Withdrawal of NHS Funding Has ‘Ruined My Life’: Katherine’s Story
June 27, 2012
The Fresh Outlook
With the UK locked in double-dip recession, The Fresh Outlook hears first hand the consequences of unprecedented NHS efficiency savings.
Amidst a climate of sweeping government reforms and brutal cuts to reduce the UKs deficit, the NHS is targeted to reduce costs by £20bn over the next four years.
Earlier this month, a survey published by GP Magazine revealed that 90% of Primary Care Trusts (PCT) are rationing or withdrawing treatment deemed to be non urgent or of low clinical value. Editorial comment from the magazine stated: “The restrictions vary significantly from PCT to PCT, meaning patients face a postcode lottery.” Responding to the survey at the time, The British Medical Association described the situation as a “cost-saving exercise”, with deputy chair Dr Richard Vautrey adding: “We’re supposed to have a national health service, so there should be national consistency.”
The Fresh Outlook spoke to a patient whose treatment for two chronic illnesses has been withdrawn due to funding cuts determined by her local PCT.
Katherine, aged 70, from Roehampton has suffered from the bowel condition Crohn’s disease and two different types of arthritis – ankylosing spondylitis and osteoarthritis – for over 40 years. Conventional nonsteroidal anti-inflammatory medications prescribed to treat the arthritis caused the bowel complaint to flare up and the various treatments provided for Katherine’s Crohn’s disease failed to have any impact. She suffered years of ill health and prolonged hospital stays, and such was the debilitating effect of her illnesses that in 1976, at the age of 33, Katherine was retired from her civil service job on the grounds of ill health.
“I was at Guys Hospital at the time” says Katherine, “and the professor there who was treating me told the civil service board that in his opinion, I would never work again … I was in a terrible state; I didn’t know what to do.”
Shortly after, Katherine was given a magazine by a friend which contained an article on homeopathy. “It was something different, completely different, because I’d found all the other hospitals were exactly the same,” she says. Katherine managed to get a referral from her then GP to the local homeopathic hospital, despite the doctor’s opinion that homeopathy was “complete rubbish”.
And then everything changed.
“They did an absolutely brilliant job, it was just incredible,” says Katherine. “In 1976, I spent 17 weeks in three different hospitals. The homeopathic hospital had me in for eight weeks and that was the last time I ever went in to hospital for my illnesses … They told me straight out, ‘homeopathic remedies won’t work for you, what we can do is actually find mainly orthodox drugs for you, but we’ll tailor them to your needs. It won’t be the prescribed drugs for your disease because obviously they don’t work. But we’ll find drugs that will work for you, and that’s what we’ll give you.’ And they did; they were absolutely wonderful.”
The homeopathic hospital, now the Royal London Hospital of Integrated Medicine, recommended two drugs: Gamolenic Acid and Maxepa, usually used to treat other conditions, for her arthritis. Katherine also received apis injections, derived from bee venom, at the hospital when the arthritis in her knee was at its worst. They also identified conventional antibiotics which kept the Crohn’s disease under control, even though they aren’t designed for that purpose, complemented by iron injections to maintain her energy levels. These prescriptions were all fulfilled by her local GP. “The treatment I have had for the last 36 years has made it possible for me to live a normal and productive life,” Katherine told The Fresh Outlook.
Then, in 2010, amidst a swathe of NHS reforms, Katherine’s local PCT, Wandsworth, made the decision to withdraw funding for homeopathic treatment. A series of misunderstandings and communication failures within her original GP’s surgery meant that Katherine was not made clearly aware of this fact until she moved to a new GP midway through 2011.
“This decision has left me with no treatment,” says Katherine. Now unable to attend the homeopathic hospital and with GPs unwilling to continue to prescribe medicines which, although they worked for her, were not designed for her illnesses, Katherine was referred back to an array of conventional specialists to no avail.
As her health deteriorated towards the end of 2011 and arthritis weakened her knee, Katherine suffered an accident: “I was getting off a bus with a load of shopping, my knee just gave out, it was terrible and I fell to the kerb and broke my wrist.” At Kingston Hospital, her wrist was put in a cast and although x-rays of her knees were taken, the hospital said it was clear she had a pre-existing condition so there was nothing they could do in that respect.
For weeks the pain in Katherine’s knee got worse and worse, to the point where she could barely walk. Finally, a recent referral for an MRI scan revealed she actually tore the meniscus – cartilage tissues which act like shock absorbers in the knee joint – and may need surgery to repair this.
With her arthritis untreatable with standard medication and after numerous unsuccessful attempts by a gastroenterologist to control her Crohn’s, Katherine says she is “in constant pain” and that the decision to withdraw her funding has ruined her life. Less than two years ago, she enjoyed an active life, even attending ballet dancing classes, but now she can hardly walk and has to rely on neighbours to help her.
Despite repeated appeals, with the support of her conventional gastroenterologist, to her local PCT to reinstate funding for her treatment; Katherine has been refused on the grounds that she is not an ‘exceptional’ case. “We are informed that we need to prove that we are exceptional cases,” she says, “without having any idea of the criteria. This secrecy allows the PCT to move the goal posts as it sees fit.”
A further appeal to the Health Service Ombudsman was also rejected. Although the written response acknowledged some concerns about how her complaint was handled up to that point, the Ombudsman ultimately concluded that: “The PCT acted reasonably in making their commissioning decision about homeopathic treatment, as there is no clinical basis for it.”
A final plea to David Cameron himself, which was passed to the Department of Health, resulted in further frustration, with Katherine told to follow the official NHS complaints procedure; her previous appeals seemingly deemed not to constitute a complaint.
“So now I follow the complaints procedure and see what comes of this,” says Katherine.
Fully aware that homeopathy was withdrawn due to efficiency drives, Katherine spells out the financial paradox of the PCT”s refusal to reinstate treatment in her case: “In the past, I had been treated only by my hospital and GP. The treatment was effective and relatively inexpensive. Since all this happened, I have been attending three different hospitals for my various ailments, and have had approximately 13 appointments since December, many of them requiring hospital transport due to my knee injury. Clearly this has cost the NHS a small fortune and was entirely unnecessary.”
When asked for comment on this case, a spokesperson for NHS Wandsworth told The Fresh Outlook: “A panel of clinicians, local GPs and the Chair of the Professional Executive Committee looked at the medical usefulness and cost effectiveness of homeopathy in February 2010. In the absence of robust clinical evidence to support the efficacy of homeopathic treatment, the decision was taken to cease funding.”
In response, Katherine insists: “I attended the physical medicine clinic at the hospital and therefore my treatment was not homeopathic as such, with the exception of the apis injections. I understood the PCT was stopping the funding of homeopathy alone.”
Wandsworth PCT may feel justified in withdrawing funding for homeopathy; a 2010 report by The Science and Technology Commons Committee concluded that there was no evidence homeopathy worked and to continue funding it on the NHS would undermine the principle that government funding in health should be evidence based.
Whatever the precise nature of her treatment, it’s clear that the homeopathic approach of treating the individual person, rather then the condition diagnosed, was wholly successful for Katherine.
Cristal Sumner, chief executive of the British Homeopathic Association, told The Fresh Outlook: “Patients inevitably suffer when PCTs decide – often with little or no public consultation – to stop funding homeopathy, for they still require treatment. Without having the choice of offering homeopathy, GPs are forced to prescribe often ineffective and more costly conventional medicines, which is not only bad for the patient, it makes no sense financially at all. Homeopathy has a useful place in the NHS and it continues to be available on the NHS in many areas … This costs the NHS around £4 million a year or just 0.0004% of the total NHS budget.”
When the NHS rationing stories hit the headlines earlier this month, health minister Simon Burns insisted: “Last year, we made it clear that it is unacceptable for the NHS to impose blanket bans for treatment on the basis of costs. Decisions on treatments should be made by clinicians based on what is most clinically appropriate for the patient and take the individual patient’s needs in to account.”
Sadly, on this occasion, the individual patient’s needs, plus a demonstrable record of successful historic treatment, don’t seem to have entered into the decision making process.
Have you been adversely affected by NHS cuts? If you’d like to share your story, contact: email@example.com
By Sarah Harper
[Image courtesy of Zechariah]