A holistic approach to healthcare
The High Court’s ruling dismissing the British Homeopathic Association’s (BHA) legal challenge to NHS England’s consultation that resulted in a recommendation to Clinical Commissioning Groups (CCG) to stop funding prescriptions for homeopathy is a serious blow.
It’s the second most used medical system in the world, according to the World Health Organization, with six million people in the UK among those who regularly use it as part of their healthcare, yet homeopathy is never far from scrutiny. In recent years, a number of complementary and alternative medicines (CAM)–including homeopathy–have increasingly come under attack, with campaigners calling for them to no longer be funded by the NHS.
In July last year, NHS England announced plans to cut prescriptions of what it called “ineffective, over-priced and low value treatments”. Among these were homeopathy and herbal treatments. At the time, NHS England’s chief executive Simon Stevens described homeopathy as “at best a placebo and a misuse of scarce NHS funds”.
Since then, patients of The Royal London Hospital for Integrated Medicine (RLHIM)–the largest public sector provider of integrated medicine in Europe–have been told they’ll no longer be entitled to receive NHS funded homeopathic remedies as part of their treatment.
The placebo effect
A frequent argument used against homeopathy is that it doesn’t work, or is only effective as a placebo. While the scientific base for homeopathy is inconclusive, evidence supporting its use does exist and is growing.
More than 100 randomised controlled trials into homeopathy have been carried out up to 2016, with 41% supporting its benefits beyond placebo. In addition, homeopathy is rated highly by patients who report how much better they feel after receiving homeopathic treatment. A patient outcome study conducted at the former NHS Bristol Homeopathic Hospital found 70.7% of 6,554 follow-up patients treated at the hospital for a wide range of chronic illnesses reported positive health changes.
The attacks against homeopathy’s evidence base might lead people to believe that studies into conventional medicines have found them to be indisputably effective methods of treatment. But the same inconclusive results for effectiveness beyond placebo also exist for conventional drugs funded by the NHS. And increasing numbers of doctors are starting to question their therapeutic benefit, particularly antidepressants for the treatment of mild depression.
A report published in 2014 by the Academy of Medical Royal Colleges (AoMRC) recommending ways for the NHS to save money favoured treating mild depression with support and psycho-education, rather than antidepressants. It said evidence suggested that the medication “would not bring about the desired outcome and [could] potentially cause unwanted side effects, alongside financial and environmental costs”.
In addition, a new study suggests that bath additives to treat eczema in children provide no meaningful benefit alongside other treatments for the condition. However, the NHS spends £23 million a year on prescribing them.
Unlike some treatments, homeopathy has a very low risk of side effects and costs the NHS a fraction of the price. In her article, “Don’t hate the homeopaths”, GP and homeopath Dr Helen Beaumont says homeopathy can help to “reduce costs without affecting patient care”, adding: “As a therapy it is generally less expensive than many conventional treatments and when used as a complementary therapy some patients are able reduce the number of drugs they are taking.”
A chain reaction
Rachel (name changed) from London is one of many patients who has chosen a more holistic approach to medicine because of the side effects associated with conventional treatment.
Unbeknown to the 64 year old, she had been suffering with rheumatoid arthritis for many years before she was referred to a consultant and prescribed a number of medications. One of these was methotrexate, which came with the risk of side effects like nausea, vomiting, stomach pain and temporary hair loss.
Given that she’d managed her condition for so long without conventional medication, she decided to manage it with a combination of homeopathy, Chinese medicine, nutrition and exercise. Rachel, who continues to see her NHS consultant yearly for check-ups, says: “A lot of people are fairly happy with conventional medicine, but I didn’t like the idea of taking something that was going to make me feel ill–it just didn’t make sense.”
Her decision to use alternative medicine has also saved the NHS a great deal of money. For example, she can avoid taking expensive drugs–one of which would cost the NHS £20,000 a year. “If the whole treatment package, including homeopathy, is making people feel better and not costing the NHS very much, I think it’s a very good argument for it,” she adds.
The fight against superbugs
Homeopathy could also have a role to play in tackling the issue of overprescribing medication, which has been grabbing news headlines of late. Figures released by NHS Digital reveal that a quarter of people are on at least three prescription drugs, with the biggest rise among people taking antidepressants, and the most common being blood pressure pills.
This is causing problems for the UK’s ageing population, who are often prescribed multiple medications, which can lead to harmful side effects including kidney problems. Another concern is that GPs are unnecessarily prescribing antibiotics, causing antimicrobial resistance and making these medications less effective in treating serious infections. A major study into the effectiveness of antibiotics in children has found that 50% of urinary tract infections (UTIs) were resistant to ampicillin–one of the most commonly prescribed antibiotics for UTIs.
Research suggests that homeopathy could improve patients’ health when used as part of an integrated approach to healthcare. In 2007–2008, a study tracked patients attending GP surgeries in France and found that doctors trained in homeopathy used fewer conventional drugs–including antibiotics and anti-inflammatory drugs–for conditions including upper respiratory tract infections (URTIs), musculoskeletal disorders, and sleep, anxiety and depression disorders.
Patients responded to treatment as well as, or had similar results to, those who received conventional medicine, but were given less drugs and had fewer side effects. For instance, people treated for musculoskeletal disorders received half the amount of non-steroidal anti-inflammatory drugs when treated with homeopathy.
A question of regulation
Homeopathy is often described as an unregulated profession, which means that anyone can practise as a homeopath, even if they have no qualifications or experience. However, homeopathic registering bodies exist to make sure homeopaths are trained in their area and uphold professional standards.
Members listed on the Faculty of Homeopathy directory are all healthcare professionals who have completed postgraduate training in homeopathy. This means that they’re regulated by their relevant professional body and, in order to keep their Faculty of Homeopathy membership, they must make sure they’re up to date in both their conventional and homeopathic training.
Homeopaths who aren’t medically trained can still belong to another registering body, and this requires them to have insurance, complete regular continuing professional development and comply with that organisation’s code of practice.
In addition, since 2006 homeopathic medicines have been regulated in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA), which operates a system to register and license medicines. A small number of homeopathic remedies are licensed by the MHRA and can be bought in low potencies over the counter from places other than pharmacies, such as health food shops. However, remedies that aren’t licensed can only be bought from pharmacies that are regulated by the General Pharmaceutical Council, which assures their safety and quality.
Now that it’s no longer possible for NHS patients in England to receive homeopathic remedies on prescription, people will have to pay for their treatment. Although the treatment faces a great deal of uncertainty, the fight for everybody’s right to access it must continue. The BHA remains committed to making sure people still have the choice to choose homeopathy, and it continues to invest in its clinics which offer charitable and low-cost treatment.
To read Dr Beaumont’s full article, go to www.hippocraticpost.com/integrative/dont-hate-homeopathy.