MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

THE TELEGRAPH reported that “homeopathic medicines will escape an NHS prescribing ban even though the Chief Medical Officer Dame Sally Davies has dismissed the treatments as ‘rubbish’ and a waste of taxpayers money.”

But why?

This sounds insane!

Sorry, I do not know the answer either, but below I offer 10 possible options – so bear with me, please.

The NHS spends around £4 million a year on homeopathic remedies, the article claimed. Sandra Gidley, chairwoman of the Royal Pharmaceutical Society, said: “We are surprised that homeopathy, which has no scientific evidence of effectiveness, is not on the list for review. We are in agreement with NHS England that products with low or no clinical evidence of effectiveness should be reviewed with urgency.”

The NHS Clinical Commissioners, the body which was asked to review which medications should no longer be prescribed for NHS England, said it had included drugs with ‘little or no clinical value’, yet could not offer an explanation  why homeopathic medicines had escaped the cut. Julie Wood, Chief Executive, NHS Clinical Commissioners said: “Clinical commissioners have always had to make difficult choices about prioritising how they spend their budget on services, but the finance and demand challenges we face at the moment are unprecedented. Clinical Commissioning Groups have been looking at their medicines spend, and many are already implementing policies to reduce spending on those prescribeable items that have little or no clinical value for patients, and are therefore not an effective use of the NHS pound.”

Under the new rules, NHS doctors will be banned from routinely prescribing items that are cheaply available in chemists. The list includes heartburn pills, paracetamol, hayfever tablets, sun cream, muscle rubs, Omega 3 fish oils, medicine for coughs and colds and travel vaccinations. Coeliacs will also be forced to buy their own gluten-free food.

So, why are homeopathic remedies excluded from this new cost-saving exercise?

I am puzzled!

Is it because:

  1. The NHS has recently found out that homeopathy is effective after all?
  2. The officials have forgotten to put homeopathics on the list?
  3. In times of Brexit, the government cannot be bothered about reason, science and all that?
  4. The NHS does not need the money?
  5. Homeopathic globuli look so pretty?
  6. Our Health Secretary is in love with homeopathy?
  7. Experts are no longer needed for decision-making?
  8. EBM has suddenly gone out of fashion?
  9. Placebos are now all the rage?
  10. Some influential person called Charles is against it?

Sorry, no prizes for the winner of this quiz!

 

31 Responses to Why should homeopathic medicines escape the NHS prescribing ban? 10 possible answers

  • The new figures for the number of items prescribed in 2016 in England, and the cost of doing so, is out today. Homeopathy prescriptions are included. As the Nightingale Collaboration always publish a really nice graph, from the data going back over the last 20 years, I’ll wait for their update but it looks like homeopathy is already removing itself from the NHS without much further help needed by a ban.

    I don’t know if the spend on homeopathy is more than some of the items on the ban list – which would put an end to my theory of course 😉

    Homeopaths are busy celebrating the fact that homeopathy has escaped the ban while failing to notice that its use on the NHS has declined yet again.

    Jo

  • The Royal Pharmaceutical Society continues its two-faced stance. It refuses to discipline pharmacists who practise homeopathy. They even have a past president who is a homeopath.

    https://majikthyse.wordpress.com/2016/12/30/not-my-problem-mate/

  • Well, Michael Gov, in his lying campaign against the EU, did claim that the British are ‘fed up’ with experts. This is where such crowd- pleasing nonsense gets us.
    I see that Trump and his criminal gang are currently setting their own dogs on environmental experts, with even more far- reaching effects.2

    • @Barrie

      “I see that Trump and his criminal gang are currently setting their own dogs on environmental experts, with even more far- reaching effects,” you stated. To which far reaching effects are you referring? Increased jobs for Americans, better financial security for Americans, enhanced use of natural resources so as to reduce further America’s dependence on foreign oil? Have you noticed the US consumer sentiment index has risen more than 10 points(a whopping 12%) since Obama’s last month in office prior to Trump’s election? Of course you haven’t!

      I suggest you split your reading between conservative and leftist news sources and form your own opinions. Simply assimilating spun facts from, in your case, liberal news sources exclusively prevents your acquiring a well rounded knowledge of US policy news.

      Apologies for following Barrie’s lead into an off-topic discussion.

      • what you in the US call ‘leftist’ is in fact simply non-fascist, in my view

      • LB, our new so called authoritarian- prone leader has more nazi tendencies than humanitarian. Financial security, even if partially achieved at the cost of his greed and self idolatry, does not insure security or affluence for most americans but will make the wealthier more prosperous. His so called principles are just as fake and deceitful as all his cons(Trump U.,etc,etc.) and are representative of the same shameful deception as any CAM magician, including those who perform Homeopathy. Like all who voted for him he conned the coal miners as well. As you say, like cures like, so those who con tend to support those who con.

        • Dr. Cox,

          As you might recall, Trump was certainly not my first choice for president. Hillary was and is fatally flawed, and scarred with her corrupt past, as well as her marriage to a serial sex-offender whom she enabled throughout their marriage. Trump won the Repub primary and was the superior choice, IMHO. I fail to see why you believe Trump is autoritarian-prone, save for his campaign promise to defeat ISIS and to support our domestic police force after the community organizer falsely stripped them of collective respect via his and Holder’s implicit agenda to “get back at Whitey” for past injustices committed against our African-American brothers and sisters. What else in his policy makes you think he is an authoritarian?

          Do you have something against a person who successfully acquires wealth? Why? America was built on individual freedoms, ambition, and self-reliance. Should we take care of our disabled, infirm citizens? Absolutely! America has a progressive tax system in which a higher % of tax is glommed from those who earn above certain levels. The top 5% pays 59% of the nation’s fed taxes and the top 50% pays 97%. Is this fair to all? No….but it does help the poor via redistribution of wealth. America has policies in place to help the poor. It appears that you favor further subsidies to some at the expense of others.

          The now-imploding Obamacare scheme is an example of a redistributionist folly hatched by leftists to usurp more control of citizens…and of doctors! It was hatched to have been a first step toward government-run insurance for all. Doctors who clamor for single-payer insurance in America should research well how proficient our government is(not) relative to managing entitlement costs. Without a doubt, such a liberal scheme would put patients’ doctors in proverbial straight jackets regarding many treatment decisions and move those decisions to doctors who work for “big brother.” Witness the ubiquitous Medicaid and VA debacles, both financial and medical, which have been reported. Do legitimate doctors like you really want to spend an hour(or more!) a day arguing for your treatment plan for a routine patient to some government-employed, generic, MD-hack who has never actually practiced medicine because he was unable to get accepted into a residency? Think before you post, Dr. Cox. What you think you desire might actually transpire.

          • let’s be clear: Trump is a thug, nothing less!

          • “let’s be clear: Trump is a thug, nothing less!”

            That’s obvious to anyone who is even semi-conscious, but there’s no evidence. Until there is, those in power, and the fundamentalists, will cling to “there’s no proof” and a lot of people are going to needlessly suffer.

            Seems unnecessarily wasteful, doesn’t it?

      • Curious how close alt med is to alt right. The Nazis liked homeopathy as well.

  • Celebrations? Most homeopaths are not bothered about NHS homeopathy. The Government keeps going on about patient choice so more likely this all comes from patients wanting homeopathy rather than from Prince Charles.
    Any attempt to discipline Pharmacists who practise homeopathy would be met a with a defence using the code of ethics. Easy to defend using patient beliefs. Obviously complaints have been made and the complainants got nowhere. If the Government abolishes all Human Rights then maybe Les Rose can then enforce his will on the public.

    • Actually you’re right, I re-checked and the people celebrating this on Twitter are homeopathy fans, not homeopaths.

      I’m glad that homeopaths have started to be a bit more bothered about the ASA though. It’s encouraging to see that a few have even been removed from their non-compliant online advertisers list after they complied with ASA’s requests to amend misleading information on their websites.

      Jo

    • If homeopaths are not bothered about NHS homeopathy, they must have had time to kill judging by the enormous fuss they kicked up about the Wirral decommissioning. You need to understand what patient choice is. For a start, it has to be informed. Lying to patients about how the body works does not give them informed choice. The originator of evidence based medicine, David Sackett, said that “it is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients”. The best evidence, which means the best quality clinical trials, says that homeopathy is a placebo. Patients are not well served by practitioners who tell them it is effective.

      Curiously the RPS has removed its guidance on homeopathy and herbal medicine. But their code of ethics says:

      “…if a patient approaches a pharmacist for advice on homeopathy, the pharmacist should be able to advise on the lack of evidence on the efficacy of homeopathic products, discuss the formulation and composition of the product, and provide other pertinent advice.”

      So how this can be used as a defence is beyond me, if a pharmacist is actively prescribing homeopathy as well as dispensing it. Neither are patient beliefs on their own any kind of defence. Sackett said that patient beliefs have to be taken into account, but he never said on their own. If a patient says that they believe homeopathy works for them, the ethical pharmacist should say that the evidence contradicts that, and that professional ethics don’t permit patient care that lacks evidence.

      You flatter me if you think this is a matter of will. It is not, it’s a matter of evidence and respect for patients by not misleading them.

      • Homeopaths didnt create a fuss about Wirral- It was local patients that first accounted for 90% positive response. The GTS was canny enough to get lots of responses from London and elsewhere considered. I dont think many homeopaths responded though as there are quite a few of them and as I said they have little interest in this. Jo Brody is looking at a few tweets from homeopathic Tweeting regulars and then thinks that represents interest from lots homeopaths.
        Anyway the GPhC standards of Conduct ethics and Performance states:
        Quote
        3.1Recognise diversity and respect people’s cultural differences and their right to
        hold their personal values and beliefs
        3.2 Treat people politely and considerately
        3.3 Not unfairly discriminate against people. Make sure your views about a
        person’s lifestyle, religion or belief, race, gender reassignment, identity, sex and
        sexual orientation, age, disability, marital status or any other factors, do not
        affect how you provide your professional services
        End of Quote

        It is clear that Pharmacists have to respect beliefs and we are talking about over a million people here. These codes dont really fit in with trying to get disciplinary cases against colleagues who are supplying homeopathy to those members of the public who have made a choice to use homeopathy?
        So Les hasn’t got a hope of getting any complaints against Pharmacists taken seriously .

        • Respect for individual patients’ beliefs does not mean a professional should lie, mislead, and fail to obtain fully informed consent.
          Nor that NHS funds should be used to support a patient’s faith.

          IMHO pharmacists can sell legal drugs, remedies, therapeutic kit to anyone who wishes, but that does not mean they should give inappropriate or false advice about them.
          Caveat emptor.

  • I’ve got another possible reason. Because homoeopathy saves money overall as people are getting it instead of more expensive effective medications. Not good for patient care, but I can see the way some people think.

  • BBC Radio4, TODAY, 31st March 2017 (at 8:25 a.m.).

    Michal Husain and Simon Stevens, CEO NHS England.

    SS: We want to get the maximum value out of the money the country’s investing in the NHS …the paradox is that there is still inefficiency and waste…
    MH: You announced earlier this week a ban on the prescribing of certain medicines, is it true that the NHS is still spending £4M on homeopathic medicines?
    SS: I don’t know whether £4M is the right number, but those would be the classic example of the sorts of things that we want to see less of.
    MH: The Chief Medical Officer Dame Sally Davies has described them as ‘rubbish’. If the NHS is spending any money on homeopathic medicine, is that a good use of money?
    SS: No, I mean, they’re placebo at best.
    MH: So it would be absurd if anybody was prescribing homeopathic medicine.
    SS: In my opinion, yes, I agree with the Chief Medical Officer.

    Mr Stevens must now explain why homeopathic remedies (not ‘medicines’) were not included in his list of banned medicines.
    I am putting up a motion to the BMA Annual Conference (June 2017) on this point.

  • Head of NHS England agrees with the Chief Medical Officer: homeopathy is rubbish.

    Clearly he would like to save every last penny spent on it.

    Perhaps the end is nigh!

    This morning on Radio 4’s Today (from 2.24).

    http://www.bbc.co.uk/programmes/b08k1b4s#play

  • I just found another comment on this subject – by our friends from WDDTY (https://www.wddty.com/news/2017/04/homeopathy-escapes-the-nhs-cuts.html):
    Despite a relentless campaign by doctors, medical regulators and internet trolls, homeopathic remedies will continue to be made available on the UK’s National Health Service (NHS).
    The remedies, which cost the NHS around £4m a year, have escaped the latest round of cost-cutting which has removed heartburn pills, paracetamol, sun cream, omega-3 fish oils, travel vaccines and gluten-free foods from the list that can be prescribed to patients.

    The decision has angered many in conventional medicine, including the UK’s chief medical officer Dame Sally Davies, who has described homeopathy as “rubbish” and a waste of taxpayers’ money. She has been joined in her condemnation by a range of groups, even including the House of Commons science and technology committee, which concluded that NHS funding of the therapy should be stopped.

    Critics have said that homeopathy is unscientific and unproven, but supporters say that good evidence exists for its effectiveness against a range of conditions such as depression. The Swiss health authority has announced that homeopathy is effective enough to be included among therapies that can be claimed under health insurance plans. It will be available, along with four other alternative treatments, from May this year.

  • I am amazed you are amazed!
    WDDTY understand perfectly well – but they are not in the business of obtaining fully informed consent from gullible and vulnerable patients.

    Or were you referring to the ‘Swiss Authorities’?
    They also understand – but are in the business of placating their clients/voters – and how better to placate folk than use placebos!

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