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From The Times

May 23, 2007

Hard-up NHS trusts cut back on unproven homoeopathy treatment

Mark Henderson, Science Editor

NHS report on the commissioning of homoeopathic services

The NHS is turning its back on homoeopathy and other unproven alternative medicines in the face of a financial crisis and pressure from doctors.

More than half of the primary care trusts (PCTs) in England are now refusing to pay for homoeopathy or severely restricting access a year after The Times revealed that 13 senior doctors had urged them to fund only therapies that were backed up by scientific evidence.

Figures obtained by Les Rose, one of the doctors, and The Times under the Freedom of Information Act show that at least 86 of the 147 trusts have either stopped sending patients to the four homoeopathic hospitals, or are introducing strict measures to limit referrals. Another 40 trusts have yet to provide data. More than 20 have taken action since receiving a letter organised a year ago today by Professor Michael Baum, a cancer specialist at University College London, which argued that “unproven or disproved treatments” such as homoeopathy and reflexology ought not to be available free to patients.

The NHS should not be funding such therapies while it had to refuse or ration access to effective cancer drugs such as Herceptin and Velcade, the authors said. Financial issues have also contributed to the trend. The NHS overspent by £547 million in 2005-06 and many trusts have made savings on homoeopathy to avoid cuts.

The move away from homoeopathy has been so significant that two homoeopathic hospitals are threatened with closure. West Kent PCT is consulting over plans to shut Tunbridge Wells Homoeopathic Hospital and the Royal London Homoeopathic Hospital (RLHH) has asked supporters to lobby trusts and MPs.

London trusts have been particularly tough, partly as they have had to reduce some of the largest deficits in the country. Six trusts, including some of the RLHH’s most important financial backers such as Barnet and Islington, have introduced referral management systems that will restrict spending.

At least ten more from London and southeast England have cancelled their contracts.

Homoeopathy involves treating patients with substances that have been diluted so many times that there is often no active ingredient left. It is popular with members of the Royal Family but derided by most scientists. Research suggests that it has no benefits beyond being a placebo.

Doctors behind the original letter sent a second document to PCTs yesterday, providing a sample commissioning paper that many trusts have used to reduce homoeopathy funding.

Gustav Born, Emeritus Professor of Pharmacology at King’s College London, its lead author, said: “Progress has been slower than we’d like and there are still trusts that continue to use these unproven remedies through clinics and prescriptions. That is why we have written again to all the PCTs urging them to follow the commissioning example set by others.”

Hilary Pickles, director of public health at Hillington PCT, said: “It isn’t just that there is no evidence base for homoeopathy; it is also a question of spending priorities. Every time you decide to spend NHS money on one thing, something else is losing out. It is completely inappropriate to spend money on homoeopathy that is unproven, as it means less money for other treatments that are known to be effective.”

One person who could benefit from a switch is Anne Fleming, 58, who had multiple myeloma diagnosed 2½ years ago. She has been told that she will need treatment with Velcade, an anticancer drug that costs up to £25,000 for eight cycles. Her primary care trust in South Cambridgeshire has diverted funds from homoeopathy to conventional medicine.

She said that the NHS should also abandon non-essential treatments. “I feel very strongly about using public money on tattoo removal. Things on the national health should be about life or death,” she said.

I'm a registerd nurse in the US. Several years ago, my 1 year old daughter developed eye fluttering with unresponsiveness. The number of episodes per day began increasing to about 15 episodes within a half hour. I took her to specialists at the Children't Hospital of Philadephia and then took her to a board certified neurologist who practiced homeopathy. The doctors at CHOP wanted to put her on anticonvulsives without a definite diagnosis. The homeopathic doctor wanted to put her on a rotational diet and supplements and treat colds, ear infections, etc. with homeopathic remedies. I went with the more natural approach. Within 1 month of using alternative treatments, my daughters eye fluttering and ear infections decreased dramatically. Six months later, she was episode free and has been for over a year and a half. I wouldn't have believed that homeopathic medicine would work, but I am now an advocate of it.

Penny Fatato, Exton, USA/Pennsylvania

This debate is crazy - its science vs emotive opinion.

Andrew Dempsey, Edinburgh,

My husband was told by an NHS doctor that there was no option to deal with his piles except surgery. I took him to the lead doctor at the Outpatients at the Royal Homeopathic Hospital at the time (Dr June Burger) With her prescribing, the problem sorted within 10 days and has never recoccurred.

I have also observed a remarkable case of homoepathy where a man, suffering from severe migraine headaches, in the middle of an attach, with swollen red eye, water pouring out of his eye and nose, almost paralysed with the pain, was administered one homeopathic dose by my lay homeopath. Within 3 MINUTES, the redness and swelling had subsided, the water stopped, the headache gone. Even the homeopath expressed her gratitude at seeing such a profound change, saying that it was good for herself to see the beneficial effects of homeopathy at work. She and others are currently running a homeopathic program in Africa, with very obvious & profound beneficial effects on the people treated.

Deborah Laycock, London,

i wrote a very long response to this article which disappeared into the ether.........................one of the points i was making was:
people who make stock comments like some of the above, who believe homeopathy to be pure placebo, or that it isn't proven, have obviously never looked into the history of homeopathy and are just making the usual bland remarks uttered out of the mouths of the ignorant !
Just off home on the old broomstick now Jennifer Hynes of Plymouth and may just be casting a spell on you so watch out!!!

jayne, lancashire,

I am a total cynic, but have been treated at a Homoepathic hospital as an outpatient for some years, and as in patient at the start of the treatment. The patients on wards were extremely ill, had been through most of what allopathic medicine had to offer and found it lacking, but homoepathy made a difference. Without treatment there many were totally reliant on nursing and hospital care to go about their daily 'lives', so I'm not convinced that removing this option would actually total cut costs. There is a particular case for offering homoepathy to people with mental health issues because the 'diagnosis' and 'treatment' with drugs and ECT is far from an exact science! Many people choose alternative therapies rather than anti-depressants and other drugs (which we already pay a fortune for and I'd put money on the expenditure rising if homoepathy is removed from the NHS). Finally, there is more to research than a RCT (an RCT very often sponsored by the drug companies!)

Elizabeth Smith, Norwich, Norfolk

the pharmacutical companies do not possess the answer to people's disease - i watched my friend slip away as she was administered more and more drugs for her lung cancer and the side effects of these drugs. At one particular point the nurses could'nt figure out which drugs to give her - as these NHS nurses argued between them they did'nt see how distressed she was at their confusion - it took my intervention to point out to both of them that they had forgotten all about the patient !

v.woolley, surbiton, surrey

If the NHS want to cut expenditure, a better stategy would be to reduce the number of prescriptions for expensive and often risky drugs.

Homeopathy is an effective, safe and low cost option that needs to be encouraged. It is also a treatment regime that encourages holistic thinking with regard to health and often leads on to life style changes that benefit the patient in the long term.

Steve Parker, Leeds,

The NHs need to look at all the inefficient and ineffective treatments they provide under the guise of scientifically tried and tested medical practice, not to mention the waste, referrals to colleagues when not entirely necessary etc. I do agree that cosmetic type interventions should not be provided on the NHS however. As stated previously many alternative remedies are known to be very effective and some of our most effective drugs today have herbal medicine at their origins. I use homeopathy all the time at home wiith my family and have saved the NHS thousands of pounds by doing so. All this type of action does is give more power to the massively rich and influential drug companies and the old boys network of consultants who want to retain power and influence . What are the true motives (and funding streams) behind this particular agenda. As usual the NHS respond by making knee jerk reactions which leave the public to miss out .What price "patients choice....?".

Suzanne, Hertfordshire,

It's all very well saying that homoeopathy is an 'unproven' therapy, but has anyone asked those people who have been treated successfully at the homoeopathic hospitals how they feel about it. Too much emphasis is put on those cases which haven't been successful for whatever reason. We are living in a world where people thrive on the failure of others and it simply isn't good enough. I maintain that these highly paid professors and people who are continually disparaging about homoeopathy are feeling threatened by its capabilities. They are not willing to look at objectively because they are scared that it might actually be a legitimate option for millions of people. It is common knowledge that many pharmaceutical companies govern the medical profession to some degree or another and that homoeopathic medicine would never make as much money as orthodox drugs. But the other thing to remember is that these orthodox drugs always come with a selection of often harmful side effects.

Zoe Cook, Somerset,

Many people feel that alternative therapies, including homoepathy, do work although there is no scientific evidence for it. I would like to recommend everybody to read 'Why Bogus Therapies Seem To work' by Barry L. Beyerstein. You can find it here: http://www.csicop.org/si/9709/beyer.html
Beyersteins point is that there are many reasons why people FEEL that bogus therapies work, although they don't. It's very interesting.
I can also recommend www.quackwatch.org.
My boyfriend has been diagnosed with incurable follicular lymphoma and I am shocked to find out how many people are ready to exploit our vulnerable position by offering all sorts of expensive herbal extracts and strange therapies. I think it's deeply unethical to take desperate people's money without being able to present any scientific evidence. People who are sick will do anything to get better - even if it means spending every last penny they've got. A lot of quacks seem to know that.

K, Copenhagen, Denmark

i pity the NHS..who cares for ur peanuts of a fund ..homoepathy is the truth and will flourish for the benefit of mankind.gustav born may be funded by the paharma mafia..i repeat mafia..but the mi9llions of peop[le who have been benefitted by this wonderful system of medicine shall vote and vouch for it..i once again pity NHS and proff gustav..i request him to have a peep at any basicv level hospital and to study before scorning..such foolish remarks dont suit a profeesor..pity him thy lord

sankara narayanan, kerala, india

I am so lucky to have retired to France at a time when I was in need of help
With the deaths of four members of my family in three years my moral was down and all sorts of side effects of depression and failure to cope presented themselves physically as well as mentally

I found that i was required to register for a docter under the new rules to benifit for the refunds from treatments and visits
I was amazed to find that both general and homeopathic docters are eadily available and the pharmacys have large homeopathic sections

No one finds it strange to choose this type of medcine and it is refunded both by the state and my mutual insurrance

I have been very pleased with the results and hope that in England too poeple will continue to have the choices of treatment

susan lunt, lunel, france

My heart sunk when reading this article. I am doing my internship in Ayurveda in a Ayurvedic hospital in India. Ayurveda is definatly not alternative in India, nor is Homeopathy as far as I know. I have had first hand expirence of Homeopathy working for me through out my life and heard only positive things, and am seeing incredile resluts in the Ayurvedic hospital. I feel this article is unfare and inacreate. The most powerfull and expensice medicines in Homeopathy are the most diluted! I would hope that some writing for the times wouldn't have made a mistake like that. The whole aritlce is a good example of the closed minded Modern perspective that doesn't realy have a welcoming atitude to anything that is not made in a laboratory and with a name that is virtualy unprouncable.

George Harris-Jones, Mangalore, India

Doctors and nurses, not charlatans and witches!

Jennifer Hynes, Plymouth, England

'Science' is an interesting subject. Over the centuries it has changed beyond all recognition. What is science today will be tomorrow's mumbo-jumbo. I was led to believe that there is no 'cure' for cancer - so why spend huge amounts of money on poisons that are supposed to prolong life with whatever noxious side-effects they produce?. Why not invest in treatments which help with the quality of life, such as Reflexology and Aromatherapy, which are currently offered by volunteers in hospices. Okay, there is no 'science' to back them up, but ask those who are in receipt of these treatments what benefits they bring. What has happened to a patient-led NHS? Can I stop my contribution to it please as it is not offering me the CHOICE I am supposed to be entitled to?

Liz Flynn, Exmouth,

Homeopathy is extensively used in the veterinary world (not all Vets agree that it works but many do and there are many Homeopathis Vets). So if, as many sceptics say, it is only a placebo, then how do you explain the fact that it works so well for animals. I have used homeopathy and also a homeopathic vet. for over 30 years. So many times I have recommended desperate owners of small and large animals to go to the homeopathic vet. and I have seen many remarkable results. As one homeopathc vet. said to me, "We often refer to ourselves as TEATH - Tried Everything Else, Try Homeopathy". It works, believe me.

Helen Found, Brighstone, Isle of Wight, United Kingdom

NHS and HOMOEOPATHY
Homoeopathy has been efficaciously used for thousands of years. Allopathic medicine for barely 100 has deleterious, long-term effects on the body. Just read the contra-indications. The reason fewer people go to homoeopathic hospitals is because the present Government has instructed the PCT to REFUSE patients access. More GPs are learning that drugs merely poison the body; so the pharmaceutical industry has put pressure on the Government who have shares in their motivated-by-profit companies, to suppress traditional healing. I do not take drugs and my GP asked the local PCT in Fulham to refer me to London University Hospital because of chronic ME. There was no debate and the letter came back from PCT: "The PCT does not currently commission first out-patient attendances for clinics where the treatment is intending to use homoepathic remedies and we have advised the hospital not to accept new referrals from H&F PCT GPs for homoeopathic services.

Dawn Adrienne Taylor, London,

Quite right too. When will people and in particular politicians face up to the truth that we cannot go on funding everything and anything health related making it free at the point of use? Lifestyle treatments, fertility treatments, tattoo removal etc are things that are unnecessary and often down to individual choices. Cancer is not. Let's get some realism and make the NHS about saving lives.

Paul Owen, Birmingham, UK

Bad idea. There is no drug cheaper than water, nor any with fewer side effects. Most patients will get better anyway and are basically wasting the doctor's time. So packing them off to the homeopath is the right solution.

Malcolm McLean, Bradford, UK

I trust that all the people shouting for firm proof that complementary theapies work.....don't advocate belief in any kind of God?
Unless The rest of us have missed some undeniable 'proof' of 'God's' exisance ..?

Holisticplace, Andover, Hants., England

Homoeopathy is the only thing that helped my wife's eczema. I have known remarkable healings effected with it, and it hurts no one, unlike many pharmaceutical products. Arnica is a wonder for the dentist. Indeed I recently endured a bone marrow depression with my orthodox thyroid medication and many other side effects. Choice counts for so little in reality. And large drug manufacturers count for so much. Do the university staff complaining receive large grants from the pharmaceutical industries? Have any tried homoeopathy or perhaps Chinese Traditional Medicine, which has helped me so much too? Placebos are in fact quite effective, and make some clinical tests difficult. Testing a homoeopathic remedy against a placebo is an unsatisfactory way of proving its effectiveness. Both may be helpful. Is there some harm in this?

John Souttar, London, UK

Homeopathy proved more effective to my health than the poisons prescribed by the NHS.
Doctors are not practicing medicine now but instead are prescribing dangerous drugs with many and varied dangerous side effects.
It would be interesting to find who is behind this attack on alternative medicine.

Jim Gilmer, Clydebank, Dunbartonshire

This is a very sensible decision. Homeopathy and other forms of alternative medicine have no scientific basis, and any benefits they offer are merely the psychosomatic benefits of placebo therapy. The NHS should not waste money on these practices.

Dr Thomas Mathews, Ely, Cambridgeshire, U.K.

Denis MacEoin is so right in what he says. He summarised the position so clearly.

I would far rather put my trust in alternative/complementary medicine to heal me than in drugs that could make me ill and undermine my immune system. A significant number of admissions to hospital are because people have been made ill by the drugs they are taking.

Stella, Knaresborough, UK

Once you know how cheap homeopathy is compared with all the other pills prescribed, you know that there must be other reasons. And I dare say, that BIG PHARMA will be behind it, one way or another. It would be interesting to find out what is going on behind all those closed doors and what kind of influence/pressure big pharma actually exerts on the NHS.

Kauri, London, UK

What people do not realise is that their 'choices' within healthcare services are being eroded not only by ineffective politicians who think they are managers but also doctors who think they are politicians. How can we begin to investigate the usefullness of homeopathy if it gets cut out of the NHS. Why has no one asked 'Why can't we have both! - homeopathic hospitals and expensive cancer treatments. The public is being hoodwinked- where are our taxes really going- to fight wars which are harming even more people. Why should our NHS even have to face these difficult choices- what are your priorities?

E Lemon, London, UK

The cut back could be as a result of popularity of this method of treatment which deals safely with many medical symptoms people have. It is the powerful drug manufacturers who seem afraid of the competition - a viable alternative treatment which does the job of helping people with their medical problems without side-affects. Everyday we hear on the media the various draw backs with many types of Western style medicines. Unfortunately the drug companies are so powerful that they have creat ed bad puplicity against Hohomoeopathy treatment. So I would read the headlines carefully and draw your own my conclusions as whose agenda the mentioned cutback is serving?

jan Drena, London,

Velcade for Multiple Myeloma does NOT cost £25,000. This is the NICE figure based on 8 cycles. Current treatment is a few cycles of Velcade with Dexamethosone, or other drugs. Doctors know within 2 cycles whether or not Velcade will work. PCTs are using NICE as an excuse for refusing Velcade.
PCTs should not have responsibility for any new drugs. These should be costed under a "development budget" and all treatment given in the form of NHS trials.
I am alive and well because of a manufacturer's trial with Velcade + other drugs.

Malcolm Cole, Fulbrook, Burford, Oxfordshire

Of course. The NHS should only spend money on medicines that have been proven to work.

I fail to see how anyone could suggest that the NHS spend money on medicines until after they have been thorougherly tested. If money is wasted on an ineffective alternative treatment then it can't be spent on something we know works.

By all means fund alternative medicine, but only people can prove that its as cost effective as established treatments.

Nick, Newcastle,

If the homoeopathy lobby feel strongly enough about this they should finance a full set of double-blind trials for each 'remedy', in which their magic water has to preform as well as, or better than, the conventional remedy. It's all very well to talk about choice in medicine, but that doesn't mean choosing between homoeopathy and reiki. What if the choice is (as has actually happened), between one elderly man going blind, or his wife, because their NHS trust can only fund person's treatment? That's the kind of 'choice' facing the NHS Trusts these days.
Homoeopaths are pretty good at painting themselves as selfless healers, beset on all sides by sceptics and nasty scientists. But the manufacturers of homoeopathic medicines have made millions down the years - why couldn't they spend some of their profits on proper trials?

Sarah N., London,

This is excellent news, after a worrying few years we finally seem to be back on track with evidence based medicine. Hopefully the MHRA will now review it's regulations on the labelling of "alternative" medicines so that we don't simply see more unsuspecting members of the public getting ripped off rather than the NHS/taxpayer.

Paul Browne, Cambridge, UK

Someone needs to get real here. None of the campaigners for a ban know anything much about homeopathy. In my own academic field, as in others, amateurs get short shrift. Why doesn't that apply in medicine? These people have never even visited, let alone sat in at homeopathic practices or hospitals, so they really don't have a clue why their fully trained colleagues find homeopathy effective where conventional medicine fails. As for the trials that are claimed to disprove homeopathy, not one of them has tested homeopathy. Homeopathy is a process that depends heavily on feedback between homeopath and patient, with regular changes of medicine and dose. Standards trials can't allow those variables, so they show negative results. That's hardly surprising, but it's not good science. A first-year undergraduate would be failed for testing A when he was asked to test B. Baum and his friends are, quite simply, bad scientists with a dogged fixation on their own system.

Dr. Denis MacEoin, Newcastle upon Tyne, UK