For reasons that will probably never be clear, at a time when the nation faces so many challenges, the UK government’s parliamentary select Science and Technology committee decided to conduct an Evidence Check into homeopathy at the end of 2009.
The homeopathic community scrambled to make written submissions before the deadline passed and waited for invitations to make oral submissions to the committee. They never came.
The first Evidence Check meeting was held in two parts – the first group of witnesses made it plain where this evidence check was intended to go. Tracy Brown, Managing Director of Sense About Science – the lobby group responsible for a series of anti-homeopathy actions over the years, including the 2006 sting of homeopaths for BBC NewsNight, and the push for the WHO to ban homeopaths from working in the developing world in August 2009. Dr Ben Goldacre, journalist for The Guardian and author of badscience.net who saves his most vitriolic anti-CAM rants for the homeopaths. Professor Jayne Lawrence, Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain, enough said; Paul Bennett, Professional Standards Director of Boots the high street chemist (who with his first words gave the media the perfect sound bite when he said he had no evidence that homeopathy works, but since consumers want it he felt they had a responsibility to supply it. He also said he had no evidence that homeopathy doesn’t work, but that doesn’t make good headlines.) And lone pro-homeopathy witness, Mr Robert Wilson, Chairman of the British Association of Homeopathic Manufacturers.
What was meant to be an investigation into what informs government policy about homeopathy devolved rapidly into something reminiscent of a courtroom brawl about whether homeopathy works or not, according to the narrow world of Random Controlled Trials and meta-analyses. Witnesses for the ‘prosecution’ were well prepared and at times it was a tempting diversion to count how many times Dr Goldacre could fit ‘sugar pills’ into an answer. Dr Evan Harris MP, one might say senior counsel for the prosecution, excelled in the art of puerile questions and distractions from the issue at hand.
You need to watch the meetings archived on the parliamentary website to fully appreciate how stacked the decks were.
http://www.parliamentlive.tv/Main/Player.aspx?meetingId=5221
http://www.parliamentlive.tv/Main/Player.aspx?meetingId=5257
Transcripts here:
Next up was Prof Edzard Ernst, nemesis of UK homeopathy and self-appointed expert; Dr Peter Fisher, Director of Research at the Royal London Homeopathic Hospital (and the only practicing homeopath); Dr Robert Mathie, Research Development Adviser at the British Homeopathic Association, and Dr James Thallon, the Medical Director at NHS West Kent – the man personally responsible for withdrawal of funding and the consequent closure of the Tunbridge Wells Homeopathic Hospital last year.
Dr Harris feeling on safe ground took great delight in letting rip. His line of questioning to Dr Fisher included such questions as: “Why do you think that there has been no Nobel Prize given to the people who have made these astonishing discoveries of the potential for the memory of water…..?”
And: “On that basis then, why is it that when you have a solution of water that used to have some homeopathic substance in it but it has been diluted, that the water is said to retain that memory but does not remember all the poo, you could call it, that has been in it….”
My own MP Ian Stewart, also on the committee, made a vain attempt to bring some dignity to the proceedings, but he was only one man.
The second Evidence Check committee meeting on Nov 30th called witnesses Mr Mike O’Brien MP, Government Minister for Health Services; Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency, and Professor David Harper Chief Scientist, Department of Health.
At the start of the meeting, the Chair of the Science and Technology committee was at pains to put on record that:
“…… there seems to be a little confusion about the nature of the work that we are doing, this is not an inquiry into whether homeopathy works or not. This is an inquiry which follows a series of evidence checks across a number of government departments to see whether in fact there was any evidence to support the Government’s policy towards homeopathy. I want to make that absolutely clear.”
And then he proceeded: “I wonder if we can therefore start with you, Minister. Does the Government have any credible evidence that homeopathy works beyond the placebo effect?”
Mike O’Brien started to talk about the 2008 Department of Health’s Northern Ireland CAM project, which had proved so successful, but then inexplicably said that the project had not included homeopathy!! Of course it included homeopathy and the patients and the GPs who referred their ‘heart sink’ patients to the homeopaths, were very satisfied with the results.
And so it went on…probably one of the most frustrating pieces of theatre I have ever had cause to watch.
The last Saturday in January brought us the so-called1023 publicity stunt when small groups of denialists, skeptics, and their siblings and supporters did ‘their bit for science’ and took part in a national ‘mass overdose’ of homeopathic medicines, thereby proving yet again that these people know nothing at all about homeopathy.
The London event saw Dr Evan Harris of the Science and Technology parliamentary select committee wearing the T-Shirt, amusing the crowd of overdosers with an account of his questioning of Dr Fisher and taking part in the overdose. To say he was in breach of the General Medical Council Guidelines for Good Practice, Sections 1.46 and 1.47 Respect for Colleagues might be described as an understatement. To say he made a public display of a bias so extreme that it ought to disqualify him from the Evidence Check is in no doubt.
You can watch him here: https://www.youtube.com/watch?v=xYuLjl9bgIw
The Evidence Check report with its recommendations regarding NHS homeopathy will be made public on Feb 22nd. We can expect it to be very critical, and I predict calls for withdrawal of funding for NHS homeopathy; tightening of regulations of manufacturing and labeling of homeopathic medicines; limits to sales of over the counter homeopathic medicines, and further down the road, increasing restrictions for professional homeopaths.
Since the Evidence Check was supposed to be about what informs government policy, the focus SHOULD have been the reports from the homeopathic hospitals submitted to the committee about the effectiveness, cost effectiveness and patient satisfaction of homeopathy in the real world – yet this was never discussed at all – and the government’s own successful pilot study in Northern Ireland, which was not discussed because the Minster of Health mistakenly said it had not included homeopathy!
Those in the UK who have been following the campaign to remove access to homeopathy within the NHS, are clear about several points – and homeopaths worldwide would do well to pay attention to the UK situation.
This Evidence Check was part of that orchestrated campaign. Powerful lobby groups like Sense About Science, funded by the pharmaceutical industry, and related organizations spikedonline and The Institute for Ideas, feed misinformation to sympathetic journalists in major mainstream media outlets, which in turn allow no rebuttals of the misinformation that they publish. Armies of bloggers use the internet and twitter to spread the misinformation far and wide. Individual practitioners are isolated and personally attacked on webpages, credentials called into question, threats made.
We need to ask why these groups would invest so much time, effort and resources to get rid of NHS homeopathy, which comprises just 0.004% of the total NHS budget? If they were concerned, as they claim, about patient welfare, surely it would be more productive if they looked into ghost writers in medical journals skewing the facts; dangerous pharma drugs brought to market despite evidence of harm; pharma influence of doctors, medical schools, university departments, and etc. etc. etc. But they don’t because their job is to spin the corporate line.
Homeopathy is the easy target of the CAM world – but we need to think of it as “first they came for the homeopaths”. Codex in the European Union is already moving manufacture of supplements into the hands of the pharmaceutical industry, and pushing for prescription-only delivery, by a medical profession that knows almost nothing about the subject.
Homeopaths and their professional organizations need to get politically savvy, it’s a powerful agenda that’s being served. CAM groups should collaborate urgently and throw all their weight behind defending homeopathy, because what’s happening in the homeopathic world is only the thin end of the wedge that’s being hammered into place.
For more on the Evidence Check and the UK situation check out:
Great article Carol, thoroughly chilling. Canada in its own mild way is coming up against these same challenges, though due to a lack of profile in the public health service will not meet such a public debate. It behoves us all to step up to the plate, continue our work in a professional manner and to get educated about the politics of health care!
Excellent reporting and informative. Thank you to those homeopaths who are spending time trying to support the maintenance of choice in health care. As I cannot join other homeopaths on wed 24th at westminster I am arranging to meet my MP at his local surgery. I will be able to use the article to help put the homeopathic viewpoint. Perhaps if we talk with our MPs? I had a reply from an MP talking about “people like you”. Perhaps on a 1:1 basis we can help debunk the ignorance? I am sure we will all find our own way to lend support.
Thank you for the update, Carol. Grim news. The silver lining is that if there was not recognition that we really do pose a threat, however minor, they would not bother.
Why was the egregious error by Mike O’Brien allowed to stay on the record? That sounds mighty suspicious to me.
The Science and Technology committee is very remniscent of a similar committee centuries ago that vehemently disregarded evidence that the earth is round and did all it could to prevent the news from spreading. A very narrow mindedness or is this one about profits?
A sincere question:
If Randomized Controlled trials aren’t the right way to figure out how to spend public money in the area of health, what is? That is, how should governments figure out what’s worth funding?
I posed this question last year on my blog — specifically asking homeopaths and naturopaths for their input — and unfortunately got very little help.
I wrote:
“Which alternative health services ought to be covered by insurance plans (private ones, or public ones like Medicare), and which ones should not? Presumably all practitioners of alternative medicine would agree with this: some alternative or “natural” therapies probably work, and some probably don’t. How can insurers (public and private) tell the difference? Presumably Homeopaths believe Homeopathy should be covered, and Chiropractors think Chiropractic should be covered, and so on. That’s understandable. But what other services do Homeopaths and Chiropractors think should or shouldn’t be covered?”
(For the rest, see http://www.businessethics.ca/blog/2009/06/second-plea-to-alternative-health.html )
I really would like to know what *general* principle homeopaths would like to see applied here.
Thanks,
Chris.
I really hoped someone would reply to this.
I believe that homeopaths are dedicated to healing. That should include helping people figure out which kinds of remedies to seek, and which to avoid. It should be possible to give some guidance to patients who are offered something *other* than homeopathy — is there any way for the public (or a retail outlet) to tell whether a particular therapy is useful or whether it is instead fraudulent?
Dear Chris,
RCT’s are just one of the MANY research methodologies available. ME Dean in his work ‘The Trials of Homeopathy’ has covered a host of homeopathic trials, issues related to homeopathy and RCT’s and the alternative research methodologies. The limitations of RCT’s are not propagated by homeopaths. There is a whole lot of research into this and you can find many research and review publications online itself. I reviewed the above mentioned book long back:
https://hpathy.com/homeopathy-book-reviews/the-trials-of-homeopathy-origins-structure-and-development-2/
Thanks for the reference to the Dean book.
But that still doesn’t answer my question. What standards *should* proposed therapies in general be subjected to?
For what it’s worth, Big Pharma doesn’t much like RCT’s either. They’re expensive, and many candidate drugs fail. But consumer advocates and academics in the field of human subjects research ethics have managed to get government to force pharmaceutical companies to carry out RCT’s. It’s quite likely that Big Pharma would be pleased by anything that effectively critiques RCT’s as a standard.
I’ve recently posted this entry on my own blog to invite people to suggest general answers to this question:
http://www.businessethics.ca/blog/2010/03/which-alternative-therapies-is-it.html
The question of how to test a specific therapy would depend a lot on the nature of modality being tested but one of the key criteria should be the ability to demonstrate clinical efficacy in reproducible long-term clinical trials, which follow the nature of the modality being tested. There is much more but I guess it is better that the people who are involved in clinical research methodologies pour their thoughts on this. Most homeopaths are clinicians and not scientists who can discuss research methodologies.
I’m intrigued. You say that “one of the key criteria should be the ability to demonstrate clinical efficacy in reproducible long-term clinical trials” – but isn’t that the evidence that the committee looked at?
Also I’d be grateful if you would explain “follow the nature of the modality being tested” as I don’t understand this sentence at all.