Popularity and Placebos: The UK’s Troubling Acceptance of Homeopathy

Last year I found myself immersed (academically – heaven forbid I should do so in any practical manner) in the workings of Medicine and Bioethics in the UK. I was, for the most part, impressed. Particularly in contrast to some positions in the US and Ireland, the UK system seemed to handle many tricky issues remarkably well. The Nuffield Council on Bioethics, the NHS, the GMC the  were all models which, while not perfect, could certainly serve as examples for some of their foreign counterparts. All in all, I found attitudes to healthcare perhaps a bit more progressive in the UK than in Ireland, in certain areas at least. This makes the widespread tacit, and even official, acceptance of homeopathy in the UK all the more surprising. In many jurisdictions homeopathy manages to avoid much controversy for the simply reason that it is seen to be (much like the planet Earth itself) as “mostly harmless” by those who understand that it involves little more than sugar pills and ludicrously diluted remedies which amount to simply water. To make matters worse, it is often defended with a wag of the finger and a “don’t buy into what Big Pharma want you to think” attitude by those who (mis)understand homeopathy to be a catch-all term meaning “alternative” or “natural” remedies. Let this be clear, hompepathy is not the practice of alternative medicine or natural remedies, it is a very specific and truly bizarre system of alternative medicine created in 1796 by Samuel Hahnemann, (a German medical doctor who suggested diseases were caused by miasm, psora and coffee) based on his idea that like cures like, according to which a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people. This practice generally involves repeatedly diluting a chosen substance in alcohol or distilled water, which usually continues well past the point where no molecules of the original substance remain. Let this be clear, even most homeopaths agree homeopathic remedies almost undoubtedly have no physical trace of their supposed active ingredient. (Presumably unproblematic if one accepts that water has memory). Homeopathic remedies are found to be no more than a placebo and homeopathy is widely considered a pseudoscience.[1] Tom Chivers, writing for The Telegraph summed it up nicely;

I probably don’t need to rehearse this, but: homeopathy does not work. Homeopathy is the treatment of disease using literally non-existent amounts of ingredients which wouldn’t cure the problem even if they were actually there. It is not to be confused with herbal medicine, which often involves real active substances (eg aspirin, which is distilled from willow-bark). If homeopathy worked, we would need to explain how this non-existent substance did what it does: but it doesn’t work, so we don’t. Homeopathic hospitals are not “valuable national assets”, they’re £7-million-a-year white elephants for middle-class hypochondriac hippies.

In part, this acceptance of homeopathy in the UK is either demonstrated by, or worse encouraged by, the position of the Royal Family on the subject. Sarah Rainey of The Telegraph wrote;

The Royal family has long been devoted to the practice of homeopathy – in fact, to this day, there is a court homeopath, a position that seems as anachronistic as the royal horologist or the master of the Queen’s music. The Queen’s father, George VI, was a firm convert to the cause, as was his father, George V.

This sterling tradition of supporting unfounded pseudo-science is valiantly carried on by Prince Charles these days, who is forever fighting the good fight to have homeopathy accepted as mainstream medicine. Homeopathy certainly has friends in high places in the UK with Jeremy Hunt, styled the “Minister for Magic” by Andy Coughlan,[2] as Secretary of State for Health, having previously signed a motion “[welcoming] the positive contribution made to the health of the nation by the NHS homeopathic hospitals“, and reasoning to concerned constituents that because “[h]omeopathic care is enormously valued by thousands of people” it should be supported by the Government. I imagine that a considerably larger proportion of the British population might enormously value a brand new Xbox One or a bedside visit from Tom Hiddleston, but I somehow feel the NHS “Therapeutic Games Console and Celebrity Visits Scheme” won’t quite get off the ground (despite the likelihood of it being at least as effective a treatment as homeopathy, if not more so).

A piece written last month by Andy Lewis entitled “Ten Reasons why the Society of Homeopaths Should not Receive PSA Accreditation” gives an excellent overview of precisely how unfounded the claims of homeopathy and homeopaths are, as well as the numerous reasons why it would be ridiculous, as well as dangerous, for The Society of Homeopaths to become accredited as a voluntary professional register with the Professional Standards Authority. A number of people and organisations (including yours truly) wrote to to the PSA with feedback regarding the unsuitability of the Society of Homeopaths for accreditation, including that; homeopaths are for the most part not medically qualified; hompeoathic remedies have not been found to have any medicinal value beyond a placebo effect; there is little training or self-regulation among the homeopathic community; and, most importantly, homeopathy can actually be a serious danger to public health by discouraging mainstream medicine like vaccinations and proper treatment for diseases such as cancer.

Lewis points out that;

In Steiner Schools, now publicly funded as Free Schools, the in-school doctors practice homeopathy on the children. Measles outbreaks are common in Steiner Schools and the  Health Protection Agency views Steiner Schools as “High Risk” and as “unvaccinated communities”. As such, they pose direct risks to the children within them and to the surrounding community.

… and similarly disturbingly that;

As Professor Edzard Ernst points out on his blog, Neil Spence RSHom makes many ‘far reaching’ claims about his ability to treat people with cancer. Not only is this against the Code of Conduct of the Society of Homeopaths but is also almost certainly in breach of the Cancer Act 1939. As Ernst concludes, “The thought that some cancer patients might be following such recommendations is most disturbing.” And I would add that the thought that the PSA will be rubber stamping such practitioners is even more disturbing.

The practice of homeopathy is far from victimless, and more often than not it is the children of parents who don’t believe in vaccines or mainstream medicine who suffer – such as the case of the Australian couple who tried to treat their daughter’s eczema with homeopathy, and by the time they brought her to a hospital, she was in such an advanced state of infection that she tragically died of septicaemia.

Though there were moves by the British medical Association (BMA) in 2010 calling for the NHS to cease funding homeopathy as “[i]t can do harm by diverting patients from conventional medical treatments“,[3] the NHS maintains its position that “[i]t is the responsibility of local NHS organisations to make decisions on the commissioning and funding of any healthcare treatments” and that “[h]omeopathy is not available on the NHS in all areas of the country, but there are several NHS homeopathic hospitals and some GP practices also offer homeopathic treatment.“[4] Much of which will, of course, be indirectly funded by the British taxpayer. Sadly, the situation is still such that Professor Sir John Beddington, the outgoing British Chief Scientific Adviser to the Government, criticised the Government for ignoring his advice against the use of homoeopathic remedies by GPs and in NHS  hospitals. Worryingly, even the British Homoeopathic Association says that roughly £4 million of public money is spent each year on homoepathy, though some claim that the figure could be as much as £12 million.

It is very important that society, whilst attempting to practice a respect for dissenting opinions, does not “aggrandise quacks” or allow unsubstantiated practices to be deemed as trustworthy as accepted medical treatment. True, there are mistakes, abuses of power and position, and commercial interests at play in the world of traditional medicine too, but there are at least rigorous systems for training, testing and qualification, which we simply cannot ingore for the sake of benign-sounding “alternative” treatments. To quote the great Tim Minchin; [5]

“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call alternative medicine
That’s been proved to work?

Medicine.”

~ Shane

[1] Kevin Smith. “Homeopathy is unscientific and unethical.”Bioethics Volume 26, Issue 9, pages 508–512, November 2012, DOI: 10.1111/j.1467-8519.2011.01956.x

[2] Andy Coughlan,  “Hail Jeremy Hunt, the new minister for magic“, New Scientest, September 2012

[3] Nick Triggle, “Doctors call for NHS to stop funding homeopathy“, BBC News, June 2010

[4NHS Choices: Homeopathy, available at  http://www.nhs.uk/Conditions/Homeopathy/Pages/Introduction.aspx

[5] Tim Minchin, Storm, available at http://www.stormmovie.net/

For further reading, see:

Lyndsay Buckland, “Legal bid to save homeopathy on the NHS”, The Scotsman, October 2013, available at http://www.scotsman.com/news/health/legal-bid-to-save-homeopathy-on-the-nhs-1-3159793

Richard Gray, “Homeopathy on the NHS is ‘mad’ says outgoing scientific adviser”, The Telegraph, April 2013, available online at http://www.telegraph.co.uk/health/healthnews/9982234/Homeopathy-on-the-NHS-is-mad-says-outgoing-scientific-adviser.html

Andy Lewis,  “Ten Reasons why the Society of Homeopaths Should not Receive PSA Accreditation”, Quackometer, January 2014, available at  http://www.quackometer.net/blog/2014/01/homeopathy-psa-accreditation.html

Sarah Rainey, “Prince Charles and homeopathy: crank or revolutionary?”, The Telegraph, November 2013, available at http://www.telegraph.co.uk/news/uknews/prince-charles/10433939/Prince-Charles-and-homeopathy-crank-or-revolutionary.html

Shang A, Huwiler-Müntener K, Nartey L, Juni P, Dorig S, Sterne JA, et al. “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”, Lancet. 2005;366:726–32. [PubMed]

Photo Credit: SnaPsi Сталкер via photopin cc

4 thoughts on “Popularity and Placebos: The UK’s Troubling Acceptance of Homeopathy”

  1. It might not be such a bad idea if patients were diverted from many conventional treatments to safe, effective and inexpensive homeopathic medicines.

    In 2010 the NHS spent 10.2 billion pounds on conventional drugs. It also spent 2 BILLION pounds on treating the side effects of those drugs. The market for homeopathics in the UK has grown by 18% since 2008 and was worth a staggering 213 million pounds a year. Experts expect a rise to 282 million pounds by this year. While the NHS is spending inordinate amounts of money on drugs that cause disease, the British people are putting their confidence in homeopathics. Many have used them over and over and over again for decades, even generations. People who can afford any type of medicine they wish, choose homeopathy.

    As to conventional drugs, adverse drug reactions are believed to cause over 100,000 American deaths every year. Serious adverse events are the third leading cause of death in the U.S. ADR’s caused over 2 million hospitalizations in 1994 alone. Drug-related mortality/morbidity is estimated to cost the U.S. health care system more than $150 BILLION annually. 19 drugs have been withdrawn from the market since 1998. 26% of drugs introduced between 1980 and 2006 carry black box warnings (meaning use at your own risk).

    Source: FDA/CDER/PhRMA/AASLD Meeting “Detecting and Investigating Drug induced Adverse Events, The International Serious Adverse Event Consortium’s Experience to Date”, March, 2008

    Having experienced first hand, the wonderful things homeopathy can accomplish, I’m sticking with it. It’s my primary form of medicine and always will be. Love it for my animals, too.

  2. There are millions of people worldwide who have found homeopathy cost effective, safe and curative for many chronic conditions and diseases that conventional medicine has not been able to cure. For example, homeopathy is practiced legally in the following countries:

    Argentina, Australia, Austria, Belgium, Canada, Chile, Colombia, Costa Rica, Cuba, Cyprus, Czech Rep., Denmark, Ecuador, Finland, France, Hungary, Germany, Greece, Italy, Japan, Kenya, Latvia, Luxembourg, Malaysia, Netherlands, Nepal, New Zealand, Nicaragua, Norway, Philippines, Portugal, Romania, Russian Federation, Saudi Arabia, Spain, Sweden, Switzerland, South Africa, U.S.A., and Venezuela.

    1. There may indeed be these millions of people. Though, by definition, what is essentially just water will most of the time be safe and cost effective, though arguably not as cost effective as tap water. But the difference here is that tap water is unlikely to have the “curative” effect you refer to. I do not deny that some homeopathic remedies have a curative effect. But I remain highly sceptical that this curative effect is anything other than a potent placebo.

      Nor did I suggest that homeopathy should be made illegal. While it might have dangerous indirect effects, in that people fail to seek proper medical attention, I see little reason to legally prohibit the practice of homoepathy in any kind. What is problematic is when unsubstantiated practices – for which their is neither a good scientific explanation or a body of respectable peer-reviewed research which shows homoepathy to be any more effective than a similarly administered placebo – get public funding either directly or indirectly. Tax-payer money contributing to scantly regulated non-medical vendors of pseudo-science and water is something I do think should be stopped. But I consider the practice of homeopathy should remain, outside of those confines, as legal as spiritual healing, reading auras and telling fortunes.

      Let us not forget that you also have a vested interest in promoting homeopathy, as practicing and promoting homeopathic remedies seems to be your profession, so let us not pretend you do not have more reason to be biased here. If a standard medical treatment is to be practised, and even publicly funded, it needs to have both a solid scientific foundation and clinical experimental evidence. Extraordinary claims require extraordinary evidence, and as such, the homeopathic claim that statistically non-existent or negligible quantities of an ingredient diluted into water can cure a patient should require a higher standard of evidence than traditional medicine. Homoepathy does not meet this standard, and as such can only be seen as pseudo-scientific business of selling water to those for whom a placebo might in fact bring some comfort.

      1. You are wrong on all counts, including my profession. I am not a homeopath. I am a homeopathic student and patient. I can comment from a position of knowledge. You cannot. Or, can you say that you have consulted a homeopath and been treated by him/her? Otherwise, mere opinions passed among skeptics and repeated by you here are no longer effective. . .

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