden children use homeopathy medicine to fight against Dengue hemorrhagic fever

        • That is an exercise in futility. It is also outrageous that children’s health and lives are put at risk because of nonsensical witchcraft.

      • Only states that mandate payment for AM would pay. Oregon, New Mexico, Washington. There are others, but not yet the majority I believe. ACA may have changed this now I think about it, but again, likely to be state by state.

  • Professor is this insurance publicly funded in the countries you mention?
    In my country (Australia) most private health insurers do provide rebates for homeopathic services but public funds for them are not provided.
    I am curious as to what prevails in other countries.

    • depends; it is different from country to country.

    • “In my country (Australia) most private health insurers do provide rebates for homeopathic services but public funds for them are not provided.”
      And as an Australian, I find this disgraceful.

  • I wonder if the legal challenge to NHS provided homeopathy could be strengthened if comparison with lack of public funding for clinical homeopathy internationally was put forward?

  • Ramen, Plz put also Holy FSMoPathy on NHS charges. It is as good as homeopathy.

    http://fsmosophica.org/fsmopathy

  • You won’t get much out of the secretary of state at the moment, Ed. There is an election on you know and irrational people have votes! I am tempted to say “more the pity” but I might be disenfranchising myself!

  • I hope somebody could investigate and inform what was the Total Budget of Liverpool CCG in the year GBP30000 were spent for Homeopathy and Number of Patients that availed this benefit, compared to the Total Number of Patients handled by Liverpool CCG. Also, instead of Experts making decision and stopping an effective treatment option by conniving with Bureaucracy, Why not contact the Patients who availed this benefit and Let them Have a Say in decision making?

    • Mr. Urslan Hayat said:

      I hope somebody could investigate and inform what was the Total Budget of Liverpool CCG in the year GBP30000 were spent for Homeopathy and Number of Patients that availed this benefit, compared to the Total Number of Patients handled by Liverpool CCG.

      Anyone with the requisite abilities could do that, but if you feel that would be useful, why don’t you do it rather than hoping someone else will?

      Also, instead of Experts making decision and stopping an effective treatment option by conniving with Bureaucracy, Why not contact the Patients who availed this benefit and Let them Have a Say in decision making?

      That begs the question about effectiveness, of course, but rather than making snide and unfounded allegations about connivance, why not try to do some research and find out exactly what this is actually about rather than jump to the (wrong) conclusions?

      • Mr. Alan, As you are an ardent supporter of Pharmaceutical Toxins, your comments do not surprise me. However, my question remains about the Total Budget at Liverpool CCG out of which GBP30000 were spent on Homeopathy.

        Also, Number of Patients which benefitted from Homeopathy as compared to Number of Patients using Conventional Medicine within 1year are still not informed. Answer to both Questions, I am sure Mr. Edzard Ernst knows, but fails to answer. This may show Cost/Benefit relation, effectiveness we should leave for Patients to decide.

        One additional Question for Mr. Edzard is, as he used Homeopathy in the past for treatment of his wife, was it out of Hate or Love?

        • sorry, I do not know the answers to your question. what I do know, however, is that you fail to understand evidence: the answers to your question would contribure very little to the evidence about homeopathy.

        • @Mr Urslan Hayat

          Please try to think critically – however hard you might find that.

        • Urslan, Being opposed to taxpayers i.e. our money being spent on a treatment which is both scientifically implausible and has no robust evidence to suggest it has ever worked better than placebo, doesn’t make one an “ardent supporter of pharmaceutical toxins”. You have never seen Alan promote pharmaceuticals and when you make unsupportable accusations like that, it demonstrates that you don’t have the intelligence and objectivity to discuss topics like an adult. You are simply confirming our expectations of how those with a vested interest in quackery behave.

          Don’t expect anybody here to do your homework for you.

        • I have an effective test for homeopathy.

          Make some homeopathic petrol, put it in your car and see what happens.
          Do feel free to publish the results.

  • It seems to be a clever variation of the famous theme “survival of the fittest”.

    If you give patients the choice (choice between what?), you only distribute a cheaper way of dying.

  • I’m delighted to say that my own local area in the north of England does not fund any homeopathic treatments. Given the dire straits the health budget is in, this surely has to be one of the better decisions they have taken. They have quite a list of alternative ‘treatments’ which they will not fund. Alas, they will fund acupuncture, although they are unable to give me any reason why. I have my own theory on that but it would probably get me a libel writ if I said what it was.

    It often comes as a surprise to people that homeopathy is available on the NHS at all. Most express not only surprise but disgust, if that make anyone feel any better.

    And talking of feeling bettter, I often feel, around the middle of January, that it would be nice if the NHS would pay for a short cruise in the Caribbean, which would get me away from all those nasty winter illnesses. But somehow I think that isn’t going to happen

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