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Selected Investigations Completed April - September 1999 > Part I, Case no. E.1316/98-99

Chapter 1: Hospital, Community Health and Ambulance Trusts

Case No. E.1316/98-99 - Health Authority's decision not to fund homeopathic treatment

Summary of case

Mr W had received treatment for psoriasis (a genetically determined chronic skin disease which affects 1-2% of the population of the United Kingdom) and psoriatic arthropathy (a form of arthritis caused by psoriasis and found in 3-5% of those suffering from psoriasis). In 1992 he was referred to a consultant rheumatologist, who provided homoeopathic treatment which proved to be effective. In 1997 Mr W's then GP wrote to the Health Authority, asking them to resume responsibility for funding Mr W's treatment. The Health Authority refused to do so. They later reaffirmed that decision which, they said, was based on a lack of evidence of the effectiveness of homoeopathy in the treatment of Mr W's condition. Mr W complained that the Health Authority had acted unreasonably.

Findings

The Ombudsman, advised by independent professional assessors, found no maladministration in the way in which the Health Authority reached its decision that, as a matter of policy, it could not fund homoeopathic treatment. However, he considered that that policy should be applied fairly and rationally on a case by case basis, and the merits of individual cases should be assessed properly. It appeared that the Health Authority's initial decision not to purchase homoeopathic treatment in this case was taken without sufficient consideration as to whether there might be any circumstances which could justify departure from the general policy. The Health Authority's homoeopathic extra contractual referral panel subsequently reviewed the case but it was not clear what considerations they took into account. There seemed to have been no clear indication about what sort of issues might count as exceptional circumstances. The Ombudsman upheld the complaint to the extent that the individual circumstances of Mr W's case had not been appropriately assessed.

Remedy

The Health Authority apologised. They agreed to ensure that the case for funding Mr W's treatment was reconsidered taking account of the opinion of his medical carers and that when a decision had been made, the reasons for it would be fully recorded and communicated to Mr W.

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Last updated: 9 January 2006