Homeopathy on the NHS
Is homeopathic treatment currently available on the NHS?
Yes, it is. Homeopathy has been part of the NHS since its inception in 1948 when the then government declared that homeopathy would continue to be available on the NHS as long as there were, “patients wishing to receive it and doctors willing to provide it” and it has been available to patients ever since. Four homeopathic hospitals in London, Bristol, Liverpool and Glasgow were originally gifted to the NHS and treat around 40,000 patients every year.10 These are people who were not helped by conventional medicine, yet have been helped by the NHS provision of homeopathic treatment. As the NHS Constitution states, “Everyone counts” and “Nobody is excluded”.
The World Health Organisation’s Traditional Medicine Strategy 2014-2023 states that Universal Health Coverage (UHC) is only possible by integrating Complementary and Alternative Medicine (CAM) services including Homeopathy into the healthcare delivery.
homeopathy has been part of the NHS since its inception in 1948
How much does it cost the NHS to provide homeopathy?
In 2013, from the total NHS drug budget of £13 billion a year, the NHS spent £152,000 (0.0013%) on homeopathic prescriptions.11 From the total NHS budget of £137 billion a year, £4 million (0.004%) is spent on homeopathy if everything is included, from running the hospitals and paying the staff.12
When considering value for money, it should be remembered that if these patients were not treated with homeopathic medicines, they would have to be treated by other NHS departments and be prescribed more expensive conventional medications. In 2005, a study commissioned by a German health insurance company assessed the value of homeopathy in treating chronic conditions commonly seen in general practice. Patients were treated by GPs and received either homeopathic or conventional medicines. Patients in the homeopathy group reported greater improvement than the conventional medicine group, with no significant difference in cost.13
£152,000 (0.0013%) on homeopathic
Should the NHS fund homeopathic treatment?
Yes. There is sound evidence of homeopathy’s effectiveness.
For example; by the end of 2014, 189 randomised controlled trials of homeopathy on 100 different medical conditions had been published in peer-reviewed journals. Of these, 104 were placebo-controlled and were therefore eligible for detailed review.
41% were positive (43 trials), finding that homeopathy was effective 5% were negative (5 trials), finding that homeopathy was ineffective 54% were inconclusive (50 trials).14
In addition, there have been six meta-analyses of homeopathy (large scale overviews of all previous research).
One meta-analysis was negative, concluding that homeopathy had no effect beyond placebo. Five were positive suggesting that there was evidence of an effect beyond placebo, but that more high quality research would be needed to reach definitive conclusions. The most recent of these studies, published in 2014, found that homeopathic medicines, when prescribed during individualised treatment, are 1.5-2.0 times more likely to have a beneficial effect than placebo.15
With regards to the effectiveness of conventional medicine, things are not as clear cut as many people may believe. Every six months, the British Medical Journal (BMJ) publishes the scientific clinical evidence for treatments currently available on the NHS. This study found that of 3,000 commonly used NHS treatments 50% are of unknown effectiveness and only 11% are proven to be beneficial. See chart.16
SSRI anti-depressants, such as Prozac, are an example of such a treatment. These have now been confirmed as being no more effective than placebo in the treatment of mild and moderate depression, yet in 2006 the NHS spent around £150 million on them.17
The BMJ data clearly shows that the NHS funds many treatments for which the evidence of effectiveness is unclear.
Yes. There is sound evidence of homeopathy’s effectiveness
Does the NHS constitution allow patients a right of choice?
Yes. It is firmly written into the NHS Constitution that, “patients will be at the heart of everything the NHS does” and therefore be able to make informed and personal choices about their health care. These choices should be based upon sound information, not misinformation.
Doctors (of which there are around 400 with homeopathic training within the NHS) should be able to prescribe homeopathic medicines or refer to homeopathic hospitals for those patients they cannot otherwise help.
Advocates of Complementary and Alternative Medicine (CAM) like to choose the natural and gentle health solution where their circumstances allow it. However, homeopathy is often used along side conventional treatment and homeopaths make patient referrals to doctors.
“patients will be at the heart of everything the NHS does”
What are the implications if homeopathic medicines are cut from the NHS?
The 40,000 patients10 a year who benefit from homeopathic treatment would either have nowhere to go or would have to be treated by other NHS departments and be prescribed more expensive conventional medications i.e. it would exclude patients and cost more.
A “black-listing” of homeopathic medicines would run contrary to the NHS constitutional principles of “Everyone counts” and “Nobody is excluded”. It would also be unsupportive of the Royal College of General Practitioners campaign, “Put the patient first”.
It would also be inconsistent with the premise of only funding treatments with known effectiveness, especially given that 50% of treatments currently provided by the NHS are of “unknown effectiveness”.16
In 2014 the number of adverse drug reactions reported to the MHRA was 31,550 of which 5% were fatal. The number of adverse homeopathic medicine reactions for the same period was zero.28
it would exclude patients and cost more
What might be a way forward for the NHS?
The NHS was created in 1948, in a period of austerity. We are currently enduring another period of austerity and the NHS is struggling to provide the high level of care for which it is renowned. Running costs are increasing every year; prescription numbers have increased by 70% over a ten year period29 and for anti-depressants by 500% over the past twenty years.30 Something needs to change.
In 2005, the Smallwood report found that patients treated with complementary and alternative medicines showed a 30% reduction in the number of GP consultations and a saving of 50% on the prescription drugs bill.31 Comparable high quality studies have been carried out in France and Germany with similar results.32, 33
The Swiss Health Authorities, for example, commissioned a report which confirmed homeopathy, “as a valuable addition to the conventional medical landscape – a status it has been holding for a long time in practical health care.”34 The Swiss interior ministry plans to give five complementary therapies including homeopathy the same status as conventional medicine. As a result, these treatments will be covered by basic compulsory insurance.35
Given that the NHS is “in crisis”, it would make common sense to embrace a more integrated approach to patient care; at least continuing provision of homeopathy for the doctors and patients who currently value it, or even increasing it.
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a more integrated approach to patient care