tCI commentary:
This week, the British Homeopathic Association (BHA) has been to the High Court, seeking to overturn a decision by NHS England to ban the routine prescribing of homeopathic medicines by GPs.
There is a long and sometimes acrimonious history to the relationship with this form of complementary medicine and the clinical establishment. The popular columnist, Ben Goldacre questioned evidence submitted by supporters of homeopathy, and in his celebrated book Bad Science, tells the story of how he was threatened with legal action but ultimately won the arguments.
As the NHS’s purse strings have been tightened, a number of Clinical Commissioning Groups (CCGs) have consulted on proposals to abandon or limit GP prescribing of these medicines, often to find that the controversy it arouses is scarcely worth the bother, as the savings are (appropriately) often minuscule.
There has already been one Judicial Review – in Scotland. A lady called Honor Watt took the Lothian Health Board to the Court of Session in 2015[1], alleging that the decision to withdraw her service was in breach of the Public Sector Equality Duty (PSED) and that the Board had failed to have ‘due regard’ to the impact of their decision. The Judge rejected the case with the words:
I have reached the conclusion that the Board had a proper and conscientious focus on the statutory criteria and that it had obtained sufficient information to discharge its duty of inquiry under section 149 of the Act.
The current case may turn on different matters. The BHA seeks to challenge the consultation upon which the NHS decision was based, and it seems to have been part of a much wider exercise on the potential withdrawal of a much wider range of treatments for which it was argued there was insufficient medical justification. No doubt lawyers will argue that this may have prevented a sufficient focus on the likely impact upon patients of the withdrawal of the service which they champion.
The significance for the rest of us may lie in the vulnerability of consultations if they seek to cover too broad a range of services, and the difficulty of pinpointing the patients or ‘consumers’ of one service among many. As the councillors of West Berkshire found out in a 2016 legal judgment[2], when they sought to implement 47 different budget cuts in one fell swoop, it can be a problem to show in respect of each one of them that specific impacts have been identified and due regard given to them properly.
We will look carefully at what emerges from this week’s hearings.
[1] Honor Watt v Lothian Health Board [2015] CSOH 117
[2] R (ex parte DAT & BNM) v West Berkshire Council [2016] EWHC 1876 (Admin)
Article:
The British Homeopathic Association (BHA) has secured a judicial review of NHS England’s decision to stop GPs prescribing homeopathy on the health service.
Richard Clayton QC, who represented the BHA during a judicial review hearing at the High Court, claimed an NHS England consultation did not provide a balanced argument and was too complicated for “ordinary” people to understand despite there being “ample” evidence that homeopathy worked, according to the BBC.
Last year NHS England decided to scrap what it regarded as 18 “low value” treatments on prescription following the consultation, including herbal remedies, homeopathy and dietary supplements to generate £141 million in annual savings.
The NHS Choices website states: “There’s been extensive investigation of the effectiveness of homeopathy. There’s no good-quality evidence that homeopathy is effective as a treatment for any health condition.”
Seven products were also referred to the Department of Health and Social Care for blacklisting, including homeopathy, herbal treatments, omega-3 fatty acid compounds (fish oil), co-proxamol, rubefacients (excluding topical NSAIDS), lutein and antioxidants and glucosamine and chondroitin.
The measures were based on the belief that stopping those items on prescription will generate significant efficiency savings and free up millions of GP appointments. About £92,000 was spent on prescriptions for homeopathy last year.
Article originally appeared on Pharmacy Business
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