The boss of NHS England has said homeopathic medicine is “placebo at best” and it is “absurd” for doctors to prescribe it.
Simon Stevens, chief executive of NHS England, made the comments as he admitted that NHS patients in England should expect longer waiting times as a “trade off” for improvement in other areas, such as hitting the four-hour A&E target and better cancer care.
Longer waits can be expected for pre-planned operations, which include things like hip and knee replacements, cataract removal, hernia operations and laparoscopies.
Responding to concerns that the NHS plans to stop prescribing some medicines as part of cost-cutting measures, but still uses homeopathic medicine, Mr Stevens told the BBC’s Today programme: “We can see that despite the fact we are a hugely effective service… there is still waste.
“Some of that is patients are being passed from pillar to post and ending up in the wrong place, rather than being looked after in the right place.”
Asked if it was true the NHS is still spending £4m on homeopathic medicines, he replied: “I don’t know if that’s the right number. But those would be a classic example of those sorts of things we want to see less of.”
He then agreed that the NHS shouldn’t spend any money on those types of medicine saying they were “placebo at best” and that it would be “absurd” if anyone was prescribing homeopathic medicines.
In October 2015, a charity reported that the NHS spent at least £5m per year on homeopathic remedies.
Although the Department of Health doesn’t keep track of how much it spends on homeopathy, Good Thinking Charity has claimed the NHS spends £5,187,025 – enough to fund 239 fully qualified nurses.
A hospital in Essex also sparked controversy in October 2015 when it posted a job advertisement for a “reiki/spiritual” healer.
Unveiling a blueprint for the NHS for the next two years, Mr Stevens said hundreds of thousands of patients would no longer be referred to a consultant by their GP.
Instead, GPs will be able to phone consultants to ask for advice, while other measures will be put in place to cut the number of people needing to be sent to hospital for care.
Hospitals will also be told part of their funding will be tied to improving health generally – with staff urged to have a “quiet word” in patients’ ears if they drink or smoke too much.
Other measures to save the NHS cash, already announced, include cutting the prescriptions bill for items such as sunscreen, fish oils, painkilling plasters, gluten-free foods and travel vaccines.
Mr Stevens admitted that waiting times were coming under pressure and that choices had to be made.
The NHS has a target that 92% of patients should be treated within 18 weeks of referral by their GP. But the NHS has not hit this target since February 2016 and performance has been slipping since then.
Mr Stevens said: “We are saying that we expect that the number of operations that the NHS pays for will continue to go up, but we recognise that – right now about nine out of 10 people get their operations in under 18 weeks – in some parts of the country that will be under pressure.
“We won’t second-guess what that looks like, we want to try and keep short waits in the system where we can.
“We do expect and we do say here there is a trade off here … We do expect there will be some marginal lengthening of waiting lists but this will still represent a strong, quick waiting times experience compared to 10 years ago, let alone 20.”
Mr Stevens said demand on the health service was growing, which had led to tough decisions. But he declined to say “anything new” on whether he was happy with Government funding for the NHS.
In January, Mr Stevens told MPs it would be “stretching it” to say the NHS got more money than it asked for from ministers.
Now, Mr Stevens said: “What we say here is that we accept that the 2017/18 budget for the National Health Service is fixed, and so we’ve set out what we intend to do within the budget that’s available.”
Turning to incentives for hospitals to tackle smoking and drinking, he said: “There is going to be an incentive on hospitals to have a quiet word, because the evidence shows that if you’ve had a heart attack or are in hospital for something, that’s actually the moment when people are willing to think about making changes to their lifestyle.”
The new document presented by Mr Stevens sets out how GP practices that are seen to refer too many patients to hospital for specialist care will have their referrals scrutinised more for whether they are clinically appropriate.
All clinical commissioning groups (CCGs) will also review their “referral management processes”, in some cases enabling direct referrals such as to physiotherapists for back pain.
GPs will also have an “advice and guidance option” where they can chat to a specialist “to avoid the need to default to an outpatient referral”.
Mr Stevens said there was a “big variation between individual GP practices in different parts of the country” when it came to referrals, although referral rates more broadly have been lowered.
He said patients did not all need to go to hospital, adding: “It’s clearly going to be hundreds of thousands of patients at least for whom better alternatives which don’t involve being sent off to the outpatient department will be put in place.”
Treatments judged to be of low clinical value will also come under scrutiny, such as spinal surgery and injections for back pain.
The plans also set out changes to treatment centres to take the pressure off A&E, creating a single brand that is easy for patients to recognise.
The NHS will also aim to speed up cancer diagnosis to within 28 days, and improvements are planned for mental health.
The Government has already announced that GP surgeries will offer weekend and evening appointments across the board.