A response to the Professional Executive Committee’s Homeopathy paper dated 18 January 2011 as presented to the ‘Public Meeting’ called by the Primary Care Trust (PCT) for 9 March 2010.
This meeting was announced to the ‘Public’ at one day’s notice on their website and notified to the North West Friends’ of Homeopathy (NWFH) a week earlier in a letter dated 2 March 2011 from Mr Martin McEwan (Director of Communications and Engagement NHS Wirral). The letter reads (para 1)
“You will be aware that NHS Wirral is considering a recommendation from its Professional and Executive Committee (PEC) that it does not commission homeopathic therapies from 1 April 2011” (ie in under one month from that date), notwithstanding the existence of the very long established front line service through Liverpool PCT from Old Swan Liverpool and its outreach clinic at St Catherine’s Birkenhead. The opening words
‘you will be aware…’ refers to a letter 3 days before (dated 28 February) starting
“You may be aware that NHS Wirral is considering a recommendation from its Professional and Executive Committee (PEC) that it does not commission homeopathic therapies from 1 April 2011” specifying that a ‘public meeting’ would take place but that the date had not been decided upon.
The Professional Executive Committee (PEC) are charged with an obligation to ‘champion public involvement’ via:
- An obligation to their ‘Parent’ — the Primary Care Trust (PCT)
- The National Health Service (NHS) Act 2006
- World Class Commissioning Competencies (Department of Health)
- Wirral Compact
- Wirral LINk
The PEC have failed on each test to consult meaningfully. It is completely outside their own remit as a sub-committee to put for ratification, or otherwise, any recommendation that has been framed without due process. The Director of Communications & Engagement was only informed by PEC of the recommendation to cease, on 1 April 2011, in January 2011 after it had been finalised (without consultation) by the PEC.
What came out at the meeting in discussion — with the General Practiotioner shadow consortia heads present — was that the ‘process’ was triggered by a notice that the Liverpool service’s hosts were planning to withdraw. Whilst it is true that there may be some change in who is to host the service later in 2011/12 (currently Liverpool Community Health) nonetheless the Liverpool PCT have confirmed they are committed to continue to commission homeopathy and it is a question of reconfiguring the appropriate service provider structure, not a matter of withdrawing the service.
By contrast, Wirral PEC have made an opportunistic, ill-considered and inaccurate, attack on homeopathy itself rather than the actual body hosting it — despite the popularity of the service provided in the area by qualified doctors in integrating homeopathy with conventional medicine. The local area, for which Wirral PCT is responsible, is fortunate in having a pool of medical expertise in homeopathy which is not necessarily matched in all other areas of the country, as well as having a long established local front-line service that has been available since the inception of the NHS. The government has pledged its support for NHS front line services and so any suggestion that the recommendation to cut the service needs to be made for cost reasons cannot be substantiated.
Whilst Wirral PCT have a responsibility for local commissioning recommendations, they are still subject to bring into account — in framing their recommendations — the guidelines issued by the NHS in respect of how they go about that process. As regards complementary therapies (including homeopathy), these are succinctly summarised on the NHS Website dealing with NHS supported career roles. The PEC, in framing their recommendation on behalf of the PCT and the shadow GP consortia, have taken no account, in their report, of the availability of local expertise or indeed even consulted the doctors who have specialised in homeopathy in the area when framing their recommendations — notwithstanding the NHS guidance.
In particular the guidance clearly sets out that:
“The safety, clinical, cost-effectiveness and availability of suitably qualified/regulated practitioners are all issues that they should take into account.”
Given the Liverpool PCT’s commitment to the homeopathy service, what emerges now following the Public Meeting is that:
- Any excuse by Wirral PCT for calling for a withdrawal of homeopathy triggered for hosting reasons has evaporated;
- The recommendation for the termination of the service on 1st April 2011 (or indeed at all) should therefore be withdrawn forthwith;
- The PCT should seriously investigate the manner in which their Sub-Committee (PEC) has gone about its business.