Homeopathy and acupuncture backed for NHS funding

What is notable about this project is not just the satisfaction patients expressed, but the satisfaction of GP's too.

It is time, now, for PCTs throughout the country to begin to incorporate these therapies into the day-to-day work of the NHS. I speak as someone who had to fight, and complain to obtain homeopathic treatment for 11 MONTHS a couple of years ago!

If patients and GPs are happy, only the so-called 'scientists' of the Colquhoun and Ernst variety will find objection - and it is time that their views, and vested interests are more closely examined.

As a General Practitioner I am grateful that I have homeopathy in my tool bag. Not only is it useful for patients who are unhappy about conventional treatment but also for those in whom it is more effective and appropriate.

I do hope that Roger Neville Smith has like minded collegues. For too long there has been a them and us attitude to health care and treatment. Alternative and complementary treatments like homeopathy not only provide a cost effective solution to particularly long term and chronic physical, emotional and mental disease but also reduce the frequency and intensity of patient demand on GP services.

I'm dismayed. Don't get me wrong. I think it's great that people feel good after these therapies, but then people feel good after pedicures, manicures and facials, don't they? Why not include these on the NHS also?

The fact is that with a limited budget, one cannot really justify these "treatments", when essentially you're taking money from other evidence-based therapies e.g. chemotherapy, that have at least attempted to justify themselves with sound scientific principles.

The above "study" is an exercise in trying to give these alternative treatments some kind of scientific credibility. If you really want to know what's going on follow this link. If people want these things fine, but they should pay for them. I fear that we're sleeping-walking into another NHS swindle. Competing interests? None.

Steve Scrutton is a lay homeopath - even though he hasn't bothered telling us this - who is, completely predictably, agitating for his particular quackery of choice to be funded by the NHS.

Note that whenever anyone calls a real scientist or doctor a "so- called "scientist" then it is a safe bet they are a sectarian Alt.Medicine type. Of the two people Steve refers to, David Colquhoun is an eminent professor of pharmacology and an FRS. Edzard Ernst (MD PhD FRCP) is a professor who has published literally hundreds of papers evaulating the actual evidence base for complementary therapies. What is "so-called" about either?

As Jerry Quill points out, being pampered makes people feel better. So next time I am feeling a bit old and tired, I look forward to getting my haircut and rejuvenating cucumber facial on the NHS. And could I have a weekend at a nice country house hotel health farm too? Please?

I am one of the homeopaths who worked in the pilot, which was not a clinical trial but an evaluation of a real-world referral service for GPs and their patients. It was very apparent that the doctors were delighted to have extra treatment options for their patients, especially their chronically-ill 'heart sink' patients. Three-quarters of patients referred had had their conditions for over a year, and nearly half for more than five years.

We in turn were delighted to be able to give so many of them back to the GPs in better health. We were able to show that we have something to offer in a primary care setting, especially in the GP-reported 'effectiveness gaps' in what conventional medicine has to offer. It also became very clear that patients want us to work together in this way to provide the most appropriate forms of treatment.

There are problems about evidence but they are not, as our critics would like to think, just about evidence for Complementary and Alternative Medicine (CAM) treatments. In the conventional medical world, evidence for conventional treatments remains remarkably sparse, considering the vast expenditure on clinical trials using RCT methodology. The international resource for such information, the BMJ Clinical Evidence website, tells us that:

Of around 2,500 treatments covered 13% are rated as beneficial, 23% likely to be beneficial, 8% as trade off between benefits and harms, 6% unlikely to be beneficial, 4% likely to be ineffective or harmful, and 46%, the largest proportion, as unknown effectiveness.

Nor is this situation improving with time. In 1978, the US Office of Technology Assessment reported that, "Only 10 percent to 20 percent of all procedures currently used in medical practice have been shown to be efficacious by controlled trial." Sir Michael Rawlins, chair of NICE recently said that the RCT has been on an undeserved pedestal, and that other forms of evidence such as observational studies should be considered.

In the CAM world, we have always argued that the individualisation of treatment means that evidence for CAM treatments must come from clinical outcomes research, but the Lords' report on CAM in 2000 concluded that CAM had been 'starved' of research funds.

However, in recent observational studies such as that at the Bristol Homeopathic Hospital, and those carried out by the multi-discplinary IMPACT team in Nottingham, a very consistent and positive picture is emerging.

In order to forestall the usual sterile slanging match about evidence for CAMs, and to provide context for the publication of the results of the Pilot, Boo Armstrong and I jointly proposed that the Department of Health should host a process of dialogue - 'a Peace Process, to maintain the Northern Irish theme - 'in which stakeholders of all shades of opinion could be faciliated in developing a consensus on the results of the pilot.

If CAM therapies are to be offered to NHS patients, GPs will be the gatekeepers of such services. They must therefore be fully informed, and I think that a fully considered and authoritative opinion resulting from such a dialogue would be of great value to doctors in offering the most appropriate treatments to patients.

Unfortunately the Department did not take up the idea, but I propose it again here, as I believe it would be very much to the advantage of doctors and their patients.

It is interesting that a model had been proposed for GPs to be the gatekeepers for alternative therapies on the NHS.

When I was asked for my first referral to a homeopathic hospital, I discussed it with my senior partner. I wanted to know whether to redirect the referral to another partner, as is done for termination referrals.

I did not feel comfortable making a referral for something I felt was little more than a placebo.

Are you a scientist if you have a science degree? It seems to me that being awarded a degree is somewhat like being awarded a driving license. The license allows us on the road yet tells us little if anything about real experience.

Since receiving my license in 1979, I have spent the past 30 years working in the field of electronics and physics. I have always worked as part of a team and practiced my skills in Europe, the USA and Asia. I have had the great privilege of meeting and working with brilliant and fascinating people from all walks of life and from many different cultures.

Our greatest successes were always as a result of doing what worked rather than what was strictly scientific. We assumed that if it worked then it must be scientific anyway! We simply had not yet fully understood the science.

In 2006 I became quite unwell. I made many visits to my GP who was very helpful but not able to find a solution to my health problems. After more than a year with more than 5 visits to my GP and to a specialist, I decided to try Homeopathy (actually a friend recommended Homeopathy). I started to feel better within 3 weeks and I was back to full health within 8 weeks.

The homeopath was a registered homeopath but not a registered doctor or registered scientist. A ‘lay homeopath’ which I guess is something like calling a wood carver a lay carpenter. The homeopath was qualified, registered, insured and had 18 years experience of helping people to feel better. This was a very dedicated and very skilled person. I know because this person helped me get better and made it feel like a partnership.

My GP is also very skilled and very dedicated but on this occasion homeopathy appears to have expedited the cure and may have saved the NHS some costs.

Who knows? I could have continued with seeing my GP and the specialist and perhaps the NHS would have spent thousands of pounds attempting to diagnose my health problems. Ultimately the NHS may have been successful but in the meantime my health was suffering. In my case, homeopathy appeared to work despite the fact that certain aspects of homeopathy are not fully understood. Was it a placebo effect? Perhaps. But why did the placebo effect not kick in after I went to my GP and after I took several different conventional medications?

I am saying only this: Please work as a team. Please let us have a health service which uses therapies that work whether or not they are called scientific. If I get run over crossing the road then please get me to a consultant in emergency medicine, if I get cancer then please get me to an oncologist and if I have a chronic ailment that is not life threatening but greatly impacts the quality of my life then please send me to a good, qualified and registered homeopath or other appropriate therapist. First solve the problem then figure out the science.

Interesting reading all round - those who rail against homeopathy should, I hope read the piece about the relative ineffectiveness of the western medicines so ably described above by Ken Mayne.

I am sad that so many of what I would call the attack minded, rigid western medical champions, cannot read real world evidence more openly. But if its a battle they want - then the battle will continue, my own piece last December is a personal response to the attacks (based on their own feelings of weakness), that they will no doubt carry on making: http://tinyurl.com/c6as4m