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Science Committee ignores Health Minister’s advice

I guess it was predictable. Despite the strong words of Health Minister, Mike O’Brien in favour of liberty and democracy, the crew of MPs on the Science and Technology Committee announced this morning that “the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy.” You can read the report here.

At the end of the report, MP, Phil Willis states: “It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is ‘evidence’ enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government’s response to our report with interest.”

As the man says: The DoH will need to consider if the ‘existence of a community which believes homeopathy works’ is ‘evidence’ enough for their money to be spent on what sort of medical doctors and medicine they want. Clearly the committee (but hopefully not the Government) believes that people are too stupid to choose for themselves and need these choices to be made for them.

Yes, I too await the Government’s response ‘with interest’. Will they bow to the pressure from this committee and act in a scientismic, totalitarian and authoritarian way by saying:“We know better than you what is good for your health! Now shut up and let us spend your money in your best interests!” Or will they heed the words of Health Minister Mike O’Brien’s plea for liberty when he said it would be ‘illiberal’ for the government to cut funding for homeopathy. We can but wait but there is much more at stake here than just the future of NHS homeopathy.

By | 2010-02-22T15:50:58+01:00 February 22nd, 2010|Current Affairs, Homeopathy|23 Comments

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23 Comments

  1. Malcolm Armsteen February 22, 2010 at 9:25 pm

    Either deception or delusion – which is it?
    You seem to be in a different world from those who understand truth.

    • Dr. Kaplan February 22, 2010 at 10:32 pm

      So tell me then who exactly do you think are ‘those who understand truth’? Mike O’Brien, the Health Minister, Evan Harris, Liberal Democrat MP, Prince Charles, the Queen?

      When old age shall this generation waste,
      Thou shalt remain, in midst of other woe
      Than ours, a friend to man, to whom thou say’st,
      ‘Beauty is truth, truth beauty,—that is all
      Ye know on earth, and all ye need to know.’ 50

  2. Andy Lewis February 23, 2010 at 12:54 am

    Brian, my guess is that out of 100 homeopaths who criticise this report, one of them will have read it.

    A simple question: have you read it?

    If you have, why no mention of paragraphs 98 to 101 that explicitly tackle the nature of patient choice and homeopathy?

    • Dr. Kaplan February 23, 2010 at 1:24 am

      I said that I had read it on Sky News at 7.19pm tonight. I thought it appropriate to focus on Paragraph 93. The integrity of the doctor-patient relationship, a field on which I have written a book, The Homeopathic Conversation; The art of taking the case (Natural Medicine Press, 2001) A simple question for you: Have you read it? Of course I’m happy to talk about patient choice; that’s my main point: Let GPs and patients in wholesome doctor-patient relationships choose appropriate interventions for which
      the doctors are fully accountable – of course. The section in the report that implied that patients are too under-educated/stupid/uninformed to make choices for themselves based on informative talks with their GPs and their own inherent intuition, was so condescending and patronising that it deserves a post on its own.

  3. Dr Andrew Sikorski February 23, 2010 at 1:26 am

    Dear Homeopathy-There’s no such thing as bad publicity and from the rise of Dan Brown since the times of the Inquisition, the rise of the moneylenders since they were thrown out of the temple, history has a strange habit of supporting the doctrine of what goes around, comes around. Deception is a familiar figure in the land of business, politics and magic- and, my, how humanity gets addicted to a rubbish show!! Love your enemy, turn your cheek, don’t get shafted by your best mate’s partner and you’ll get done as you’ve done them all….don’t you love a good discussion? As for winners and losers- Japan had the A bombs, Germany the conventional bombs and China got Tibet. The Allies got quantitative easing and all we need do now is watch out for the ark and hope our kids are able to swing on up and grab a lift with Noah! No matter how much we worry about being right and succeeding we can all rest assured we’ll get 100% when it comes to dying. Enjoy the trip and remember to breathe in as you go through that eye of the needle!!! Have a nice day, now….

  4. Ian February 23, 2010 at 1:45 am

    Your comments on patient choice ignore the fact that when NHS money is spent on Homeopathy it prevents NHS money being spent on other more effective treatments.

    Personally I’d prefer the NHS to spend money as effectively as possible.

    If folks want Homeopathy then let the patient spend their own money on it, and let the referals cash be spent on the effective treatments.

    I really have to doubt any advice given by a GP that goes against hundreds of peer reviewed papers that show homoepathy as effective than placebo, against a few that show it does.

    What other treatments has that GP cherry picked to recommend?

    • Dr. Kaplan February 23, 2010 at 10:52 am

      @Andrew: Ah, philosophy. The problem is that these days people are more interested in profits than prophets.

      @Ian: The money issue is a red herring, comprising 0.001% of NHS budget on drugs. See here for more on the money issue. If you want to save the NHS millions you should campaign for GPs only to prescribe anti-depressants according to this pLos study – just for starters of course. The people pay for the NHS and not only the scientismists. As for GPs: They are accountable for their decisions – that is enough for me.

  5. Andy Lewis February 23, 2010 at 1:58 am

    Of course any sensible discussion on this would depend on your answer to one simple question: do you believe that homeopathic pills have specific effects over that of a sugar pill?

    If you answer yes, then you pretty much rule yourself out of any sensible discussion on the subject as you obviously are a believer in witchcraft.

    • Dr. Kaplan February 23, 2010 at 11:03 am

      Yes, Andy I absolutely do believe that homeopathy acts over and above the placebo effect. Your question is ridiculous. If I didn’t believe this, would I spend years studying homeopathy? Do you seriously believe that homeopaths ‘know’ their medicines are placebo but continue to prescribe them? This is how I see it.

      The View of Homeopathic Doctors: You take the case in the normal and homeopathic way. You prescribe a homeopathic remedy if appropriate fully believing in the efficacy of the medicine. If the patient gets better the homeopathic process has been successful.

      The View of Skeptics like yourself, Ernst, Ben Goldacre etc: Homeopaths prescribe placebo and patients get better. This is dishonest because the doctors ‘know’ they are prescribing placebo and should admit it to the patient.

      The S&T Report is deeply disingenuous when it agrees with Ernst that doctors are deliberately misleading patients; they certainly are not.

      Now you say that if I believe this then I ‘obviously are a believer in witchcraft. No I believe homeopathy works – that’s all. I don’t know exactly how it works but I know it works and is highly cost-effective and people appreciate it.

      There are more things in heaven and earth, Andy Lewis, than are dreamt of in your philosophy.
      (apologies to the Bard)

  6. Dr Andrew Sikorski February 23, 2010 at 11:48 am

    Regarding effective use of taxpayers’ money- ISCATS are wasting enourmous amounts of our cash(1)- don’t get hot under your collars about these unpiloted, unresearched, evidence free ideas which use your money to line someone’s pockets without having the inconvenience of treating patients now- keep picking on Homeopathy. Have you taken a minute to consider the cost to the NHS of treating those patients who have had apparent benefit from homeopathy- Mate- it’ll be much much more expensive, but hey that’s not the point is it?
    1 http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4125097&c=2

    • Dr. Kaplan February 23, 2010 at 11:18 pm

      Eloquently put Andrew.

  7. James Colthurst February 23, 2010 at 12:09 pm

    I enjoyed your response this morning on R5L in the ludicrously short time they gave you to comment on the freedom of choice. I remember when this came up before with an MP struggling to defend it and I suggested in the HoC that he might raise the issue of the NHS GP clinics ironically becoming the ‘alternative’ to those who were previously managing on complementary health systems costing minimal amounts. I encouraged him to look at what might happen if all those patients using ‘other’ systems were to converge on, and saturate, GPs because their favoured approach had been banned. The GP practices would be overwhelmed, day after day. Of course, scientific evaluation has an important part to play in safeguarding us all; but this act against homoeopathy is not for those reasons.

    The whole concept of ‘evidence-based’ medicine could be said to be fundamentally flawed in its current state of use. It disregards the whole idea that members of a population are composed of an infinite series of ‘normal distribution curves’ – we are therefore unique. Someone may fit in the centre of one curve (eg. height) and at the outer centile of another (cardiac output). Since ‘evidence-based’ pharma approaches are geared towards the robotic bell curve (ie what dose or drug would work for most people) it can only, sometimes, address any given patient adequately. I believe, as I think you do, that the value of the actual interaction with the practitioner is of paramount importance and allows for, dare we say it, the uniqueness of patients. A decent consultation allows a bespoke plan of action, whatever the approach, to be constructed for a patient. It has often been said that patients value their consultation time very highly, but evidence-based ‘outcome’ measurement of millions of different consultations would be near impossible to assess. I look forward to the day when the practitioners learn (again?) to harness the real therapeutic power which resides in the patients themselves!

  8. Andy Lewis February 23, 2010 at 3:59 pm

    Ha.

    There are more things in heaven and earth, Andy Lewis, than are dreamt of in your philosophy

    The phrase that is used by so many scoundrels who cannot argue from reason or evidence.

  9. Ian February 23, 2010 at 10:12 pm

    Thanks you for continuing this debate, Dr. Kaplan. Too many pro-homeopathy site don’t have comments sections, or moderate replies that are unwelcome.

    I don’t think spending several millions on an ineffective treatment is a red herring. Pointing at other completely unrelated issues within the NHS and saying “look at them they are worse than us for wasting money” simply doesn’t deflect that the evidence shows that this money could be better spent elsewhere. Multiple wrongs don’t make a right. So as I say, it’s not a red herring.

    You believe that homeopathy acts over and above the placebo effect. I am interested to understanding what this belief is based on, and more importantly what would change your views on this?

    And since I am asking the question it’s only polite for me to give my own answer. To change my view it would take either the several hundred peer reviewed RCT to be refuted, or at least a equal amount of RCT that show that it has an effect greater than the placebo.

    • Dr. Kaplan February 23, 2010 at 11:36 pm

      Thanks Ian,

      My personal belief that homeopathy works over and above the placebo effect is based on my own experience. It is subjective, I admit but nevertheless personally convincing. Sometimes I have had several in- depth conversations with a patient with a chronic disease with no response to several homeopathic prescriptions. Then one day I hear something from my patient that makes me think of a reason for giving a medicine I’ve not used before and the patient responds suddenly and dramatically. In my opinion it must be due to the medicine because if it were placebo it should have happened before when I spent longer talking to the patient. Subjective I admit but you asked what my belief was based on. I am also convinced by several well-designed trials and think the analysis of the various meta-analyses is deeply controversial.

      Re: Money: As Andrew Sikorski has pointed out. EVEN IF the detractors of homeopathy think it’s placebo it’s still good value for money for the NHS as these difficult-to-treat patients would have to be treated elsewhere. The report’s ‘refutation’ of this idea based on the idea that homeopaths would have to tell patients that their remedies are placebos is beneath contempt. Homeopaths absolutely believe their remedies are effective. Why else would they spend thousands of hours studying this detailed and difficult subject?

      Re: NHS If there were three segments of the NHS (compulsory NI but you choose one of 3) then one could offer homoeopathy and CAM and we could compare their expenses at the end of each year. This happens in many countries and improves standards through competition. The fact that we have one system of universal healthcare is being used to try to BULLY doctors into not referring patients for NHS homeopathy and THWART GPs (having failed to persuade them) from prescribing homeopathy on the NHS. It is an insult both to patients, doctors, liberty and democracy and a sad day for a country that likes to think itself tolerant of minority views.

  10. paul February 23, 2010 at 10:19 pm

    I found this letter from the Times online particularly illuminating.

    http://www.timesonline.co.uk/tol/comment/letters/article7019709.ece

    Is science about free thinking. Me thinks not.

  11. Dr. Kaplan February 23, 2010 at 11:54 pm

    @ Paul.

    Paul, thanks so much for drawing everybody’s attention to that letter to The Times. I’m repeating the link for everyone because I agree it’s particularly apposite.

    http://www.timesonline.co.uk/tol/comment/letters/article7019709.ece

    Yes, truth is not something that comes easily. I would hesitate to accuse anybody of having vested interests (without being able to point to a smoking gun) – but do I think that some of homeopathy’s detractors have something other than a philanthropic desire to help their fellow man as the main reason for their actions? I’ll think about it for a while…

  12. Paul Steeper February 24, 2010 at 9:58 am

    Dear Dr Kaplan

    You wrote;

    //My personal belief that homeopathy works over and above the placebo effect is based on my own experience. It is subjective, I admit but nevertheless personally convincing. Sometimes I have had several in- depth conversations with a patient with a chronic disease with no response to several homeopathic prescriptions. Then one day I hear something from my patient that makes me think of a reason for giving a medicine I’ve not used before and the patient responds suddenly and dramatically.//

    Could I respectfully suggest that the ‘sudden and dramatic response’ you observe could still be the outcome of a ‘placebo’ response, generated by the intersubjective exchange of realities perculiar to the developing conversational dynamic and rapport that you are having with your patients.
    As a councellor and provocative therapist, your exquisit skills of listening and the ability to successfully manipulate transference dynamics, may well be the ‘agency of effect’, especially in case where ’emotional’ distress is the most significant pathogenic factor in the (unspecified)’chronic disease’ that initially presents.

    regards

    paul

  13. ez February 24, 2010 at 3:52 pm

    Dr. Kaplan,

    WHen I read the last comment by Paul, I recalled how the other day I thought that all those statements by Andy Lewis and such saying that “people just get better” can quite easily be refuted by a number of good epidemiological studies of, say, the rate of such recovery after skilfull counselling alone compared to an interview with a homeopath followed by administering a remedy chosen by the homeopath, and in particular – the time frame for such events. DO such studies exist? Probably, no, but they are certainly worth doing.

    I myself have heard directly from a psychologist wondering why is it that psychotherapists spend enormous amounts of time and energy to talk to their patients and hardly anything happens, while after a single, or possibly several (but not really many) consultations with a homeopath and some sugar pills suddenly there are dramatic changes… This person was very intrigued and went into selling hoemopathy books, deeming this was a better job than going on doing what she did… – counseling.

    • Dr. Kaplan February 24, 2010 at 7:49 pm

      @kotmurka
      Your comments are very thought-provoking indeed. I think the skeptics will say ‘intention to help’ the physical problem has something to do with it but this can be no reason to exclude NHS homeopathy – even if THEIR model of the mechanism of homeopathy proves to be true. Thank you for your contribution.

  14. paul February 24, 2010 at 7:59 pm

    Ez,

    Its because we homeopaths use witchcraft you kmow, (Ask Mr Lewis about it he appears to be something of an expert) and therefore are really clever at convincing people that they will now get better despite them having tried just about every other form of therapy to no good effect.

    It is as they say “in the wrist action”.

    • Dr. Kaplan February 24, 2010 at 8:14 pm

      🙂 Yes indeed. You’ve heard of TEETH patients of course. Tried Everything Else Try Homeopathy. And even these ones get better too – as we know.

  15. Sastry.M March 21, 2010 at 5:59 pm

    Gentlemen-Going through the various comments the discussions point out to only one aspect viz. the human condition. Every one becomes conscious of oneself and feels restricted when diseased but forgets oneself when in good health.In either condition there is not much to believe about oneself because every one takes his/her existence at the present to be granted as real. Realities and fallacies are conceived by mind and compared with personal experiences. Actions in the physical world are governed by Universal Laws conforming to the Principle of Duality and therefore are rational and definitive to subtle comprehensions of the mind and sensory perceptions of the body respectively. However actions relating to the mind need not follow the set patterns of the physical world and hence are known as transcendental, i.e. can hop over the patterns under rules conforming to rationality and logic. Thus the question of belief boils down to the conformity of repeated experiences. We have not seen the paternal or maternal parents of our great grandparents and yet implicitly accept their existence beyond belief because of our present physical existence.The set patterns of physical body buildups over the generations are easily conceivable but not the aspirations and beliefs entertained in their minds. Thus we arrive at a Dichotomy in the creation of Human Species in which rational physical bodies are equipped with transcendental mindsets. Can any one of us believe or deny this assertion? Pancakes freshly scraped from a hot plate may be relishing to taste directly but the displeasure of touching the hot plate need not be believed emotionally! All difficulties arise with us human beings only because of our transformative thought and intellect,adaptive intelligence and above all choice over subjective actions. All these faculties stand to good stead in the study and interpretations of external phenomenal world under various scientific disciplines because of the set patterns and conditions cited above but bog down when applied to internal ones of human being himself. This is because we have an instrument of human body which is equipped with external organs whose operative domains are rationally definable to external stimuli and internal ones functionally definable with perfect harmony in health. However the overall use or abuse of human body are linked to the wisdom or vagaries of individual mind programs. This is the bone of contention between the Classical Old School and modern Homeopathic Schools of Medical philosophies and applicative therapeutics. The toxic and curative effects of medicaments are well recorded and established by the Classical and hence considered dependable for rational application as therapeutic agents.This classical principle, the Homeopathic School contends, need not be true always since we are reckoning with a bodily system which tends to be irrational in response to rational medication.This is understandable because the individual sensitivities and susceptibilities vary from person to person. Then also there exists the irrevocable natural principle of duality and hence by the New School contentions the ensuing bodily reactions following the positive effects of medication tend to be unpredictable because of individual characteristics. Given these arguments the tilt of scale pointer swings between predictable belief on the classical and experienced relief from the new one. After all every human being aspires for health and happiness and relief from dis-ease and suffering whatever the deliberations of consulting professionals. Dogma is the anti-thesis of democracy and humility is the hallmark real human progress in whatever field of authoritative human service. We people boast of progress in external achievements setting the sky as the limit because these are external and rationally achievable but cannot set the same internally due to unpredictable management difficulties. If positive counseling from a psycho therapist can afford relief from tension and uncertainties of mind in an individual the spoken word acts as a therapeutic agent applied in consonance to actions already taking place autonomously in subconscious levels and hence augments the process substantially. This shows that a medicinal agent need not be materially packed to address the sufferings in an individual but coherently suggested to the will to overcome his own self generated negativity to win over the suffering.
    Human health cannot be guaranteed by health insurances which can only reimburse partially the attending treatment costs and choice of medical advice should be left to the suffering individual and not dogmatically decided in favor of any school since Life is created by the Grace of God and vested democratically and money is created by man vested with values in a promise of hope.

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