Ben Goldacre writer for The Guardian and blogger on his website badscience.net has been one of the most prolific critics. He has a band of supporters who seem to have nothing more to do than indulge in ridicule and tired old jokes about homeopathy, clearly a subject they know nothing about, every time Goldacre has an article published. He positions himself as an innocent defender of the gullible public, while he delights in disparaging CAMs, with special ridicule reserved for homeopathy.
Reading any of the writing by Goldacre, Ernst et al is an education in how to use the media. They are careful to include apparent criticism of allopathic medicine, while maintaining a fundamental difference. When writing about homeopathy, the entire system of medicine is condemned. When writing about allopathy they focus on the drug that has proved problematic, ineffective or dangerous, offering their article as an example of their balanced reporting. The allopathic system itself is never held accountable. (The irony when drug recalls have never been more frequent and iatrogenic disease is now, in some reports, the leading cause of death in the US.)
We can be reassured that the strongest criticism leveled at homeopathy remains that homeopathy is placebo and therefore homeopaths are duping the gullible public, and the biggest danger that homeopathy poses, is that patients may waste time valuable time visiting a homeopath, when they should be consulting with an allopath.
2008 has seen two books published in quick succession, the titles of which might lend a clue to their contents. Rosie Shapiro a well-known journalist wrote; Suckers. How Alternative Medicine Makes Fools of Us All. (publisher Harvill Secker). The book is described as a “vigorous polemic” by The Guardian and in The Independent: “The ferocious assault on the evidence-free mountebanks who peddle alternative medicine, and the dupes who fund them, is a bracing tonic…”. Presented as a necessary calling to account of the CAM world, it paved the way for the “scientifically credentialed” Trick or Treatment? Alternative Medicine on Trial by Edzard Ernst and Simon Singh, of News Night sting fame (Bantam 2008). A brief search of the internet reviews will provide examples of the kind of negative conclusions they draw and the extent of the authors bias and / or ignorance. The titles alone are enough to deter the timid from admitting that they use CAMs!
There is a trend
There is a legislative trend in process most clearly illustrated by Codex Alimentarius currently setting regulations governing CAMs in the European Union. Codex is charged with setting the standards for everything regulated under the definition of food. Given the intensive lobbying in the regulating committees, the underlying concern must be who is actually setting the standards and why. Using something called the Precautionary Principle, together with risk assessment, Codex has the means by which to restrict public access to, for example, nutritional supplements. Vitamin C will be restricted to 50mg doses for public sale with higher doses needing a medical prescription and – in order to lessen risk since they can be more easily standardized – limited to synthetic versions and manufactured by the pharmaceutical industry. The required registration of products and product ingredients are now prohibitively expensive for all but the largest manufacturing companies. Although Codex is described as voluntary, it is tied to the World Trade Organization and trading pressures can be brought to bear when necessary. The Alliance for Natural Health, a small UK non-profit organization is successfully challenging Codex all the way to the European Court and shows it’s still possible for David to take on Goliath. (www.alliance-natural-health.org) If you have not taken a close look at Codex, you should, it’s an excellent example of the trend in regulations governing consumer access. (See the article Magnus Pharma in Similia.)
Bill C-51 currently before the Canadian parliament is another good example.
Changes in terminology (“drug” changed to “therapeutic product”) would allow the widest possible interpretation. The Bill also provides for a radical extension of the powers of enforcement, and shifts the decision making power away from elected officials to administrators behind closed doors.
In the US a similar trend can be seen in the Bills advocating mandatory vaccination schedules. That such schedules are to be decided by unelected committees in closed meetings, at a time when cases of vaccine damage are before the courts, makes no rational sense to anyone not tied to pharmaceutical profits.
In the UK the decision to withdraw funding for provision of NHS homeopathy has been given to non-medical administrators in PCTs. The overall trend is towards increasingly restrictive legislation in relation to CAMs and towards diminished public involvement in the decisions which directly affect its health.
Current situation in the UK
Sadly the Royal London Homeopathic Hospital is still waiting for the final word on its future. What once occupied an entire building is now reduced to just one floor, and that shared with other CAM practitioners and their support staff. PCTs are afraid to allocate funding to a therapy they have been told “doesn’t work” in an NHS that is strapped for cash. The fact that the combined budget for the hospitals is $20 million in an NHS budget of almost $200 Billion, and further that the hospitals balance their budgets (almost unique within the NHS), seems to have little effect.
Tunbridge Wells Homeopathic Hospital was slated for closure in March 2008 but a concerted effort by patients and their supporters won the hospital a one-year reprieve. Bristol and Liverpool are still functioning, albeit as small outpatient clinics in separate buildings. Referrals from GPs have been made more difficult and/or refused funding, and in a great example of circular thinking, the consequent reduction in referrals has been used as confirmation that there is no public demand!
To call any of these facilities “a hospital” now is really a misnomer. Gone are the full service facilities with in-patient beds, all are reduced to a series of outpatient clinics.
The Glasgow Homeopathic hospital alone is active and well supported by the Scottish NHS and GP referral service after a strong grassroots lobby secured their position.
New UK government funded CAM regulatory body
A new Complementary and Natural HealthCare Council (CNHC) will begin regulation of CAMs in summer 2008. Although voluntary, it will set standards for a number of CAMs, including homeopathy. The homeopathic profession was not consulted but the professional bodies are confident that their own standards already exceed those set by CNHC. I wonder if allowing a government funded body to set standards is a potentially dangerous precedent in the current climate? In a country with an NHS, CAMs always suffer when economic pressure makes itself felt, so it may just be coincidence that as the negative press has escalated, practitioners have reported a drop in new patient bookings. In the same way, a drop in the number of new students may reflect a population less willing to risk a career change, and afraid that by the time they are trained there may not be a profession to join!
The professional homeopathic societies are busy organizing media responses and conferences and if nothing else, have seen a healthy increase in their membership.
The British Medical Journal has started an open access online journal for submission of cases from any area of healthcare. It’s a wonderful opportunity, but to take advantage of it we must be rigorous in our case write ups: write according to the BMJ convention; discuss all the possible variables that might have contributed to the patient’s improvement; use the cautious language of research; offer it as information rather than definitive proof, and check grammar and spelling. It’s a time for us to take ourselves seriously and step up to the plate. Perhaps homeopaths who are used to writing in this way can offer help to homeopaths who are in the process of learning this skill.
Beyond the crisis
I believe that homeopathy has the potential to fundamentally change this world for the better. Holding the vision of a healthy world in which homeopathy is mainstream medicine is important, but a vision will not manifest without action. The homeopathic community must consciously prepare for this change; and events are moving very, very quickly. Big Pharma is caught up in a global shift in which it cannot survive in its current form. Having engineered its own demise, in its fear and panic it is lashing out.
We need to keep our eye on the ball and our focus on excelling at what we do best, so that we can move into the vacuum that this healing crisis will create.
Let’s not be defensive or angry. Let’s be assertive and most importantly, let’s be fearless. We know the cost of living in fear and the dangers of trying to compromise to the middle ground. We know we have a phenomenally effective medicine, one that the world needs now more than ever, and we should hold to that truth. To be alive during such a fundamental shift and to be on the side of a healing modality that works is just the most wonderful place to be! Rest assured: although it may not feel like it, our time is now and the future is ours.