The presence of homeopathic remedies in pharmacy, both in the dispensary and on sale in the pharmacy itself, has been the focus of a debate that has been raging for decades.

Available on the NHS since the service opened its doors in 1948, homeopathic remedies have been around for hundreds of years, but many people would like to see them taken off the shelves for good.

The NHS, Royal Pharmaceutical Society (RPS) and other health bodies all argue that there is no evidence that homeopathy works for any health conditions. However, a recent investigation by the Independent newspaper found that £1.75 million of taxpayers’ money was spent on homeopathic remedies last year. This revelation has seen renewed calls for homeopathic prescribing to be banned on the NHS, and the Department of Health (DH) is expected to launch a public consultation into this issue soon.

Why is it still funded?

The last time the Government looked at the funding of homeopathy was in 2011, when ministers recommended that it should neither be funded nor licensed as it does not work. Shortly afterwards, local commissioning groups were put in charge of deciding whether or not to provide homeopathic remedies to patients. This means that today, patient access to homeopathic treatments on the NHS depends on whether there is a local homeopathic hospital or a GP willing to prescribe it.

In light of revelations that millions are still being spent on homeopathy, Alex Wild, research director of the TaxPayers’ Alliance told TM: “At a time when NHS bosses are talking of a cash crisis, it’s astonishing that so much is being wasted like this. The NHS must focus its resources on proven medicines.”

Although the Independent investigation has reawakened this debate, the total amount spent on homeopathy has actually dropped over the past two decades. “The number of NHS prescriptions for homeopathy fulfilled in community pharmacies in England has plummeted 95 per cent in the past 19 years,” says Alan Henness, director of the Nightingale Collaboration, an association set up to challenge misleading claims in healthcare advertising.

The number of local areas where homeopathy is available is also falling, and last year NHS Liverpool CCG stopped funding it following a consultation.

What is homeopathy?

Homeopathy is a complementary medicine (also known as an alternative medicine) that was first invented by a doctor in 1790s Germany.

Plant extracts, minerals, fungi and even parts of animals are mixed with water and diluted many times until there is none or almost none of the original substance left. Practitioners argue that the water retains a memory of the substance that has been dissolved in it and the higher the dilution the more effective the remedy is. The mixture is shaken a certain number of times in a process homeopathic practitioners call succussion, and then added to pills or creams.

Homeopathic practitioners advise patients that ‘like cures like’, so remedies based on stinging nettles should, for example, be used on eczema as it also causes a red, itchy rash.

Homeopathy should not be confused with herbal medicine.

Giving patients choice

So whether or not NHS doctors are able to prescribe homeopathic products, the debate remains as to whether or not pharmacies should sell them. Many of the pharmacy chains say homeopathy is available because customers want it. Asda told TM that it offers homeopathic remedies as it is “a family-friendly retailer”. A spokesperson for Boots echoed this sentiment, saying: “We aim to offer the products we know our customers want, but with the added benefit of being able to get impartial advice on their choice.”

This reflects advice from the RPS (see box, below), which argues that though there is no evidence for homeopathic remedies, it is best for a person with an ailment to seek advice from a healthcare professional who can give them advice about possible treatments, and refer them if appropriate.

Despite falling numbers of NHS prescriptions for homeopathy, there is still significant demand from private patients, says registered pharmacist and homeopath John Morgan, managing director of Helios Homeopathy. “The demand is steady for homeopathy and it is still as popular as ever,” he says. “It is important that pharmacy staff understand what they are selling and take some training such as the GPhC CPD module on complementary medicine.”

Some people still disagree that homeopathic remedies should be available in any healthcare setting, as this could be seen as an endorsement, says Michael Marshall, project director at the Good Thinking Society, a pro-science charity that promotes rational thinking. “It is not the case that pharmacies only sell what their customers want, regardless of the impact they have on health. It is putting profit before professionalism and reputation as pharmacists should know that homeopathy does nothing at all,” he argues.

Clearer rules

While the latest revelations about NHS spending on homeopathic treatments have stimulated debate on this issue, the last time the subject was seriously discussed by Government was over five years ago. Perhaps with falling pharmacy funding and patients expected to take on more self care, it is now time for the matter to be put to bed for once and for all, with clear regulation from the Government on these controversial treatments.

Dealing with customer requests

Customers may self-select homeopathic products from a display without consulting a pharmacist or member of pharmacy staff, but when speaking to customers who want to purchase homeopathic products, the Royal Pharmaceutical Society (RPS) advises the following:

• Make sure they are only taking them for minor,self-limiting conditions

• Ensure they don’t stop taking conventional, prescribed medication

• Be able to discuss the lack of evidence for homeopathy

• A pharmacist must refer on to another healthcare professional if they suspect there is an underlying health condition.

More information can be found in the RPS homeopathic and herbal products quick reference guide.

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