Tag Archives: homeopathy

UPDATE: What the Liberal Democrat position on homeopathy IS

Since I previously wrote about what it was, and then wasn’t, I feel it is encumbant on me to include here what the official line on homeopathy now is:

A recent report by the House of Commons Science and Technology Committee examined the provision of homeopathy through the NHS and called for funding by the NHS to be stopped. The Committee did recognise that many users derive benefit from its use and did not argue that such treatments should be banned.

The Liberal Democrats believe that, as a basic principle, individuals should have maximum freedom about how they choose to get treated, so long as the therapy is safe. When it comes to NHS provision, we support a review by NICE into the cost effectiveness of Complementary and Alternative (CAMs) therapies, including homeopathy; as well as expanding the work of NICE to look at the cost-effectiveness of existing conventional treatments.

We know that many complementary therapies are popular with the public. The NHS budget is limited and we want to make sure that NHS funding is focused on treatments which are efficacious and cost-effective. NICE reviews of all existing treatments would give us the best possible basis for future decisions over funding.

That sounds much more sensible and measured. On top of that, I am now getting (unconfirmed) reports that the Scinos will not be at Lib Dem conference after all. Looks like the party may have had an outbreak of common sense.

Or maybe not.

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 The second one was to inform me that, five hours later, it has been rescinded.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.

Homeophobia? I am not a scientist but…

Article slightly amended from first version – woke up this morning to realised I’d forgotten to make a point.

Rustum Roy writes a belated rebuttal of Ben Goldacre’s diatribe about homeopathy in the Guardian last month. We are to understand that anyone who is sceptical about homoeopathy is to be regarded as a “homeophobe”. This is starting to sound even less like science and even more like identity politics.

A few lines in this article wrestled for my attention. First:

As it happens, there is agreement among all those who have studied liquid water that it is, in fact, the critics, who are totally wrong. Proof? Diamond is the planet’s hardest material; graphite one of the softest. They are absolutely identical in composition, and they can be interconverted in a millisecond with zero change of composition.

I hasten to preface this with the disclaimer that I am not a scientist, but hang on a minute. The Queen is not constantly in fear that, at any given millisecond, her priceless Koh-i-noor diamond might turn into a pencil. I’m sure there are processes that can convert carbon to diamonds and vice versa, but they aren’t exactly easy to come by.

The reason why carbon can exist in multiple forms is fairly well understood – if I remember my GCSE chemistry it is all to do with “spare” electrons – and it is hard to see what relevance it has here. We know, for instance, that water can interchange from liquid to solid to gas, but that doesn’t prove it has a “memory”.

In any case, I’m also not convinced that Goldacre was basing his argument on scepticism about the idea that might have a memory. He only mentioned the word once in his article. The science behind memory metals is now well understood, and there are other applications of the same principle.

But it is one thing to say that water might have a “memory” and quite another to claim that snake venom diluted in water to an extraordinary degree can be used as a cure for feverish symptoms. The argument is not with the science; it is taking that science and contorting it to an absurd degree. I might just as well claim that the alpha waves emitted by my brain can be used to program water.

Roy also writes:

But the main thrust of Goldacre’s argument is the role of the “placebo effect”. Yes, this works. And, yes, it is without doubt present in every homeopathic intervention; but it is far more powerfully present in orthodox medical pills because they are advertised so widely in billion-dollar campaigns.

Goldacre is accurate in pointing out the high rates of positive v negative outcomes in many of the homeopathy studies. But there are enormous discrepancies in any set of randomised controlled trials on the same orthodox pills.

Does Goldacre seriously suggest that a homeopathy paper with a positive outcome would be treated fairly in any mainstream journal?

This is a very circular argument. “My paper won’t get treated fairly, therefore I won’t submit it” is a pretty piss-poor excuse. And once again, Goldacre is not – as far as I’m aware – claiming that “orthodox” pills are the answer to everything. He’s has written plenty of critical articles about “Big Pharma”. When he writes about the placebo effect, he’s talking about its effect in traditional medicine as much as the alternative:

You both think you know about the placebo effect already, but you are both wrong. The mysteries of the interaction between body and mind are far more complex than can ever be permitted in the crude, mechanistic and reductionist world of the alternative therapist, where pills do all the work.

The placebo response is about far more than the pills – it is about the cultural meaning of a treatment, our expectation, and more. So we know that four sugar pills a day will clear up ulcers quicker than two sugar pills, we know that a saltwater injection is a more effective treatment for pain than a sugar pill, we know that green sugar pills are more effective for anxiety than red, and we know that brand packaging on painkillers increases pain relief.

A baby will respond to its parents’ expectations and behaviour, and the placebo effect is still perfectly valid for children and pets. Placebo pills with no active ingredient can even elicit measurable biochemical responses in humans, and in animals (when they have come to associate the pill with an active ingredient). This is undoubtedly one of the most interesting areas of medical science ever.

If the limit of Professor Roy’s ambition is to claim that homeopaths are no worse than big pharmaceutical companies interested more in making lots of money than they are in actually making people well, then whoop-de-doo. I thought you were claiming to be the good guys?

It reminds me of Great Cthulhu’s eternal presidential election slogan “why vote for the lesser evil?“.