The NHS should Stop Wasting Money on Homeopaths and Homeopathic Hospitals and should Offer Placebo Pills to Patients Requesting Homeopathic Treatments
The NHS spends three to four million pounds per year on homeopathic remedies, despite conceding that there is no evidence that homeopathic remedies actually work. They justify this expenditure on the grounds of patient choice: http://www.nhs.uk/news/2010/July07/Pages/nhs-homeopathy.aspx. In a post on this subject, on August 20th 2010, I took the view there is something right about this line of reasoning. If people want to choose homeopathic remedies that are known to be no more effective than placebos, rather than conventional medical alternatives, then they are making a foolish choice, but it is their choice to make and provided that they are not harming others it should be respected. However, I also argued that the NHS has a duty to manage its budget carefully. They should only pay for homeopathic remedies when these are cheaper than the conventional medical alternatives that they are replacing and they should not spend more money on homeopathic remedies than is necessary. Given that the NHS spends three to four million pounds on approximately 25,000 ‘homeopathic items’ per year, I calculated that the NHS spends an average of £140- per homeopathic item prescribed. This figure could easily be reduced. In the earlier post I offered two suggestions to help the NHS save money on homeopathy. First, on the grounds that homeopathic training makes no difference to the efficacy of homeopathic remedies, I suggested that the NHS should pay homeopaths minimum wage. Second, I argued that the NHS should reduce the cost of homeopathic remedies by making its own homeopathic remedies, or outsource the job to a competitive supplier who can reduce the price of homeopathic remedies.
I now have three new suggestions to help save the NHS money on homeopathy. First, the NHS should stop wasting money on paying for specialist homeopaths or homeopathic hospitals (there are currently three of these in Britain). GPs can prescribe homeopathic remedies just as well as homeopaths can and there is no reason to believe that a homeopathic remedy prescribed by a homeopath will be any more effective than one prescribed by a GP. Second, until such time as the NHS is able to make its own homeopathic remedies more cheaply than pharmacies do, they should pay pharmacies to provide homeopathic remedies. Boots stocks a range of homeopathic remedies which seem to cost about £5- a bottle on average: http://www.boots.com/en/Pharmacy-Health/Shop-by-product/Complementary-Therapies/Homeopathy/. Rather than spend an average of £140- for a homeopathic remedy, together with an appointment to see a homeopath (perhaps at a homeopathic hospital), the NHS should save itself an average of £135- per homeopathic item by sending patients who want homeopathic remedies to Boots and paying for their remedies. Patients who demand more expensive forms of homeopathic treatment should be refused, on the grounds that what they want is no more effective than an off-the-shelf remedy from Boots. Patients who complain that Boots does not stock the particular homeopathic remedy that they favour should be advised that they are not entitled to waste public money on remedies that are either more expensive than equally effective alternatives, or hard to locate, and as all homeopathic remedies are as effective as one another, they are only entitled to the cheap, available homeopathic remedies on the NHS.
My third suggestion is that when a patient requests a homeopathic remedy, or when a GP recommends a homeopathic remedy to them, they should also be required to consider taking a placebo pill as an alternative. The basic placebo used in clinical trials is a sugar pill that cost very little to manufacture. Universal Placebos sell bottles of 700 pills for approximately £10- a bottle – approximately 1.5 pence a pill. Patients should be advised that placebo pills are just as effective as homeopathic remedies and offered these as an alternative to homeopathy. If even a few patients choose placebo pills instead of homeopathic remedies, large amounts of money can be saved. If, say, 10% of prescribed homeopathic items were replaced by placebo pills then a current spend of approximately £350,000- could be reduced to £37.50. It might be objected that if people are aware that they are taking placebos then these will be ineffective. But according to Universal Placebos this is simply not the case: http://www.placebo.com.au/.
The NHS has a responsibility to use taxpayer’s money effectively. If it is going to provide homeopathic alternatives to conventional medicine then it has a duty to provide the cheapest available homeopathic remedies, unless it can be shown that more expensive remedies are significantly more effective than cheaper ones. But the NHS’s official position seems to be that all homeopathic remedies are equally effective so it should only provide the cheapest available. My suggestions can help them to fulfill this responsibility.