Friday, 2 March 2012

Patient Choice: no decision about me without me?

Government policy is clear. It is in favour of Patient Choice. As their white paper states, clearly and concisely, "No decision about me without me". So for those of us who would want to have homeopathic treatment for our illnesses, this should mean that we just go to our GP, tell him/her we want homeopathy with this (named) homeopath, and we will get it. But matters are not quite so straightforward!

This may be the policy of the central government at Westminster; but what about decision-making within the NHS at PCT (commissioning) level? Everywhere, requests for homeopathy are meeting with a bureaucratic veto, whether this is in Bournemouth (with a 94 year old pensioner), in Birmingham (my son), in Swindon, where a group is currently fighting a battle with the local PCT adamantly opposed to patient choice - if that choice is homeopathy!

The situation is the same in the South-West of England, where the Bristol Homeopathic Hospital is now under threat because local PCTs are refusing to refer patients there. This was, of course, why the homeopathic hospital in Tunbridge closed recently. And the homeopathy hospital in London is under pressure for the same reason. This report, sent to me by Oliver Dowding, is about a meeting held recently regarding the situation in the Bristol area.

In attendance we had the chairman of the British Homoeopathic Association, John Cook, the chief executive, Crystal Sumner. They succinctly outlined the difficulties they've been having on the Wirral in getting referral to the Liverpool Homoeopathic Hospital unit. John then ran through why everything that the BANES (Bath and North East Somerset) NHS trust has done recently is 'challengeable'. The trust didn't tell anyone they were not going to allow referrals by the PCT's. This only came to light when the Bristol homeopathic hospital highlighted that they were getting no referrals. John asked whether this could be, if one were cynical (and the way they act tempts us to be that), an attempt to reduce referrals and therefore say there was no demand for homeopathy! As he told us, this goes completely against the NHS Constitution.

As has happened in Liverpool/Wirral, there is still hope that the referrals will be reinstated, and if this happens, then this becomes the new 'status quo', which could be an even better situation.

John also handed out a piece from the British Medical Journal, dated 13th January 1996. I found a copy online, and have saved it and attached it. This contained this excellent quote, that "evidence-based medicine" is not "cookbook" medicine because it requires a 'bottom up' approach that integrates the best external evidence with individual clinical expertise and the choice of the patient. Evidence based medicine, it says, cannot result in slavish, cookbook approach to individual patient care. External clinical evidence can inform, but can never replace, individual clinical expertise; and it is this expertise that decides whether the 'external evidence' applies to an individual patient, and, if so, how it should be integrated into a clinical decision." It goes on further to say that "evidence-based medicine is not restricted to randomised trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions."

John also highlighted the anomaly which allows local GPs to refer if they think it is clinically relevant. Naturally, with so many GPs being opposed to homoeopathy, some quite violently, this is just not going to happen. Therefore, the NHS is likely to conclude 'there is no demand' for homeopathy, and the vicious circle continues. He noted that Wiltshire has currently reached the position of disinvesting from homeopathy, and that there was therefore the risk of contagion. So BANES are now trying to follow suit, and whilst there is now with significant likelihood of this decision being overturned, this leaves Somerset (which is treated as one PCT) being the most favourably disposed towards homoeopathy. Therefore, he suggested that it was best not cause a ruckus at this stage, and risk this situation turning against us.

Those at the meeting were told that what patients need to do is to ensure that when they visit their GP surgery, and ask to see a homoeopath, or they are referred to somewhere such as the Bristol homoeopathic hospital, they need to quote the 1948 NHS act, which has enshrined their right to homeopathic treatment.

Several people at the meeting highlighted the excellent Swiss Government report on homoeopathy, which needs to be widely publicised. (For an assessment of this report, and its importance for homeopathy, click here). It seems a mystery that the report was completed in 2005 but only published in English in 2010! Nevertheless, we now need to read it, and use it.  The report has found homoeopathy to be a very successfully medical therapy, and that there is lots of important evidence to support this claim. Homeopathy has demonstrated that it is now truly an 'evidence-based medicine'.

We then had presentation by Dr Lee Burton, from the Bristol Homoeopathic Hospital. He highlighted that many PCT's and doctors, when asked about referring to homoeopathy, seemed to rank its level of importance with that of a referral for tattoo removal!

Yet about 40% of their referrals come from conventional medicine, which has failed to resolve the health problem. The worst case came to the hospital after seeing 15 different consultants! After a period with the Bristol homoeopathic hospital the patient was 80% improved. Success indeed! 

Dr Burton also highlighted that for the NHS one big problem is "MUPS", which stands for "Medically Unexplained Persistent Symptoms. He noted that in general these conditions get a 60 - 70% positive response to homoeopathy, which appears to be remarkably constant. He also remarked that around 58% of the patients are in the working age category, with only 12% being above 65 years old. In noting the 60-70% successful resolution figure he agreed that this was a skewed statistic, given that a large number of these patients are considered the "basket cases" - the one's that the NHS (and conventional medicine) has failed to resolve.

Finally, he exhorted us all to join the friends of Bristol Homoeopathic Hospital. This does not mean that one is committing to either financial or time support, but one is giving them more power to their elbow by being a supporter. Given that the homoeopathy has always been patient-driven he said that having the largest possible support base is now more important than ever, as it helps to justify the patient's voice being heard within the NHS. Becoming a friend is easy, by going to their website (, or alternatively sending an e-mail to either or   

I also suggest that as many people using Facebook as possible enrol with this group,  H:MC21 ... Homeopathy Worked For Me  

We all need to remember that we are entitled to free homeopathic treatment on the NHS when we are ill. What Oliver's report does is to highlight that if we want to be treated safely and effectively with Homeopathy, or want to avoid the dangers and ineffectiveness of conventional medical treatment, we are all going to have to demand it, and fight for it.

The conventional medical establishment is in control of the NHS, and they are vehemently opposed to opening it up to homeopathy - quite regardless of what Government policy say, or their patients want.

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