Newly exposed by Pulse magazine, the shopping habits of some NHS patients, using their personal health budgets, recall nothing so much as the MPs’ expenses scandal. True, nobody seems to have suggested buying a duck house with public funds, or pornographic videos – or cleaning out a moat, like the latest ornament to our upper house, Douglas Hogg. But to judge by what patients were authorised to buy, there seems no reason why MP-style amenities would not also qualify, supposing a patient could make a plausible case for duck or moat therapy. One patient, after all, used the budget to build a summer house.
Other investments included horse riding, a satnav, computer games, a holiday with a dog, theatre tickets and music lessons. Patients funded by NHS Kernow clinical commissioning group spent £2,080 on aromatherapy. Nene and Corby funded Indian head massage therapy. Although personal health budget funds have, as anticipated, largely been used to pay for personal assistants and conventional care provision – and it is, in any case, a scientific fact, confirmed by some of the world’s leading garden centres, that the right summer house can be a marvellous contributor to general health and wellbeing – Pulse’s revelations have aroused clinical concern, as well as some derision.
The scheme is alleged to be draining money from conventional services, at a point when NHS England estimates it needs to make £22bn of efficiency savings. But even if the NHS were rolling in money, or now intent, as a matter of policy, on empowering all patients to self-medicate with consumer goods and pampering treatments, there would surely be a case for these innovative health aids to be subject to same kind of evidence-based scrutiny that Nice applies to orthodox treatments, such as cancer drugs.
Dr Richard Vautrey, the deputy chair of the BMA’s general practitioners committee, told Pulse: “We continue to have real reservations about this scheme and the inappropriate use of scarce NHS money on non-evidence-based therapies.”
In defence of the scheme, however, NHS England cites an early, independent evaluation, suggesting that personal health treatments are cost effective. And although this is, in turn, challenged by another study , champions of garden shed and satnav therapy could surely argue that, so long as NHS England persists in funding a single homeopathy practitioner, it is unfair to pillory personal health budgets for, among other things, waste, wishful thinking and the adoption of commercial consumer values.
There is no denying, after all, that, correctly used, an NHS-funded satnav will help a patient get about. An NHS-funded horse can be told to giddy up. NHS homeopathy, although this probably needs no rehearsing here, supplies patients with preparations so dilute as to have no active properties. Were they to contain active ingredients, these would, anyway, be pointless, poisonous or both, thanks to homeopathy’s founding principle, “like cures like”.
For insomnia, the remedy might be owl. Because owls stay up at night. Though the approach can equally be compensatory. One homeopathic remedy for emotional distress is human placenta. In the case of insomnia, if I understand this correctly, preparation by the NHS’s homeopathy suppliers involves diluting owl with water until no owl remains, the theory being that the water still carries the curative memory of owl. The “remedy” was recently investigated by the Good Thinking Society, founded by Simon Singh, which is currently campaigning, with considerable success, to end NHS protection for homeopathy.
Even at this reduced, but alas not homeopathic level, as Good Thinking argues of NHS support, “its symbolic value cannot be underestimated”. At a time of financial difficulty and alleged scientific rigour, NHS England reserves a cosy corner for magical thinking, justified only by consumer choice. Why, in the circumstances, shouldn’t the anonymous Nene or Corby patient have his or her Indian head massage? While superstition thrives within the NHS maybe it is equally unfair to ridicule the police for wasting time on psychics.
That homeopathy, having been repeatedly discredited in academic studies and dismissed by both the chief medical officer and the BMA, which called it “witchcraft”, should still be funded by NHS is less about owl feathers, more a commentary on ignorance and interference at the highest level. Publication of Prince Charles’s “black spider” memos confirmed that Charles had, as suspected, been pressurising ministers to spend on homeopathy. It is a mercy, given the effectiveness of his interventions, that Charles has not, so far as we know, conducted similar operations on behalf of haruspication for use in military planning or, for the benefit of the Treasury, alchemy.
He got a smarmy reply from Andy Burnham in which the current leadership contender volunteered – why? – to come and discuss complementary medicine. He signed off: “I have the honour to remain, Sir, your Royal Highness’s most humble and obedient servant.”
Charles finds an instant ally in Jeremy Hunt, who asked the chief medical officer, Dame Sally Davies (who describes homeopathy as “rubbish”), to commission expert reviews of commercial homeopathy studies. And in the Conservative MP David Tredinnick, Charles has an astrology-loving homeopathy fanatic embedded, as if by some ancient Hahnemannic curse, on the Commons health select committee. Alas, he also haunts the chamber, howling untruths that would endanger public health if most people were as credulous or “lunatic” (Lord Winston) in their views as he. “Macular degeneration,” he once told an unimpressed Yvette Cooper, “can be treated by using homeopathic remedies, by herbal remedies and by using acupuncture.” It is one of the joys of the discipline that no disease, not even Ebola, is ever too challenging for homeopaths to admit defeat. Snake venom, apparently.
In one respect, a person’s support for state-funded homeopathy has enormous practical use, as an immediate signifier of gullibility, fiscal irresponsibility and scientific illiteracy, to the point of disqualifying them from public office. For some critics, the irrationality is “typically Tory”. Either way, any weakness for Hahnemann has been unforgivingly portrayed in the cases of Charles and Hunt. For many of us, these boobies might as well agitate for a Loch Ness monster tsar, an inquiry into alien abduction, a state astrologer, in the mould of Nancy and Ronald Reagan’s.
It is intriguing, in the circumstances, how many sceptics must, in the case of another NHS homeopathy enthusiast, Jeremy Corbyn, have made a different assessment. Perhaps his many good points should protect him from the derision aimed at fellow signatories to early-day motions composed by David Tredinnick. One in 2007, calling for recognition of NHS homeopathy hospitals; another effort in 2010, asserted its effectiveness. Asked about the latter, Corbyn tweeted back: “I believe that homeo-meds works for some ppl and that it compliments ‘convential’ [sic] meds. They both come from organic matter.”
“I believe”. For those who can accept this justification for pouring precious NHS funds into the cognitive vacuum that is homeopathy, the first thing on Corbyn’s agenda, even before he expresses our regrets for the Iraq war, must be an apology, on behalf of all flexible sceptics, to his long-suffering fellow believer, Prince Charles.
