Open letter to Brent Primary Care Trust (PCT)

Demand for immediate restoration of contract with
Royal London Homeopathic Hospital (RLHH)

Nigel Webb, Chief Executive

Brent Primary Care Trust

116 Chaplin Road

Wembley, Middlesex

HA0 4UZ

International Women’s Day, 8 March 2007

Dear Nigel Webb,

We the undersigned write to express our outrage at the abrupt termination of the contract between Brent Primary Care Trust (PCT) and the Royal London Homeopathic Hospital (RLHH). As patients, carers and other supporters of the hospital, many of us on low incomes (benefits, pensions or low wages), we demand the immediate restoration of this much-valued service to all Brent residents.

Founded in 1849, the RLHH is the oldest homeopathic hospital in the world.  There are five homeopathic hospitals in the UK – Bristol, Glasgow, Liverpool, London and Milton Keynes.  RLHH is the largest, treating around 2,000 patients per week.  In addition to homeopathy, it offers acupuncture and other complementary therapies. 
 

Brent PCT’s decision means that residents can no longer be referred by their GP to the RLHH.  It denies users access to established treatments which are effective and an alternative to conventional medicine, which is often invasive, toxic and expensive.  Many of us stopped conventional treatment in other hospitals after a bad experience and chose to go to the RLHH instead.  We have found that it provides a better level of individual care, more sensitive and person-centred than other NHS facilities.  Homeopathy has had a dramatic positive effect on our health.  RLHH patients from Brent include babies and children, older people, and people with chronic pain and disability, including those with MS, ME, diabetes complications, cancer, depression  and those who have complications following surgery and maladministration of drugs.[i]  As Brent NHS users, we do not want to lose access to the RLHH. 

The very next day after making its decision on 23 November 2006, Brent PCT wrote to tell patients that their treatment at the RLHH was terminated.  There was no advance notice or consultation.  Some of us only found out at a public meeting organised by the League of Friends of RLHH on 29 January 2007, where some 150 Brent residents expressed their fury.  But no-one from Brent PCT addressed us. 

We found ourselves abandoned in mid-treatment, while others waiting to be seen have had their treatment cancelled.  Others still who were counting on using the RLHH in the near future will no longer be able to do so.  Some of us have only just found out that we could have had homeopathic treatment on the NHS; we are angry that the PCT never informed us and we want this option available to us now. 

We do not accept that there is insufficient evidence to validate the contract.  On the contrary, there is plenty of evidence, not only of demand for homeopathy from NHS users and doctors but of its effectiveness.

1. The demand for Homeopathy on the NHS has increased.

·               43% of PCTs provide access to complementary and alternative medicine (CAM) either wholly or largely free, with acupuncture, chiropractic, homeopathy, osteopathy, therapeutic massage and nutritional therapy being the services most commonly provided.[ii] 

·               The Patients’ Association has called for greater access to complementary medicine on the NHS.[iii] 

·               70% of GPs think that some access to complementary medicine should be available on the NHS.[iv]

·               One in four members of the public want to see complementary medicine on the NHS.[v] 

·               A 2000 Law Lords report lists homeopathy as one of the ‘Big Five’ complementary and alternative therapies, and recommended a more integrated approach to medicine and healthcare with more access to such therapies on the NHS, not less.

·               In 2005, 67% of individual GPS and 85% of practices in the Camden PCT area made referrals to RLHH, an increase of 29% over previous years.[vi] 

·               Elsewhere access to complementary and alternative therapies on the NHS is being extended: pilot schemes are planned for Northern Ireland and Wales.

·               In Scotland, the Glasgow Homeopathic Hospital has set a standard of patient-centered care of extraordinary beauty and therapeutic value which should be adopted by NHS hospitals everywhere.

·               Homeopathy is widely available through other European public health systems including France, Greece and Italy.

We are constantly bombarded with claims that changes to the NHS are based on offering patients choice when in fact choice is constantly undermined.  Homeopathy should be available not only to those who can afford to pay for it privately.  To do so discriminates against people on low incomes, especially women and people of colour whose average income is lower than white men’s but who happen to be homeopathy’s most likely users. 

We launch this letter on International Women’s Day because women are homeopathy’s main users and practitioners.  As society’s main carers women provide, unwaged, more healthcare than all the health services of the world put together.  We take responsibility for the health and well-being of loved ones – children, partners, parents, friends, neighbours and relatives – from the cradle to the grave, from breastfeeding and daily food provision to nursing and emotional support, often putting our own health last.  Those of us with disabilities and long-term ill health are usually seen as the receivers of care, but we often also do caring work for others, especially children and partners.  Most complementary and alternative practitioners – as most hospital and other healthcare staff – are also women. 

As the key decision-makers on health matters in our families and communities, women want the best for those we care for.  We deserve to be consulted, listened to and offered access to treatments which are safe, effective and holistic.  PCT’s decision to terminate RLHH’s contract without any consultation, affects women most and is therefore sexist. 

The decision dismisses the experiences and wishes of many Brent residents.  It is not only women but people of colour[vii] who are more likely to use complementary and alternative therapies, particularly people of Asian descent since homeopathy is one of the main healthcare systems used in the Asian subcontinent.  As Brent is one of the most ethnically diverse boroughs in the country with people of colour in the majority, according to the 2001 ONS Census, denying free access to homeopathy in the borough surely amounts to racist discrimination. 

We also want to point out that access to complementary and alternative therapies has been shown to help overcome men’s acknowledged reluctance to address health issues.[viii]  Why undermine a major provider of such therapies?

2. Homeopathy is effective.

Homeopathy’s reputation for effectiveness in this country was established beyond doubt during the cholera epidemic of the 1840s.  80% of affected people survived when treated with homeopathy compared to only 20% with conventional treatments.

Much research confirms the effectiveness of homeopathy for a wide range of illnesses.  Below are a few recent examples:

·               A study commissioned by the Prince of Wales concluded that homeopathy improved conditions such as anxiety, stress and depression, and needed fewer follow up appointments.[ix]  It also found that homeopathy could be relatively easily integrated into the NHS and would offer potentially significant cost savings.

·               45% of GPs consider homeopathy useful; 60% of the doctors who use it do so because they have found it effective and due to anxiety about the hazards of conventional treatment. [x]

·               Impact Integrated Medicine Project in Nottingham provided free treatment including homeopathy with funding from the New Deal for Communities (2004 to 2006).  Impact’s 2006 Annual Report states that during this time, 87% of patients reported reducing or stopping prescribed medication; 76% saw their GP less, and some no longer required hospital treatment.  Impact won the NHS Alliance Acorn Award in 2006, yet funding was not renewed.  People can no longer self-refer, but GPs can refer.  Demand for Impact’s service is still very high, and 85% of patients who completed a survey reported being very satisfied.[xi] 

·               Bristol Homeopathic Hospital surveyed what happened to 6,500 patients over six years.  70% reported improvement in their symptoms and well being for conditions which had not responded to conventional treatment.[xii]

·               A review by an NHS Community Menopause/PMS clinic in Sheffield reports high levels of benefit in reducing menopausal symptoms as well as improved mood and quality of life following homeopathic treatment.[xiii]

·               RLHH offers care for people with mental health problems.  The media recently highlighted the scarcity of services for people suffering from depression.  Many doctors acknowledge that prescribing anti-depressants is over-used, often inappropriate and ineffective and has harmful side effects.  RLHH users have been referred to alternative treatments which have helped them get off or reduce the use of anti-depressants.

·               Waltham Forest PCT has successfully integrated homeopathy into a Mental Health Strategy. This work won the NHS Alliance Acorn Award in 2005. 

·               The Society of Homeopaths National Service Evaluation found 87% of patients with mental and emotional problems reported positive changes with homeopathy.

·               Some of us are volunteers at the Crossroads Women’s Centre in Camden which runs a homeopathic clinic for destitute and low income women, often asylum seekers who have severe health problems as a result of rape and other torture.  We have seen great improvements in their health despite their desperate situation.

3. Homeopathy is safe.

Homeopathy has no side effects or danger of addiction or toxicity.  Pregnant women, children, young people and pets can all be treated successfully with it. 

Drug based treatment however can lead to effects worse than the original problem.  Medical decisions have been found to be the third leading cause of death, and prescribed pharmaceutical drugs are the fourth leading cause of death.[xiv]  The House of Commons Health Committee highlighted the disadvantages of the increasing use of and reliance on pharmaceutical medicines: “The inappropriate or excessive use … can cause distress, ill-health, hospitalisation and even death.”[xv]

4. Homeopathy is cost effective.

Increased use of homeopathy could lead to large benefits and savings to the NHS.

·               One homeopathic prescription can cost as little as 16p.  Compare that to the £7bn+ the NHS spends each year on conventional drugs.[xvi]  The need for many of these drugs is reduced or avoided by homeopathy.  Cutting access to the RLHH will cost the NHS more, not less.

·               Homeopathy helps prevent ill health.  Aside from avoiding side effects and drug dependency which then require further expensive treatments, it can prevent complications associated, for example, with childhood illnesses or childbirth. 

·               A pilot study showed that doctors practicing homeopathic medicine issue fewer prescriptions and at lower cost than their non homeopathic colleagues.[xvii] 

·               Every £1 spent on promoting health in the workplace can lead to a saving of £2.50 for employers.[xviii]  What would the savings if preventative healthcare, such as homeopathy, was promoted in Brent and nationally?

·               Despite this cost-effectiveness, NHS investment in complementary medicine is just 0.5% of the NHS budget.

·               Most private health companies and many insurance policies consider homeopathic treatment a good investment.[xix]  Why not Brent PCT?

5. Why is the RLHH under attack?

Why is a therapy which causes no harm constantly under attack when conventional drug treatment which has such a lethal record is not?  Most people are aware that the pharmaceutical industry – one of the biggest in the world with the oil and arms industries, with sales of 643 billion dollars of which 17% ($109.31 billion) is profit – increasingly dictates the priorities of the NHS.  With such massive profits at stake, the pharmaceutical industry has tried to discredit any form of treatment which presents an alternative, and therefore poses a threat, to its hegemony.  It has tried to discredit homeopathy and GPs who use it by employing ‘Quackbusters’, many of whom have been exposed as professional litigators with almost no knowledge or experience of the therapies they are paid to attack[xx] 

A letter signed by 13 prominent doctors (21 May 2006) urged PCTs to end their contracts[xxi], saying they were wasting their funding on “implausible” treatment with no “convincing evidence of effectiveness”.[xxii]  At least three of the signatories have connections with pharmaceutical companies and act in their interest.[xxiii]  The clinical study which the PCT cited as the leading evidence against homeopathy has been widely discredited internationally on grounds of flawed and inappropriate methodology and political interference.[xxiv] 

The decision to terminate the contract with the RLHH has nothing to do with health or with saving money. The cost of Brent PCT’s contract with RLHH in 2006 was £142,000, less than one GP’s salary[xxv].  Nor is the PCT doing anything to locate the £10 million which they have “lost” over the past two years, and which makes up nearly half of their “overspend”.[xxvi]

The decision has everything to do with the pharmaceutical industry tightening its grip on the NHS.   Why is Brent PCT serving unaccountable vested interests over the health needs of NHS users under its care?

6. The RLHH belongs to us all.

The homeopathic hospitals have been an integral part of the NHS since it started in 1948.   Aneurin Bevan, who created the NHS, gave a commitment that ”homeopathic institutions will be enabled to provide their own form of treatment and that the continuity of the characteristics of those institutions will be maintained”.[xxvii]

The Royal Family chooses homeopathy over other forms of healthcare, and people on high incomes who can afford the best increasingly do so.  But those of us on low incomes are denied access and have to struggle to pay for what we also consider the best.  According to the Society of Homeopaths, the private market for homeopathy is growing at around 20% per year, making it one of the fastest growth sectors in the UK today.  Why isn’t this demand reflected in NHS provision?

The RLHH has recently been renovated largely by donations from patients.  The legality of denying Brent patients access to a service which they have paid for through National Insurance contributions and donations is being looked into by the British Homeopathic Association.    

While the government spends billions on war in Iraq and Afghanistan – bombing, killing, maiming and torturing innocent people against the wishes of the majority of the UK population – it is simultaneously cutting and privatising access to essential holistic, low cost, popular and effective healthcare services such as the RLHH.  Instead of cutting access, more patients must be made aware of this service and Brent GPs must be encouraged to refer more people to the RLHH as well as to other registered homeopaths.

The RLHH has always been part of the NHS.  This principle of free access to all must remain.  We don’t want the RLHH to be only for the Royals! 

Signed:

Jenny Hautman (Student homeopath & cancer fighter) and Brent residents:

Niki Adams, Cristel Amiss, Kristina Brandemo, Sara Callaway, Senka Causevic, Kay Chapman, Hanna Demel, Michael Coleman, Philip Dymond, Sian Evans, Mr Faruqi, Mrs S Faruqi, Joan Fittall, Solveig Francis, Mr and Mrs Gajjar, Giorgio Giandomenici, Alex Hall, Selma James, Mr Khan, Mrs Ranjan Kundalia, Mr Kundalia, Lisa Longstaff, Nina Lopez, Cari Mitchell, Anne Neale, Tim Owens, Sylvia Salley, Anju Shah, Anna Thorburn.

Reply to: Solveig Francis   solveig@crossroadswomen.net

c/o Crossroads Women’s Centre, PO Box 287, London NW6 5QU     

Copy to:

Prince of Wales; The Queen; Sarah Teather MP, Lib Dem, Brent East; Barry Gardiner MP, Labour, Brent North; Dawn Butler MP, Labour, Brent South; Baroness Mar; Brent Health Select Committee; Local Brent Councillors; Patient Advice and Liaison Service; Healthcare Commission Complaints Investigation Team; The Health Service Ombudsman; Valerie Lawler, Royal London Homeopathic Hospital