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.

 

 

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13 Responses to The NHS should Stop Wasting Money on Homeopaths and Homeopathic Hospitals and should Offer Placebo Pills to Patients Requesting Homeopathic Treatments

  • Laurie Willberg says:

    Check out the website at extraordinarymedicine.org for the scientific repudiation of the notion that there is no evidence substantiating Homeopathic medicine.
    Your premises are incorrect and your conclusion is predicatably incorrect. Too bad some people are still attempting to spout this type of anti-homeopathy propaganda.
    The statistical evidence showing the hundreds of thousands of people being maimed and killed annually by prescription drug use is a far more serious issue that demands public attention.
    The latest scientific studies show that placebo effect from prescription drugs is greater than that elicited in trials of homeopathic prescriptions… Guess your "research" didn't go far enough.

  • Stephen Clarke says:

    Thanks for your comment Laurie.

    My argument proceeds from the starting point that the NHS itself concedes that there is no evidence that Homeopathy works. The problem is that a funding agency concedes that a form of treatment is no better then placebo and yet goes ahead and funds that form of treatment. Another solution would be for them to produce evidence that homeopathy works. But given that there are many, many studies that suggest otherwise this would be very hard for them to do (see the wikipedia article on homeopathy for references). The latest scientific studies you mention sound interesting. Can you provide references for these?

    Homeopaths have a history of misrepresenting the relevant evidence. EG: http://www.guardian.co.uk/science/blog/2010/feb/04/homeopathic-association-evidence-commons-committee.

  • Khalid Jan says:

    Homeopathic remedies work in a specific environment, in a specific culture that controls its eating and mental habits. In today's culture, where people are addicted to foods that provide pleasures of the tongue, and their minds consuming unnecessary information, even if the homeopathic remedies are manufactured by some 'heavenly power,' it won't have any therapeutic effect. In this light, rather than bashing each others heads, and asking for proofs and evidences – which no one will care to read after 24 hours – it would be worthwhile to diagnose and treat the symptoms prevalent in the culture that seeks homeopathic remedies.

    • Theo says:

      May I add that, regardless of the efficacy of the pills, a patient that looks for and is willing to undergo homeopathic treatment is much more likely to pursue other wholesome activites and have a healthier lifestyle than his "scientific" counterpart?

      As I must always give case examples to explain my point: headache pills work, it is undisputable. But I am sure you all know someone that, instead of minding their body posture and eating less fat, choose just to take those pills and make the pain go away, without changing their attitude. Even thought they are now without, they still remain unhealthy. People who go after alternative medicines, such homeopathy, tend to be sympathetic to other practices that, when put together, do help their health and work quite well as prevention.

      Denying homeopathics to these people could, in some cases, mean denying them the push to this healthier lifestyles.

      • Theo says:

        I meant "without pain", obviously.

      • "May I add that, regardless of the efficacy of the pills, a patient that looks for and is willing to undergo homeopathic treatment is much more likely to pursue other wholesome activites and have a healthier lifestyle than his "scientific" counterpart?"

        Proof of that statement, please.

        • Theo says:

          There is none. And I doubt one would be possible. To get my point, read my example and Khalid's post again, please.

          • I did, and your statement still doesn't make sense. Moreover, a recent study – forgive me if I don't look it up, but it's late and I'm tired (try The Guardian's site) – apparently found that people who naively think they're protected by something like vitamin supplements or homeopathy tend to live *un*healthier livestyles and take more risks.

            Someone who understands risks – such as the scientific counterpart you mention – would therefore be *more* likely to live a healthier lifestyle.

    • Khalid Jan says:

      Correction: "it would be worthwhile to diagnose and treat the causes prevalent in the culture that seeks homeopathic remedies."

    • Matt Sharp says:

      "Homeopathic remedies work in a specific environment, in a specific culture that controls its eating and mental habits"

      Which environment, and which culture?

  • Skeptic West says:

    Greetings from Canada.

    Thanks for posting this. I would like to see a more robust response to what can now only be described as the accommodation of pseudoscience in our healthcare system (we have our own growing problem with alternative medicine).

    Everyone always rushes to defend the choice of patients, but no one talks about the ethically problematic position of the alt-med provider (i.e. exploitation, making demonstrably false claims, essentially practicing medicine without the proper training which they call practicing "alternative" medicine with "alternative" medical training).

    People in healthcare need to reframe this issue in the terms of consumer advocacy and protection, 'cause the alt-med industry and its professional have so far used "patient choice" to achieve governmental legitimacy, and thus medical legitimacy in the eyes of a scientifically ignorant public.

  • downunder says:

    If homeopathy is such a waste of time why is that members of the extended British Royal Family treated homeopathically?
    Try googling the royal patronage of homoepathy. Maybe they know something that pharmaceutical institutions would rather we weren't privy to. Not good for profit.

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