Tag Archives: medicine

What the Lib Dem policy on homeopathy is not

I got two rather bemusing emails today. The first was the party’s official line on what our reaction to the Science and Technology Select Committee’s report on homeopathy is. The second one was to inform me that, five hours later, it has been rescinded. I can see why.

The line (and this is not a secret – PPCs were expected to parrot this word for word to the public) was as follows:

As you may be aware, a recent report by the House of Commons Science and Technology Committee recommended that the NHS stops paying for the provision of homeopathy. This is a decision which I fundamentally disagree with.

The NHS in England currently spends around £10 million every year on homeopathy, we believe that this should continue.

The Liberal Democrats support a review by NICE into the clinical effectiveness of all Complementary and Alternative (CAMs) therapies. It is important to note that there is extensive evidence on the value to patients of CAMs and extensive support amongst patients for their continued use on the NHS.

While the Science and Technology Committee were right to recognise there are some conditions for which CAMs are wholly inappropriate, the measured introduction of treatment with CAMs therapies at primary care level has the potential to reduce expensive secondary referrals and/or long term expensive drug therapy in a range of conditions. The value of CAMs treatments as secondary treatments also needs to be recognised.

The use of CAMs on the NHS must be subject to the same checks and balances as other NHS services, which is why we support the statutory regulation of CAMs practitioners by the Health Professionals Council. This is a vital step to ensure that standards are maintained and patients are protected from misleading claims by practitioners.

What I find really odd about this response is that the select committee were calling for “CAMs” to be subject to the same checks and balances as established medicine, and did support NICE investigating this – thus far NICE themselves have resisted this. The report notes “we cannot understand why the lack of an evidence base for homeopathy might prevent NICE evaluating it but not prevent the NHS spending money on it”.

Norman Lamb needs to make his mind up. He can’t call for established medicine and its alternative to be treated in the same way, and then protest when it is. If the evidence of the efficacy of “CAMs” (and note how this muddies the water by not talking about homeopathy in isolation – presumably he feels the point becomes stronger the more you dilute the argument) is so “extensive”, then where is it and why were Phil Willis et al unable to uncover it?

It all seems a bit rum. Hopefully they’ll have sorted out the party line by the end of the weekend. But what I really don’t understand is why it was, if Norman Lamb feels so strongly about this, he didn’t put out a press release earlier in the week and argue his case? He’d certainly have got a lot of media attention.

UPDATE: Norman Lamb has finally reissued his position on homeopathy, which can be read here.

Can science find a cure for conservativism?

Nature always does contrive
That every boy and every gal
That’s born into the world alive
Is either a little Liberal
Or else a little Conservative.

Iolanthe, W. S. Gilbert

There was an interesting article in New Scientist last week about research suggesting a genetic basis for political opinion (You can’t read the full article? You mean you don’t subscribe? Tsk!).

I have to be honest and admit that beyond the most banal level of accepting that certain genes no doubt contribute to an individuals’ personality to some extent, I’m not convinced. There are several problems with this article. The most fundamental one is that it doesn’t seem to be clear about what a “liberal” and a “conservative” is. For example, they approached the American Enterprise Institute for comment from the “conservative” end of the spectrum. They came up trumps:

David Frum says that he is “flattered by the evidence that conservatives are more honest and dutiful than liberals”. But given the huge number of variables that affect the outcome of an election, it would be a foolhardy researcher who would draw generalisations from Jost’s work, he says.

The AEI supports “limited government, private enterprise, individual liberty and responsibility, vigilant and effective defense and foreign policies, political accountability, and open debate” – that sounds pretty classically liberal to me and about a million miles away from a fruitloop like Mike Huckabee. It certainly doesn’t seem to be the sort of “drawbridge up” conservativism cited in the rest of the article. Overall, it’s a bit of a mess.

But it, and another article about autism, got me thinking. It cites one piece of research purporting to have found a link between a gene which regulates serotonin levels in the brain and propensity to vote. What appears to be happening here is that people who can better regulate their brain chemistry tend to be more sociable. In principle therefore, it would be hypothetically possible to come up with a pill that would make people more pro-social, which in turn would probably do a lot to improve election turnout.

What, in essence, is the moral difference between such a pill and encouraging pro-social values at school? Since there is clearly a link between diet and behaviour, how is it fundamentally different from Jamie Oliver’s school dinners? If we can justify mass medication for things like tooth decay, can’t we justify this? We already treat depression in such a way (or at least we attempt to).

Could we cure other anti-social attitudes as well? Xenophobia? Misogyny? Violence? We’re not talking about major surgery here or anything even vaguely resembling a lobotomy, just the slight changes in the chemical balance in the brain which leads to certain basic instincts behaving differently. Wouldn’t that be better than locking people up or wasting time attempting to reason with people who science informs us cannot be reasoned with?

(These are genuine questions by the way, not rhetorical ones.)

At the same time, we have reviewed and are in the process of reviewing a whole range of things which were at one point viewed as mental disorders and are now coming to conclude are merely personality traits. Homosexuality was regarded as a disease 50 years ago. Increasingly autistics are fighting a battle which at least superficially has many similarities to the gay rights movement.

The reason I’m pondering all this is not because I want to create a “cure for conservativism” but because I’m becoming increasingly conscious of the fact that science and our notions about free will are increasingly coming into conflict. On one level that tension does not, and never will be particularly meaningful. Science is unlikely to ever become so adept at understanding our genes, brains, bodies and environment to such an extent that it can predict exactly what anyone is likely to do at any given moment. But on another level, it is likely to throw up all sorts of inconvenient truths such as levels of intelligence and modes of behaviour which have fundamentally chemical bases and can thus be altered in a similar way. We’ve created distinctions between “disorders” and personality traits which are looking increasingly unsustainable. Surely there needs to be some kind of distinction between a negative thing that we should seek to cure or otherwise discourage, and a neutral thing that we should tolerate in a pluralistic society? But that line seems to be becoming increasingly blurred and just as we are having to seriously consider reclassifying some things from the former to the latter, so we may have to consider others going the other way. Or is it to be anything goes?

I wonder to what extent we are ready for this debate. There is a real reason why we need to be. If we aren’t, the interests of pharmaceutical companies are likely to dominate it, at least in the short term.

Or is this all merely paranoid delusional fantasy?