Molly Asher asks why Bristol is one of the last places that homeopathy is still NHS funded, despite the practice being scientifically debunked.
Photo: Richard Craig (Flickr/CC BY 2.0)
The last several hundred centuries have seen the human population make massive advances in their understanding of human physiology, disease and how to treat the many ailments we suffer in the course of a lifetime. Years and years of research, rigorous scientific testing and clinical trials go in to the production of new treatment methods. And yet, in this modern world of evidence based treatment, the NHS continues to fund one artefact of a medical treatment manufactured in a by-gone age and with a complete and damning lack of evidence to support its efficacy.
The treatment in question, homeopathy, has somehow escaped unscathed from governmental evidence reviews recommending the NHS cease funding it. Instead, the situation at present leaves the funding decision in the hands of individual Clinical Commissioning Groups. The majority of these have chosen to cease providing the service. Crucially, Bristol CCG is one of the largest remaining funders nationwide. In the last financial year £151,000 was set aside to provide the service.
Although the government’s own Chief Medical Officer has expressed she is “perpetually surprised” that the NHS continues to fund homeopathy, it has received very little public attention. It seems likely that if more of the public were aware of exactly what homeopathy was, and that taxpayer’s money was being used to fund it, then there would be more of an outcry.
Widespread misunderstanding stems in part from confusion with herbal remedies from which, as many rightly point out, much of modern medicine is derived. However, whereas herbalism involves the direct administration of these herbs, preparation of homeopathic remedies involves dissolution of the active ingredient in water. The guiding principle? The more dilute the solution, the more potent the remedy becomes. Drops of the solution are then applied to sugar pills, creating a treatment closely resembling conventional medicine.
One group, the Good Thinking Society, have spearheaded a campaign to halt NHS funding of homeopathy. And they have not been without success: the turning of the tide away from homeopathy was underlined in June when Liverpool Clinical Commissioning Group (CCG) (one of the largest remaining spenders on homeopathy) announced they would decommission funding for such services.
Nonetheless, Bristol CCG is reluctant to let go. The city’s long history of homeopathy –from 1852 right up until last year it boasted a dedicated homeopathic hospital – offers some explanation for this.
Admittedly, Bristol has not managed to fly completely above the pressure to move away from homeopathy. Last year the homeopathic hospital closed and provision of the service was shifted to The Portland Centre for Integrative Medicine. This community interest company, located on the edge of Clifton Down, aims to deliver a ‘holistic approach’ to healthcare.
At the time of the Centre being opened, a response to a Freedom of Information request stated that the CCG had “no contract in place with the [Portland] Centre” for homeopathic services. However, notes from a CCG meeting held earlier this year details that the Portland Centre’s main source of income is NHS homeopathy referrals. How can this be? Although the NHS has no direct link to the Portland Centre, they continue to fund homeopathy due to having a contract with the University Hospitals Bristol (UHB), who in turn commission homeopathic services from the Portland Centre.
A spokesperson for the CCG confirmed that:
“Following the review into homeopathic treatment, it was recognised there were a number of options the CCG could take in terms of the future commissioning of the service. Before a formal decision can be made on the long-term future of the service, a public engagement exercise needs to take place. It was decided in the interim a prior approval policy would be implemented, meaning each individual case is reviewed against specific criteria.”
This decision flies in the face of the content of this review which clearly states that the only option consistent with the evidence base is to stop funding homeopathy. The CCG declined to provide further comment on why they were not willing to act in accordance with the evidence on offer. A date for the public engagement exercise has yet to be confirmed. Michael Marshall, of the Good Thinking Society campaign, is opposed to the continued service provision in Bristol and summarises for the Cable:
“Every penny spent on homeopathic remedies is money that could be far better spent providing effective treatments, funding worthwhile care initiatives and employing more nurses, doctors and counsellors. Every patient around the country whose operation is delayed or treatment is denied due to budgetary concerns can look with frustration to the money being wasted on homeopathy. Limited NHS resources should be spent on evidence-based medicine rather than on continued funding of homeopathy.”
Correction: A previous version of this article incorrectly stated that Martin Jones, Chair of Bristol CCG, is a qualified homeopathic physician. This article was accordingly corrected on the 23.9.16.