The Politics of NHS-ConMedChapter 3 (part 2), The politics of NHS-ConMed: It is not science that NHS-ConMed is based upon - it is the preservation of a highly profitable monopoly.by Steven Scrutton17 August 2011 
Chapter 3, The Politics of NHS-ConMed (Part 1) The cost-effectiveness of medical treatmentsThe financial argument NHS-ConMed uses to justify the exclusion of traditional therapies is even less credible. Throughout its history ConMed has been the most expensive type of medicine available, and it continues to be so:
In contrast traditional therapies require little more expense than a trained and skilled therapist:
What this means is that traditional therapies are not good vehicles for making large profits, and this is the real reason they are so fiercely opposed by Medical Fundamentalists. The exclusion of traditional therapies relates to the financial and commercial interests of the NHS-ConMed establishment, whose power and influence has not been built on the concept of 'cost-effectiveness', but its ability to sell extremely costly and profitable treatments to large numbers of people through the NHS. NHS-ConMed - becoming unaffordableThe affordability of NHS-ConMed treatment is gradually becoming an issue. If the New Labour government (1997-2010) could increase expenditure on the NHS nearly 4-fold in 13 years, and still lose an election, in part because of health issues, it is inevitable that a new question is asked. "How much more money has to be spent on NHS-ConMed to make it work?" The situation is getting sufficiently serious that the main founding principle of the NHS is now being brought into question – that the health service should be available to citizens free at the point of need. Evidence from the USA suggests that medical insurance schemes in place there for many decades are now becoming too expensive for a growing number of people. And the costs of the publicly-funded scheme, Medicare, is expanding probably even more rapidly than with the NHS. Such concerns are growing but as yet they have not reached a critical stage yet. Even the subject of ‘rationing’ health services remains unacceptable at this time. But with an increasing proportion of national income being spent on health provision it will soon become an issue that needs to be addressed. Political Power of the NHS-ConMed EstablishmentBig Pharma companies are now amongst the most profitable, wealthiest and influential corporations on earth, and they use this power to further their own political and economic advantages. And the regular medical failures of Big Pharma ensures that they need to do so! If politicians, and the public they serve, really understood how unsafe and dangerous NHS-ConMed drugs were they would quickly become un-saleable, and the commercial and financial basis of ConMed would be severely, perhaps terminally undermined. But this does not happen, and the reasons for this have now to be considered. The magnitude of the NHS-ConMed establishmentThe creation of the NHS, and the success of its partnership with ConMed, has produced an enormous medical establishment. The NHS is now one of the biggest single employers in the world, and the biggest in the UK. Medical practitioners are just a tiny part of this establishment, and to understand fully its pervasive social influence, and particularly its influence on government, a wider appreciation of what, and with whom we are dealing, is required. To criticise the NHS today is to criticise vast numbers of people, and bring into question their livelihoods and personal interests, locked as they are into such a huge medical empire. So what are the constituent parts of the NHS-ConMed empire?
Everyone working for this huge establishment has a vested interest in NHS-ConMed. NHS spending not only wins votes for politicians, it secures the investment of ConMed companies in the UK, and the employment for literally millions of people. So to question, leave alone to radically change or dismantle such an establishment is difficult because of the dependence it has generated. This means that the NHS-ConMed establishment has become large enough to be self-perpetuating. It has grown quite irrespective of the huge financial burden borne by government, its lack of medical effectiveness, and the harmful consequences of its medical drugs and procedures. No government, of any description, can now ignore it. We have all become hostage to the fortunes of a failing medical discipline. The influence of ConMed DoctorsChapter 2 outlined how the 1911 Health Insurance Act made ConMed more accessible to more people during the inter-war period (1918 to 1939). However there continued to be serious limitations of access to primary medical care, even for people covered by the schemes. And large number of people remained entirely outside the schemes. The issues debated during this time were not about the 'effectiveness' or 'safety' of the medicine people were receiving but its availability, and the inadequacy of 'patchwork' nature of medical provision. During the 2nd World War plans were made to establish a more comprehensive system of medical care - the National Health Service. Yet to establish the NHS, the health minister, Anauran Bevan had to fight a major battle with ConMed doctors to bring them into the scheme. They demanded a position of primacy within the NHS if they were to take part at all. Far from seeing the opportunities offered by the new monopoly, doctors fought doggedly to maintain their 'clinical independence', and their lucrative 'private' practices. They were almost completely successful in doing so, and ConMed doctors have dominated the NHS ever since. ConMed doctors now dominate every clinical decision made within the NHS. The structure of the NHS allows little or no room for traditional medicine to be practiced, and the policies and procedures developed by NHS organisations have little or nothing to say about the use and value of traditional medicine. When a patient wants to use traditional therapy, even if (s)he refuses ConMed treatment, it is NHS-ConMed practitioners who take the decision - so it is not surprising that such requests are usually turned down. Again, it is the Vauxhall salesmen who has no interest promoting or selling Ford cars! Doctors and Big PharmaDoctors have become very close to drug companies. It is well known that Big Pharma companies seek to influence the prescribing behaviour of doctors. Certainly, the outcome of most patient visits to GPs is a prescription for drugs, even though in most cases there are many other kinds and areas of health advice and treatment that could be given. Too often health factors like diet, exercise, life-style changes, and of course traditional therapies, are ignored. Even some doctors have become concerned. WDDTY reported in October 2006 that a group of doctors were taking a stand against the 'overt and covert inducements' offered to encourage doctors to prescribe drugs. They have a website at www.nofreelunch-uk.org to try to change the current relationship between doctors and Big Pharma. They described this relationship as "based on hospitality and patronage which is unknown and undeclared to the general public" and that "without action we will continue with the relentless medicalisation of society" Most patients place their trust in their NHS GP in the belief that their advice is impartial, and in the best interests of their health. They do not consider that prescriptions might be the result of bribes or junkets. Yet drug companies are wealthy, and doctors are human - and this leaves patients vulnerable. Big Pharma - lobbying and funding political parties>Big Pharma are major 'investors' in the political and governmental structures of the USA, the UK, and most other national governments that purchase health care directly for its citizens. We may have an electoral system in which we all have a single vote. But voting power is not the only, or indeed the main basis of political power within a democracy. How do politicians and political parties get their message across? They have to communicate with the electorate, and this is expensive. Indeed, democratic politics is an expensive business, money is required, and the more money politicians have, the greater their ability to communicate, and win our votes. Politics is not publicly funded. Today political parties obtain the bulk of their money from big business. And naturally, big business does not 'invest' in the political process entirely for 'philanthropic' reasons. They do so in order to increase their business and commercial influence, and to do so, they identify, and work closely with 'industry friendly' politicians. Big Pharma is no different to any other business enterprise, except perhaps in the enormous size of their political contributions. Here, in the USA, and in other democracies, it regularly gives large donations to the electoral campaigns of individual politicians, to national political parties, and as a result has a large influence on the elections of governments, on legislation, and the way that governments behaves in relation to health. Big Pharma InvestmentBig Pharma, and other ConMed investments, are a politically sensitive issue, and economically vital. They create an enormous amount of wealth for both national and local economies. The prospect of new investment, and the maintenance of current investment, has an enormous impact on the economy. So as the NHS-ConMed establishment has grown, so too has its political influence. A Guardian article dated 28 September 2006 stated: The pharmaceutical industry is a major contributor to the UK economy. Its total investment in research and development was more than £3.4bn in 2004, which, a Whitehall briefing note points out, 'represents around a quarter of the UK's total manufacturing industry expenditure'. Again, ConMed is no different to any other large industrial interest. Their political power rests not on democratic voting (no-one 'votes' for them) but their ability to make critical investment decisions. For instance, a decision to move manufacturing capacity from one country to another is an important opportunity to the recipient nation, and a dangerous threat to the losing nation (see Pfizer and Job cuts). Each country has strong political and financial reasons for maintaining the favour of these companies, and governments often provide massive incentives to ConMed companies to invest in their country. Politicians are not health expertsEven though it is politicians who make the crucial decisions about how the health service works, it is important to realise that politicians are not usually experts in health (and those that are usually have an NHS-ConMed background). So it is not entirely helpful to blame them for the situation they have created. Most politicians are not sufficiently sophisticated or knowledgeable about health matters to withstand the intense lobbying of the NHS-ConMed establishment. What most politicians know about health is what already exists - the status quo. They know what the NHS is, what it offers, how it is organised, and how it is financed. And when they need advice and guidance in matters of treatment they turn inevitably to those they consider to be experts - NHS-ConMed practitioners - who are eager to advise that they need more of the same! Most politicians do not know about traditional medicine; and they have never seriously questioned the efficacy, safety and effectiveness of NHS-ConMed. In most other financial and commercial spheres this lack of knowledge is not a serious matter. Most lobbies involve competitive industries, so they will hear different and conflicting views from all sides. But the health lobby is effectively a single lobby, and one of the most powerful lobbies of all. And the more powerful a lobby, the more politicians have to listen (and perhaps the more they want to listen). Unfortunately the voice of traditional medicine is small, almost insignificant in comparison, and too often hopelessly disunited. Of course, democratic politicians also have to consider the views of their electorate. Generally speaking they are prepared to give us what we want (they hope in return this will win our votes). And what the majority of people want, as far as health is concerned, is more spending on what they already have, the only form of health treatment they know about, in the forlorn hope that extra resources will eventually produce more effective health care. The public desire for more of the same is based on the same lack of information, and disinformation, that politicians are given. It is not their fault they want more of the same. They rely on the media to inform them about health issues, and in this reliance they are not well served. Information and the MediaSo why is the failure of NHS-ConMed not more widely understood by the public? The difficulty arises because of the influence NHS-ConMed has on the information appearing in the media. Although many people feel increasingly disillusioned and dissatisfied with the NHS, few will have diagnosed the real problem. People are informed that NHS failure is the result of a 'lack of resources', or 'bad management' . Public dissatisfaction is thereby misdirected, aimed at politicians, governments, or NHS management. So whilst increasing numbers of people may not want to take drugs, and more people seek to avoid going to hospital if possible, rarely do they criticise the treatment they receive. There is widespread ignorance about the impact NHS-ConMed treatment has on our health, largely because we are rarely told anything about it, except perhaps for short, isolated snippets about restrictions placed on commonly prescribed drugs like HRT, or the withdrawal of drugs, like Vioxx, Seroxat and many others. The broader picture is rarely presented to the public. There has never been a serious, comprehensive critique of NHS-ConMed. This is why ever-increasing amounts of public money can be spent on it, with no corresponding improvements in health. Nothing has ever been properly examined. A Free Press?What people believe to be true at any point in history has not necessarily been found to be true in the fullness of time. The 'conventional wisdom' of one age is often found wanting in both truth or relevance in the next. When this happens the 'deception' can usually be uncovered by 'following the money', or focusing on the interests and activities of the rich, powerful and influential social forces that distort the 'truth' in any age - for their own advantage. Within modern democracies we pride ourselves about our freedom and liberty, and our ability to make informed and rational decisions about how we lead our lives. Moreover, in this 'age of science' we assume that what we do is rational, and based upon sound evidence. Not least, we pride ourselves on our free press. The freedom of the press is a central facet of our democracy. And indeed the press can investigate and report on anything and everything that happens in society. It can analyse, assess and make judgements; it can praise and criticise; it can call on people and organisations to account for their actions and misdeeds. Our media has enormous influence and power. It is a major source of information for the public, and therefore in matters of health, for patients. So, if patients receive only restricted information from the NHS-ConMed monopoly, surely the media would be able to correct this? Unfortunately it fails to do so. In general the media stays close to the mis-analysis and the mis-information of NHS-ConMed, and the reasons for this need to be examined. Influencing News reportingIn theory we do have a 'free' press in the UK, one that is able to report openly and honestly on the quality of the health treatment we receive. The media can say what it wants, and in lots of non-health areas it certainly does so. Unfortunately, this simplistic assumption omits one important fact. The media is comprised of competing private companies who earn a living not by selling papers (or gaining listeners or viewers), but by attracting advertising. Media companies are obliged to sing the song of their main paymasters in order to be financially viable. They can risk their business if they take their freedom too and are too critical of their main advertisers. If they are over-critical of 'those who feed them' they place at risk their large advertising revenues, and their financial viability, even their survival. ConMed has unlimited resources to buy mass media coverage, and they can use their advertising budgets to influence, manipulate and control how the media informs the general public, even to the extent of excluding coverage they consider contrary to their interests. The message they want the public to have is that ConMed is scientific, that the battle against disease is being won, that drugs are making us better, and that we are leading longer and healthier lives as a result. So whilst our free press can publish whatever it wants, it can only do so within the limits set by its own financial viability. The freedom of the press extends only as far as its ability to survive in a cut-throat commercial world, and this relies on its ability to attract and maintain the largesse of large and powerful advertisers. Again, what is happening in our media can be understood by 'following the money'. Anyone wanting to learn about the dangers of ConMed drugs have to do so through certain internet sites and specialist magazines that do not rely on pharmaceutical advertising. The information that appears in the popular media is severely restricted; they have to be careful about what is said and written about health; they dare not be too critical, or highlight news that might impact on a major advertiser. The result can be summarised under two headings. Toeing the line with medical breakthroughsThe UK media is content to go along with the 'good news' hype that Big Pharma companies produce. So when they introduce new drugs they are happy to announce them as imminent medical breakthroughs, with little serious questioning about the claims being made, and without bothering to question the quality of the testing, the interpretation of test results, or looking closely at possible adverse reactions. Bad newsOn the other hand, when evidence emerges about serious drug DIEs, even the most popular drugs, the information rarely receives the critical examination that other industries would get if they were found to be instrumental in causing disease, and killing people. Generally, 'bad' health news is reported only when the information has been known for several years and can no longer be withheld, or when the full enormity of the information can no longer be avoided. Even so, this is then usually described as an 'error', or a 'mistake', and successive, repeated bad news about ConMed drugs are not brought together, and questions are not asked about whether this form of medicine is inherently unsafe and dangerous. The influence of advertisingConMed's media influence is achieved mainly through advertising. If you examine a newspaper or magazine, or turn on a commercial television or radio station, you will see that ConMed companies are a massive source of revenue. Not only do their adverts provide the public with information (or perhaps more accurately misinformation) about health, it is also a vital part of the financial 'health' of commercial media organisations. So what would happen if a media group wanted to publish 'negative' stories about NHS-ConMed, and to do so on a regular basis? Simply it would risk the chemical/drug companies moving their advertising to other papers, or to other media channels. It is NHS-ConMed media advertising over the last century that has convinced us that good health comes from drugs. We no longer believe that our bodies have an amazing capacity to protect us from, and overcome illness. Instead, we have a picture of disease that focuses on a passive 'patient' who becomes the victim of diseases that strike randomly and without warning. As patients, we are helpless, and it is fortunate that we have magical, powerful drugs to can come to our rescue! Health adverts have a powerful influence on our view of health. Drug advertising in the USA tripled between 1996 and 2001, and it has been estimated that for every $1 spent, profits are increased by $4. There are more restraints on drug advertising in the UK, but over-the-counter (OTC) medicines are regularly advertised. And advertising in the UK is done more subtly, with ‘fear’ stories about the impending dangers of epidemics of diseases, and regular media announcements about 'miraculous' new drug breakthroughs. It is well known within the advertising industry that successful advertising sells a 'problem'’ rather than a 'solution'. With ConMed drugs the reason for this is clear. Knowing about a drug, and what it is supposed to do, will not necessarily convince us that we need it! The task is to convince us that we are ill, or that we might be ill, and then to inform us that a particular drug can help us. This is more likely to ensure drug sales. So drug advertising does not make us better informed. It creates fear, and persuades us to buy drugs. The result is that we have developed a multiplicity of health worries:
Even normal life processes or changes have become medicalised:
So 'normal' healthy people, with normal healthy emotions, are being turned into 'patients'. Increasingly we worry about being sick. And when we are sick, we demand medication because we are told we need it, and must have it. So when doctors are criticised for prescribing too much and too often, especially drugs like antibiotics, they can legitimately argue that they are under pressure to prescribe 'something'. All this reflects the power of media advertising, aimed to create fear about illness, and advocating an inherently dangerous form of medication as a cure. Media attacks on Traditional MedicineThe popular media also carries attacks on traditional medicine on a regular basis. The focus of attack is often homeopathy, and these attacks appear to have increased considerably over the last three years. They represent NHS ConMed protecting its business - attempts to dismiss and ridicule its relatively weak (in terms of financial strength) competitors. The attacks come from people who have a vested interest in NHS-ConMed, Medical Fundamentalists, Denialists, who are motivated not only by an antagonism towards traditional medicine, but a need to divert attention away from NHS-ConMed's own failures. Such attacks usually carry implicit assumptions about the value, effectiveness and safety of ConMed - assumptions that are usually allowed to pass in the media entirely unquestioned:
The Right to ReplyIn March 2008, I started the Homeopathy Media group. Its purpose was to present honest and accurate information about homeopathy to the public through the media, in part to counter the hostile and critical attacks to which homeopathy had been subject for several years. Despite requesting the right to reply to attacks, despite offering news releases, and writing articles for the media, it has been extremely reluctant to provide homeopaths with a platform for informing the public. The mainstream media in the UK has proven itself to be entirely subservient to the NHS-ConMed agenda, and determined not to allow any alternative views to be expressed through their information channels. The result is that most people are not fully informed about health issues, and alternative medical therapies. Questions the media should askIn the main, what patients know about health and medicine is what they are told in the media, which today reaches a greater number of people than ever before, and the techniques it uses are considerably more subtle, and more effective. The general public are not experts on health, and the information they have is obtained through a largely unquestioning media. Most people have no reason to question what they are told, so an unquestioning media leads to an unquestioning public. Yet journalists appear to be as misinformed as most other people. They could ask searching questions, but can do so only if they are aware of the need to do so. If the public is to become better informed about health they need a media that is critical and questioning of the performance of NHS-ConMed:
Social lobbying – drugs as a rightYet the power of NHS-ConMed propaganda is not limited to media advertising. It has developed many ways of promoting its philosophy, its drugs, and its treatments - ways that cost them little money but which are equally, if not more effective. The confidence most people have in NHS-ConMed can go much further than a passive acceptance of the treatment they are offered. The media is being increasingly subjected to powerful public campaigns that seek to 'encourage'’, and even 'force' the NHS to increase spending on drugs. In recent years there has been a series of health groups, apparently led by ordinary people, fighting campaigns for the right to have new drugs or treatments on the NHS. Often, the NHS is threatened with legal prosecution if such treatments are not made available. Usually, the drug is new, extremely expensive, and with little or limited evidence to support either its effectiveness or safety. Often the drug testing has not even been completed. Such campaigns appear to have increased since the inauguration of NICE, an organisation charged by the Government to make clinical decisions about which drugs should, and should not be provided on grounds of cost and medical effectiveness. There appears to be two reasons for such campaigns:
Health Charities and Patient Support GroupsAs many Health Charities and Patient Support groups have been involved in these campaigns it raises the question about whether they can be trusted. Drug companies are known to give many of these groups financial support, and in return, such groups can often be found campaigning for NHS-ConMed drugs produced by these companies. The campaign led by the charity the Alzheimers Society to make the drugs Aricept, Reminyl and Exelon available for sufferers. During the previous financial year the Alzheimer’s Society received £31,000 from Pfizer and Eisai, which sell Aricept, £13,000 from Shire Pharmaceuticals, manufacturer of Reminyl, and £14,000 from Novartis, manufacturer of Exelon (Sunday Times, 3rd December 2006). Similarly, small local groups can often be seen campaigning, often through local media, for new medical equipment, like scanning apparatus, for local NHS hospitals - initiated, at least in part, by promises of 'generous grants' or discounts made available by the equipment manufacturers. Such intimate links can be mutually beneficial:
Certainly for ConMed this constitutes a brilliant marketing strategy. There can be no better way of marketing drugs than to encourage charities, especially when they represent and support 'sick' people, to demand your product, to get them to say (usually on the basis of limited or inaccurate information) that the product is 'life-saving', and to blame the NHS for its failure to spend money on it. For the minimal cost involved in supporting health charities and health campaigns ConMed can place enormous pressure on its NHS partner. Moreover, such campaigns are usually highly 'newsworthy', which means that ConMed can get its message (about drug effectiveness) reported by the media almost entirely free of charge. Not all health charities and patient groups have succumbed in this way, but many have, receiving 'generous' funding in return for supporting the development of new drugs. Although they may be driven by the best motives, too many health charities and patient support groups seem to have sold their independence and objectiveness, whilst also giving ConMed a magnificent advertising opportunity Perpetuating the myth of successOne of the most amazing triumphs of NHS-ConMed has been to successfully propagandise its ability to transform health, mainly through its drugs, whilst at the same time being able to hide its absolute failure to do any such thing! The excuses used to explain medical failure have been widely accepted - the tacit assumption that the NHS is under-resourced, that the problem is that we do not spend enough on ConMed. This is helpful in two ways:
This brilliant strategy is successful in turning the question around completely, from why drug treatment has failed, to why we are not spending more money on them. NHS-ConMed has established a highly profitable self-perpetuating myth - that it will work, just as soon as enough money is spent! Yet NHS-ConMed failure is also hidden by another aspect of its propaganda, one concerning 'medical progress'. Whilst drugs are being regularly withdrawn because they have failed this is usually accompanied by announcements about another new medical breakthrough. What this means is that drug failures can be shown to be failures of the past, whilst maintaining the faith that drug triumphs are still to come, in some distant future. We have been subjected to a century and more of intense indoctrination about NHS-ConMed. We believe what we have been told about health. It will take much to persuade us otherwise, particularly as the propaganda circus is still working hard to persuade us that NHS-ConMed is not failing. In contrast to the resounding noise of NHS-ConMed, traditional medical therapies are usually quiet. As professional groups they have never been well organised, or sought publicise themselves. Most therapists are content to get on with their work quietly and unobtrusively, working within small circles of family, friends, and local people who have heard about their about their ability to heal. Rarely does traditional medicine seek the limelight of publicity, even when they are successful in treating illness. Often, therapists do not make a full-time living from what they do, working part-time, or in their spare time, with sick people who have decided, against all they have been told, they want to try another therapy for their illness. In part, their quietness has something to do with the hostility they face, for if and when they do decide to become more visible they are subject to attack. Homeopaths, in particular, have come under regular and gratuitous attacks by Medical Fundamentalists with a vested interest in the continuation of the NHS-ConMed monopoly. Their aim is to stop people turning to traditional therapies, to prevent patients choosing how they wish to be treated. Patient Choice - denial of traditional therapiesThe political and commercial commitment of the NHS to ConMed leaves few resources for people who want to use traditional therapies. The NHS-ConMed monopoly see such therapies as 'unproven', despite centuries of proven efficacy, their record of safety, and low cost. So even when faced by the large and increasing numbers of people who can vouch for the efficacy of traditional therapies, their testimony is discounted as merely 'anecdotal'. The popularity of traditional therapiesThere is an increasing number of people opting to pay privately for traditional therapies. Despite the NHS-ConMed monopoly, despite the fact that its treatment is available 'free at the point of need', despite the constant barrage of propaganda, despite regular attacks on traditional medicine, many people still feel that they can justify spending money on these therapies. It is an extraordinary situation. Large numbers of people are ‘voting with their feet’ and moving to safer and more effective therapies. Channel 4 News ran a feature that reported on the rise of herbal and homeopathic remedies entitled "Alternative medicine now mainstream" on 27th July 2007 (the source being PA News). The survey conducted by Mintel reported that sales of these remedies suggested they were “shrugging off their hippy image and hitting the mainstream”, and that overall £191 million will be spent in the UK on alternative treatments during 2007 – a 32% rise in the past five years. Homeopathic treatments such as arnica cream had seen a 24% sales growth over the same period. And Mintel predicted that sales were set to break the £250 million barrier by 2011. The survey said that a growing number of people were self-diagnosing via the internet, and that almost half (49%) of the 1,039 people aged 15 and over questioned by Mintel said they had used complementary medicine - and would do so again. The survey also found that two in five respondents felt they did not know enough about complementary medicines, while 18% did not know which to use for different illnesses. In an Independent article, 4th October 2007, the following figures were given for the popularity of traditional herbal medicines: An estimated 16 million people use them, and surveys suggest that four out of five are satisfied with the results. Sales have almost doubled since 1999 to £191m, fostered by celebrities led by Prince Charles. There are at least 1,000 registered practitioners and an uncountable number who are unregistered. The purpose of this Independent article, as is so often the case, was to attack traditional medicine! The question "Can so many people be wrong?" was asked, and two well known Medical Fundamentalists, Dr Peter Canter and Professor Edzard Ernst, were asked to give their opinions. The reason for this, and similar attacks, can be understood only when it is understood that each person who turns to other therapies reduces NHS-ConMed business, and undermines its market dominance, and its profitability. The monopoly is being challenged, so traditional medicine is becoming a threat to their financial interests. It is also important to emphasise that to access traditional therapy people have to be willing to pay twice to receive the treatment they want. Those who cannot afford to pay twice are effectively denied access to safer, more effective, albeit less expensive treatment. This is totally opposed to the original political and social intentions of the NHS. NHS spending on Traditional TherapiesThe result is that there is very little expenditure within the NHS on traditional therapies. NHS Spending on Homeopathy has been estimated at about £6 million, about 0.008% of the NHS drugs bill. There were five homeopathic hospitals in the UK, now four after one was closed. Yet all of them are regularly threatened with closure, with Medical Fundamentalists regularly attacking them, and the expenditure. PCT's are under pressure to stop spending on homeopathy and other traditional therapies. In September 2007, the West Kent Primary Care Trust withdrew funding a homeopathic clinic in Bromley, and from one of the hospitals, in Tunbridge Wells. The reason given was that "the NHS has to decide the best use of money on the evidence of clinical effectiveness, and the trust felt that the £160,000 spent on homeopathy could be better spent elsewhere" The hospital, which is run by the Maidstone and Tunbridge Wells NHS Trust, treated up to 1,000 patients each year, and has now closed the hospital. Patient Choice. 'Any treatment, anywhere, as long as it's ConMed'In recent years, the three main UK political parties have been developing health care policies that focus on 'patient choice'. But at present these policies are no more than a mirage. The choice they offer concerns the choice of ConMed doctor, or ConMed specialist, or ConMed hospital. In other words, it is a choice that does not threaten, but seeks to maintain the NHS-ConMed monopoly! It does not offer patients a real choice about the type of therapy they wish to use. No political party has yet had the courage to allow people to choose between ConMed and traditional therapies. It was once said that customers could have a Ford car in any colour they liked – as long as it was black! It would seem that within the NHS-ConMed monopoly the choice we are offered is similar - we can have any medical treatment, anywhere we want - as long as it is ConMed treatment! For patients who do not want NHS-ConMed treatment the only choice we have is to 'take it' or 'leave it'. The NHS-ConMed establishment is powerfully geared up to refuse traditional treatment, even for patients totally opposed to ConMed treatment, and completely committed to a traditional therapy. This was my own experience in 2006 and 2007 when I decided to seek homeopathic treatment via the NHS, and had to struggle hard for 11 months before receiving it. TINA - even to deathNHS-ConMed does not provide traditional therapy without a fight, nor does it offer patients information about other medical therapies, and how they might help. The rules of TINA (There Is No Alternative) apply rigidly in most pats of the UK! Indeed TINA applies even when NHS-ConMed admits that there is nothing more they can do, and has no effective treatment to offer. The approach then becomes particularly unjustifiable. For instance, arthritis sufferers will not be told about, or be referred to traditional therapies. If NHS-ConMed treatment does not work, nothing else will be suggested, offered or tried. Instead, they will spend their lives taking stronger and stronger pain killing drugs that may temporarily dull the pain, but do not pretend to treat the condition itself. Such patients are allowed to suffer, often without realising that there are alternative traditional treatments, or perhaps believing implicitly what NHS-ConMed tells them - 'there is no alternative'. The NHS is inaccurate when it offers ConMed treatment on the basis of TINA. It is not only factually inaccurate - it constitutes a lie. How much worse, then, when terminally ill patients, with a disease for which it is admitted there in no NHS-ConMed treatment, are still not told about traditional therapies. They are given no opportunity to try them, as in the case of two recent patients - a Rabies case and a Radiation case. It would seem, quite incredibly, that the NHS is content to allow patients to die rather than prejudice the ConMed monopoly on treatment! Traditional therapy on the NHS? If you want a Ford, go ask a Toyota dealer!Anyone who requests traditional therapies through the NHS not only faces the prospect of being told that it is impossible, they face a bureaucracy that is unsympathetic, and whose procedures are loaded against granting such a request. For most patients the route to traditional therapies within the NHS-ConMed monopoly is almost impassable. This monopoly position is nowhere enshrined in NHS legislation, policy or procedures. However, such is the power of the monopoly that most people, even those who might otherwise make such a request, do not even try. After all, sick people are seeking to challenge a huge bureaucratic structure at a time when they are least able to fight the resistance they meet. So it is little wonder that funding requests for traditional therapy are relatively uncommon, and those that do arise are routinely turned down, and rarely successful. To use the motor car analogy again, in order to buy a Ford car, your request to be passed through, and approved by a Toyota dealer! But it is possible to get traditional medicine on the NHS, and for those willing to battle hard for it the process of doing so is straightforward. The NHS has become a paternalistic organisation, it takes an "I am the expert, and I know better than you" view of patient care. So even if an individual wants to avoid NHS-ConMed treatment, and has made an informed decision to seek traditional therapy instead, (s)he will be told that there is ‘no evidence’ that such treatment works, or no money to pay for it. On the basis of their ‘superior’ knowledge NHS-ConMed will routinely refuse to fund it. The customer is wrong, the shopkeeper is right. The patient is expected to accept what (s)he is given. We might have paid for our treatment, but we have no choice of what that treatment should be. Distorting the health care marketAll monopolies distort the market place, and the NHS-ConMed marketplace is hopelessly skewed. The ability to pay has become a factor in health care again. The NHS was established to break down the barriers between 'health care' and 'wealth' but its monopoly partnership with ConMed has managed to establish new barriers that produce inequalities in access to health care as bad for many people as anything that existed prior to 1948. We may have already paid for health care, but when we go to the health 'shop' we discover that only one 'brand' is on offer. We have access to this brand freely, often as much as we want, and quite regardless of cost. But if we prefer another 'brand' we are told it is not available. The other 'brands' are available, of course, but we have to go to another 'shop' and pay again. The NHS-ConMed monopoly restricts the market for traditional therapies to those able to pay twice. Everyone else is condemned to ConMed - whether they like it or not. For homeopaths, osteopaths, herbalists, et al, the NHS-ConMed monopoly constitutes a serious constraint on trade. It is a restrictive practice that would not be accepted in any other area of public or commercial life in the UK. Traditional medicine, once the medicine of choice for poorer people, is now the medicine of choice only for those who have sufficient wealth to pay twice for their health care. Health Apartheid: a new class system in healthThe NHS came into existence so that people could have access to health care, regardless of their income and wealth. But now NHS-ConMed is imposing a system of health care that is ineffective and unsafe. By doing so it is creating a class of people who have become dependent on it, and damaged by it. Those who are able and willing to opt out of NHS-ConMed can avoid the dangers of this treatment, and opt for safer, more traditional forms of therapy. This health divide is beginning to show itself, and will become increasingly apparent in the health status of each individual. We are witnessing the creation of a new class system in health provision, a kind of 'health apartheid', in which there are the 'unhealthy poor' (those who cannot access traditional therapies because they do not know about the advantages, or cannot afford to pay for them), and the 'healthy rich' (those who know about the benefits of traditional therapies, and can afford to pay for them). These two classes are arising in part because of the financial 'ability to pay' barrier created by NHS-ConMed, but also by the opportunity to access information about traditional therapies. Some people who could afford to pay for safer, more effective medicine do not do so because they are not aware of it. Information about traditional health therapies are not made available within the NHS-ConMed monopoly so many people who have sufficient financial wealth to pay for traditional therapy do not do so because they are not aware of the benefits. They will continue to be part of the 'unhealthy poor':
It is a tragedy for people who are not aware that health is to a considerable extent dependent on avoiding NHS-ConMed treatment - the health care they are currently offered, free of charge, within the NHS. Conclusion - NHS-ConMed is a failed business.After 60 years of the NHS we are facing levels of sickness and disease at epidemic levels. Yet ultimately, and quite regardless of the reason for increased levels of sickness in society, the most important questions seems always to be avoided:
If we applied any kind of business model to the performance of the NHS since 1948, we would probably come to the inevitably conclusion that, as a business, it is not viable. There is undoubtedly a demand for the ‘product’ offered by the NHS-ConMed - people queue in long waiting lists to get to it! But this is because what is offered is free, has already been paid for, and no alternative treatment is offered. So the 'demand' is not surprising - patients queue for health services at the only place they know, and receive the only kind of treatment offered to them. The NHS is a wholesaler rather than a retailer of health care. The retailers are the NHS-ConMed practitioners patients see when they enter a GP surgery, or a hospital. If, as a wholesaler, the NHS wanted to stock its surgeries and hospitals with homeopaths, herbalists, acupuncturists, osteopaths, aromatherapists, et al, it could do so. But it chooses not to stock these 'brands'. Like any wholesaler, the NHS should be asking whether they are stocking the correct kind of produce, or supplying the best kind of practitioner. Is the product offered to patients suitable, does it meet their needs? Are there better products available? Are there products available that will treat illness more satisfactorily, that will make patients better so they do not return so regularly? The NHS have never bothered to ask the questions. No competitive business, dependent upon sales in a competitive market, would be able to survive with such an attitude. As customers, we do not buy products if we feel they did not work effectively, or if we had to keep replenishing them too frequently. We would look for other, more effective products. By any criteria the NHS is failing, and it has been failing for decades. It continues only because it has access to the bottomless pit of government finance. Yet despite the evidence of increased sickness, and the failure of the NHS to deliver health, increasing resources continue to be poured into the NHS. At the present time, neither politicians nor the medical establishment seems prepared to consider that spending money on other forms of medicine might be a better option, or even an option that can lead to a real comparison between different medical therapies, both in terms of cost-effectiveness and safety. Yet increased expenditure on ConMed seems only to increase the size of ill-health, and the demands for even more spending. The NHS is becoming unsustainable, and there has to be a limit to how big the NHS-ConMed empire grows before it begins effectively to bankrupt the entire nation.
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