Author: Catherine Hughes

Date: 25 11 2019

A Patients Story by Catherine Hughes

How does income affect access to complementary healthcare?

We know that increasing numbers of people are dealing with long-terms conditions that cannot be cured. Having access to services which support them to manage these conditions is essential.

However, income levels affect people’s ability to access services such as complementary healthcare. In its research on the role of Accredited Registers as part of the wider public health workforce, the Royal Society for Public Health found that the services of 72% of practitioners on Accredited Registers were paid for by their clients. For CNHC the figure was 97%.

Statistics are useful and paint the overall picture. But what is life like for someone on a low income who is trying to access complementary healthcare?

The patient perspective

Catherine Hughes is a former healthcare professional who was diagnosed with a range of complex conditions over 30 years ago. Having access to complementary health services has enabled Catherine to self-manage her conditions. However, this has not been easy and Catherine continues to struggle.

In this piece Catherine, who is based in Scotland, shares some of the challenges she faces trying to access complementary and other self-management services on a low income. She ends by making the case for a self-management fund to support people on low incomes to be able to better manage their conditions.

Catherine’s story, in her own words….

I have several complex long-term conditions that have been difficult for health professionals to treat. I have fortunately learned to self-manage many of my conditions over the 30 years since I was initially diagnosed. I experienced the grief and many frustrations of having my dreams shattered as I could no longer continue in employment as a health professional which was something that I had worked extremely hard to achieve.

I was successfully helped by the dedicated hospital staff at the NHS Centre for Integrative Care where I was empowered by being taught the various holistic skills that I needed to help me to better self-manage my conditions. The medications that are normally prescribed for my conditions gave me serious side-effects so I was taken off them. As a direct result of using holistic methods I estimate that I have saved the NHS in excess of £250,000 as I’ve cumulatively only been on the medications for 12 and a half weeks in 30 years. I had previously spent over a year in hospital in total as an in-patient and I have now not been in hospital as inpatient since 2008. Most importantly, self-management has made my life more bearable.

However, Self-management, costs money and at present in Scotland although there is Self Directed Support many people are not eligible and there is not a fund to help people personally fund their self-care. 

I have spent a considerable five figure sum towards self-managing my health and improving my overall wellbeing. In doing so, I have had to make many sacrifices as I struggle with limited means due to being confined by the shackles of poverty. I have not been on holiday for over 11 years and can’t participate in many of the opportunities that others can take for granted. I make choices daily trying to prioritise my wellbeing.

It is time for a rethink. We all deserve to live a dignified life free from the grip and worry of poverty so that we can all fulfil our potential. The Scottish Government support ‘Realistic Medicine’ and want to encourage shared decision making with health professionals to maximise our wellbeing and see self-management as important. However, we must ensure that people have access to adequate financial resources and support them in this endeavour so they are able to embrace self-management.

I believe the access to a personal self-management fund would be beneficial. It could encourage more people to self-manage and help to address the concerning rising numbers of people affected by poverty.

Further information

Catherine has provided us with details of The Poverty Alliance and the Health and Social Care Alliance Scotland who jointly hosted an event on the 6th November in Scotland to examine the links between poverty and health. Catherine says they would like to hear your views about the issues and some of the solutions.

You can make contact and find out more about them through the links below

The Poverty Alliance:     

Health and Social Care Alliance Scotland:

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Background on health inequalities

Here’s some information about health inequalities and what they mean, as background to Catherine’s piece.

The term ‘health inequalities’ describes the differences in health between groups of the population which happen as a result of where they live or their income levels. Research on health inequalities shows that low income and levels of deprivation have a significant impact on people’s health.

According to Public Health England’s 2017 Health Profile for England, those living in the most deprived areas can:

‘…expect to spend nearly 20 fewer years in good health compared with those in the least deprived areas: they spend nearly a third of their lives in poor health, compared with only about a sixth for those in the least deprived areas.’[1]

According to NHS Scotland in February 2019:

‘In the most affluent areas of Scotland, men experience 23.8 more years of good health and women experience 22.6 more years compared to the most deprived areas.’[2]

A similar situation exists in Northern Ireland.

‘Male life expectancy for those living in the most deprived areas was 74.2 years, 7.1 years less than that in the least deprived areas (81.3 years).

Females in the most deprived areas had a life expectancy of 79.6 years, 4.5 years lower than that in the least deprived areas (84.1 years).’ [3]

Statistics in Wales are not presented in the same way but findings are likely to be similar.[4]

[1] [at 30 October 2019]

[2] [at 30 October 2019]

[3] Health Inequalities Life Expectancy Decomposition 2019, Department of Health, Northern Ireland, July 2019, pages 5 - 6