Wednesday, 17 February 2010

Patient Choice in the NHS

The NHS was established in 1947, committed to offer 'the best medicine available' to every UK citizen, regardless of income. Its main creator, Anauren Bevan, was a homeopathy user, so his intention would not have been to exclude homeopathy. Yet homeopathy is being excluded from the NHS in many parts of the country.

Marjorie Titchen is 92 years old. She lives in Bournemouth where she continues to run a small hotel. She says that she will retire when she is 100! This will mean that she has worked and paid taxes for over 80 years – and yet incredibly she is being refused medical treatment by her local PCT!

Marjorie suffers from osteoarthritis and osteoporosis, which she has controlled now for nearly 12 years with homeopathy. She has never taken a conventional drug, and refuses to do so. In April 2008, she applied for another course of homeopathy with her local homeopath, who has treated her, successfully, for many years. She says:

"I had expected to be in a wheelchair by now because of my osteoarthritis. I can do two or three hours work a day. I wouldn't be as mobile and as clear-minded if it hadn't been for the treatment my homeopath has been giving me for the last decade."

The Bournemouth /Poole Teaching Primary Care Trust refused to fund the treatment, even though they had done so on previous occasions. A spokesman for the PCT told the local newspaper (the Bournemouth Echo) in August 2008:

"The clinical evidence did not show that homeopathy treatment would continue to be an effective treatment for Mrs Titchen and we will not be continuing to support that treatment. This is not about a basic funding decision. We would expect Mrs Titchen's GP to reassess her condition and if necessary refer her to a hospital consultant, should that be appropriate."

The PCT has claimed that there is no evidence that homeopathy works with osteoarthritis.

This is not correct. Mrs Titchen herself is walking proof of homeopathy's efficacy. And in addition there is ample evidence that homeopathy helps in the treatment of osteoarthritis. For instance, Shealy C.N., Thomlinson P.R., Cox R.H., and Bormeyer V. Osteoarthritis Pain: A Comparison of Homoeopathy and Acetaminophen. American Journal of Pain Management, 8, 3, July 1998, 89-91, conducted an experiment with 65 sufferers of osteoarthritis who were split into 2 groups, and through a double blinding process were given either a homoeopathic medicine or Acetaminophen, a commonly prescribed drug for pain relief. Researchers found that homoeopathy provided a level of pain relief that was superior to Acetaminophen, and, perhaps equally important, produced no adverse reactions.

So what is happening here? Mrs Titchen wants homeopathy. Mrs Titchen’s GP supports her request. Her homeopath has treated her before, successfully, and is willing to do so again. She has benefited from homeopathy, and her MP has supported her request, but says he is powerless to do anything about it.

Yet the PCT has seen fit to make a purely bureaucratic decision to deny her the treatment of her choice. It appears that the PCT believes, in its paternalistic wisdom, that they know what is best for Mrs Titchen, and are prepared to ignore her request. The result is that Mrs Titchen has gone without treatment for two years.

This is contrary to the way the government wants health services to develop. Patricia Hewitt, Health Secretary at the time the White Paper, “Our Health, Our Care, Our Say: a new direction for community services (January 2006)” was published, said this:

“(more) people (are) wanting a different approach to services, looking for real choices, more local care, taking greater control over their health, supported to remain independent wherever possible”.

Karin Mont, chair of the Alliance of Registered Homeopaths (ARH), says that the White Paper identified 5 key areas where change was required - all of which, she says, homeopathy is well-placed to deliver for the NHS. These are:
1) A greater emphasis on personalised care.
2) Bringing care closer to our home.
3) Gaining greater cooperation between local councils and the NHS.
4) More patient choice.
5) Initiatives to prevent the development of disease.

Mrs Titchen’s dilemma is not unusual. The number of people wanting to use homeopathy, in preference to conventional medication, has been growing for many decades - mostly by patients paying privately for treatment. Many more people, who cannot afford to do this, are routinely denied access to homeopathy by the NHS.

Yet all the main political parties are now proposing to develop a ‘choice’ agenda within the NHS. Yet, with a general election in prospect, the choice on offer in the NHS does not seem to go beyond the conventional medical monopoly.

What this means, for people like Mrs Titchen, is that the NHS is denying real health choice to those who prefer to use homeopathy, or other CAM therapies, to treat their illnesses.