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Thursday 19 December 2013

Health Freedom. Patient Choice. What would happen to the NHS if this became a reality?

[So] long as the people do not care to exercise their freedom, those who wish to tyrannize will do so; for tyrants are active and ardent, and will devote themselves in the name of any number of gods, religious and otherwise, to put shackles upon sleeping men.                                                               Voltarine de Cleyre

A different National Health Service
The political and financial principles underlying the National Health Service are worth maintaining. A free health service for all, regardless of the ability to pay, and offering the best health care therapies available, is a worthy objective for a civilised and caring society.
However, the drug-based medicine currently offered by the NHS is best avoided, except perhaps in dire emergency, and alternatives should always be offered.
An increasing number of people are beginning to realise this. They are slowly turning back to traditional, more natural medicine. There is a growing realisation that if we want to receive effective and safe medial care we have, at the moment at least, to go outside the NHS/Big Pharma monopoly.
This means that for large numbers of people, who are turning their back on the dangers of pharmaceutical drugs, and looking for drug-free therapies, no longer have a 'free at the point of need' medical service. For those able to pay privately for their medical care this is possible. However, for those who cannot afford to pay twice have just two options 
*** to accept an ineffective and dangerous form of medicine, and just hope that they do not suffer from the DIEs they bring with them.

*** or to struggle on with illness, without treatment.

For this reason alone the current position of the NHS, as a monopoly provider of drug-based treatment, has to be ended.
The main argument for fundamental change within the NHS is to facilitate patient choice. To achieve effective patient choice, however, patients will have to be given more open and honest information about their health, and the treatments available to them. The NHS should be a clearing house for patients, diagnosing their medical condition, and giving them information about a wide variety of medical therapies. The NHS Bureaucracy, dominated as it is now by conventional medical practitioners who seek to deny patients access to any other form of medicine within the NHS, will have to be challenged, and where necessary replaced by people willing to facilitate real Patient Choice.
At present the NHS in firmly in the hands of those who wish to maintain the ConMed monopoly. This monopoly must be ended. In providing health care to the nation, the NHS must recognise that every patient should have a choice of all the medical therapies available.
The Patient Choice Agenda
1.      Every individual should have the right to the medical treatment of his or her informed choice.
2.      The National Health Service, as an organisation, should not favour, promote or dispense any one medical therapy over and above any other.
3.      The NHS should not seek to impose any one form of medical treatment without reference to the informed choice of the individual. There should be no expectation, or pressure on any individual to accept any kind of medical treatment they do not wish to have.
4.      Informed choice is obtained by providing patients with good quality information. The NHS should commit itself to providing good quality information about every medical therapy available.
5.      This information should be full, honest and openly available to all patients. The information should include evidence about the effectiveness and safety, as well as the dangers, of each treatment.
6.      When an individual becomes ill, he or she should expect to have access to comprehensive information about the treatments available from each medical therapy. Patients should be able to discuss their treatment with any local medical practitioner, within or outside the NHS.
7.      Health funding for each individual should be based on a medical assessment of need, based on the severity of their illness. This assessment should provide an 'indicative level of funding', within which patients should have access to any form of medical treatment they prefer.
9.      The role of the NHS should be to facilitate, to provide access to, and to fund the individual's choice of medical treatment.
10.  The decision to fund, or not to fund particular medical therapies should be removed entirely from the NHS bureaucracy. 
Conventional and Traditional Medicine - comparisons
When Conventional and Traditional Medicine begin to be used on an equal footing within the NHS some important comparisons can then be made about the relative effectiveness and safety of different medical therapies. These will not be comparisons on the basis of 'randomised double blind scientific trials', which has led to so many medical disasters, but instead, on the basis of 'patient outcome' - in other words, does the patient get better on particular medical therapies, or not.
Actually, this is all patients ever want - to get better - and to get better safely.

Will conventional, drug-based medicine prove itself to be safer and more effective than other, more traditional or natural therapies? Will drugs and vaccines be able to prove their worth to patients when compared on a level playing fields with therapies conventional medicine has sought to undermine and ridicule for centuries? It is perhaps unlikely but it will be interesting to see!
Yet ultimately with Patient Choice the answer to this question does not matter. What matters is that people are informed about the health choices they have, and that they are able to decide which kind of treatment they prefer. This ability to choose will provide the NHS with useful insights and comparisons. For instance, if people find that homeopathy is safe and effective, they will use it, and tell their friends. If it is not, people will choose something else, or perhaps stick with ConMed.
However, the conventional medical establishment will find it difficult within a genuine ‘Patient Choice’  agenda. For the last 60 years people have accepted Big Pharma drugs because they have been readily and freely available, heralded by great claims for their efficacy and safety. Will patients take these drugs if homeopathy, herbalism, osteopathy, acupuncture, et al, are also readily and freely available to them? It will depend on what forms of medical therapy they see to be safer, more effective, and produce better outcomes. For Conventional Medicine, cosy within its present monopoly, this is seen as a threat!
The conventional medical establishment will not welcome the challenge of open, fair competition with traditional therapies like Homeopathy. They will prefer to hide behind the so-called 'science’ they claim for their drugs, seek to retain control of the NHS, and continue to disseminate misinformation about homeopathy and other natural therapies. 
Big Pharma, of course, will continue to threaten politicians and governments with moving their factories, and their research centres elsewhere, unless their monopoly is maintained. And they will continue to support people and organisations who are willing to attack homeopathy, and other traditional therapies. So the struggle is likely to be long and fierce. 
What will patients choose?
Patients will choose what they want to choose! That is the nature of choice! Do they prefer a Ford to a Vauxhall, the Telegraph to the Guardian? Initially, without any doubt, most people will continue to use ConMed drugs. It is what they know, what they currently use, and what they understand. But gradually, people will begin to make comparisons, and consider the merits of other medical therapies.
** They will do so when they discover that ConMed is not working with their illnesses, even after years of treatment.

** They will do so when they are told they will have to be on ConMed medication, with potentially dangerous DIEs, for the rest of their lives.

** They will decide when friends tell them that homeopathy does, in fact, work, and that it works, and they will want to try it for themselves.

When this situation emerges, entering a GP surgery, or an NHS hospital, will become a different experience. Visits will be more about seeking information about the choices open to them, and making personal decisions about the treatment they want. It will no longer be a matter of being told
          "Here you are, this is our diagnosis, this is what we have got for you, and so this is what we are going to give to you".
Health will no longer be about what emanates from a bottle of pills. Traditional medicine will gradually move the focus to a wider, more holistic understanding of health, to life-style choices, to supporting the body in maintaining its health, and eventually, when illness does strike, using gentle therapies that helps the body heal itself.
Patients will select their treatment from different therapies. They will discuss their experiences with their friends and family. They will teach each other what works, what is safe, and what is not. The 'word of mouth' route that works for homeopaths and traditional therapists now will begin to work in favour of 'the best' medical therapies, the one's that suit patients, the one's that work, the one’s patients prefer. No-one will feel obliged to take Big Pharma drugs. And no-one preferring natural treatment will have to pay twice for their medical treatment.
The Health Marketplace
Initially, the NHS Establishment, dominated as it is by conventional medical practitioners, will protest that they cannot afford to spend even more money, certainly not on traditional therapies! The costs of providing health care, they will complain, are already exorbitant (as indeed they are). But they will soon discover something they have never considered in their present monopoly position.
Patients will receive treatment, they will get better, and go away.
Gradually, the NHS will find that less people will pass through their doors. They will discover that Homeopathic remedies and Acupuncture needles will not generate more illness, treatment will not lead to yet more disease, and so increase demands on resources. Costs within the NHS may even begin to stabilise. And demands for ever more resources will begin to reduce.
Moreover, the cost of Big Pharma drugs will cease to rise to astronomic levels. Big Pharma will soon have to recognise that they are operating within a competitive health marketplace. Their drugs will have to stand comparison in terms of cost-effectiveness with Homeopathic remedies (which cost very little to produce). Perhaps the Pharmaceutical industry will even feel obliged to test their drugs more vigorously in order to ensure they are safe! They will certainly have to do more than just tell patients they are 'wonder' drugs, and rely on their NHS monopoly to distribute them on their behalf.

Patient Choice in health will make the NHS a more dynamic, pluralistic and interesting institution. Patients will re-assume a larger measure of responsibility for their own health. And health practitioners, of every persuasion, will be expected to demonstrate the safety and efficacy of what they do in terms of the outcomes they produce.
This piece was first published in the E-book "The Failure of Conventional Medicine".