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Homoeopathy should not be funded on the NHS, says report by MPs

By Laura Donnelly, Health Correspondent, February 20, 2010

Homoeopathic medicines should not be allowed to make claims they cannot justify and should not be paid for by the taxpayer, MPs will recommend.

A report from the Commons science and technology committee is expected to criticise the use of NHS resources to fund the remedies based on the current evidence for them.

The committee will also argue that medicines should not be allowed to use phrases like "used to treat" in their marketing, as consumers might think there is clinical evidence that they work.

Latest figures show 54,000 patients are treated each year at four NHS homoeopathic hospitals in London, Glasgow, Bristol and Liverpool, at a cost of £4 million.

A fifth hospital in Tunbridge Wells in Kent was forced to close last year when local NHS funders stopped paying for treatments.

Homoeopathy is based on a theory that substances which cause symptoms in a healthy person can, when vastly diluted, cure the same problems in a sick person.

Proponents say the resulting "remedy" retains a "memory" of the original ingredient – a concept dismissed by scientists.

During the committee's inquiry, the British Medical Association said the use of homoeopathic medicine could not be justified on the current evidence.

The Royal Pharmaceutical Society of Great Britain said there was no possible reason why such treatments, marketed by an industry worth £40 million in this country, could be effective scientifically.

Advocates of homoeopathy say even if the effect of the remedies is to work as a placebo, they are chosen by thousands of people, and do not carry the risks and side effects of many mainstream medicines.

Prince Charles, one of the best known proponents of the concept, which originated in Germany 200 years ago, founded the charity The Prince's Foundation for Integrated Health, which promotes the use of alternative medicines.

Dr Michael Dixon, the charity's medical director, urged the Government not to restrict the use of homoeopathy, which he said would mean "abandoning patients".

"For all those people with long term conditions for whom there is no evidence-based medicine, it doesn't matter how it works, what matters is whether it helps them get better," he said.

A survey carried out at England's NHS homoeopathic hospitals found 70 per cent of patients said they felt some improvement after undergoing treatment.

David Colquhoun, professor of pharmacology at University College London, said: "It really is very simple; there is nothing in the pills. The danger is that people get diverted from the actual medicine which could cure them."

Last year an Australian homoeopath and his wife were found guilty of the manslaughter of their baby daughter because they did not seek conventional medical treatment for the nine-month-old, who died of septicaemia.

Cristal Sumner, chief executive of the British Homeopathic Association, said: "We feel the [select committee] inquiry was too narrow in its remit, there is plenty of evidence to support homoeopathy, with 100 randomised controlled trials, and many more on outcome measures, which reflect how patients say they feel." Go to pages 35, 36

Homeopathy: medicine that’s hard to swallow? See page 37 and 40, 41

By Laura Donnelly, Health Correspondent, January 30, 2010

Protesters have staged a mass 'overdose' of homeopathic remedies but, asks Laura Donnelly, what did they prove?

At 10.23 on Saturday morning, Simon took a vial out of his pocket. He examined the instructions on the label: two pills to be taken every two hours for the first six doses. The contents should not be touched by hand, but be administered directly into the mouth. The vial should be kept both out of reach and sight of children. The middle-aged man then knocked back all 84 tablets and swallowed.

As Simon Singh stood in a public square in London, and waited for the effects of his overdose to take hold, hundreds of other despairing men and women around him poured scores of pills and medicines down their throats.

What has been called a mass overdose attempt is perhaps better described as a cry for help. By taking remedies in quantities far beyond the dosages recommended by their manufacturers, Singh – a television presenter and author of several books on science – joined campaigners attempting to demonstrate the case against homeopathy, and those who supply it.

Many scientists say theories behind homeopathy – which relies on the extreme dilution of animal, plant, mineral as well as synthetic substances so that remedies do not contain a molecule of the original substance – are a nonsense.

Proponents of the model developed by the German physician Samuel Hahnemann in the late 18th century say it is based on the principle that "like cures like" – and that a substance taken in small amounts will cure the same symptoms it would cause if taken in large amounts. They insist that despite the massive dilution, to a point that the homeopathic solution usually contains none of the original substance, water retains a "memory" of a substance, giving a therapeutic effect. Many scientists say that the only possible impact of such remedies is as a placebo.

Yesterday, hundreds of self-proclaimed sceptics hoped to demonstrate that homeopathy does nothing, by consuming its products in vast quantities in 13 city centres and outside branches of Boots, the chemist chain.

As predicted, no ill effects were reported from consuming whole bottles of homeopathic remedies, even those based on dilutions of arsenic. "They were very tasty – a bit like sweets, only really expensive," said one protester who "overdosed".

The stunt was staged in protest against the sale of such remedies by Boots as part of a £40 million industry, as well as against the funding of homeopathy by the National Health Service. It was triggered by evidence that emerged during an inquiry into homeopathy by a group of MPs.

Next week, the report by the Commons science and technology committee is expected to criticise the use of NHS resources to fund the treatment based on current evidence.

It will be entering controversial territory. Advocates for complementary medicines, of which homeopathy is a part, include the Prince of Wales, who leads a charity which promotes its use.

Ahead of yesterday's publicity stunt, Singh, a long-time opponent of homeopathy, visited his nearest branch of Boots to buy supplies. "I was happy to shell out my £5 to buy some sugar pills, to prove a point," he says. "Actually, I am always buying the things. When I give lectures I like to take homeopathic sleeping pills, one after the other. I always warn the students that they are far more likely to fall asleep than I am."

Martin Robbins, one of the campaign's enthusiasts, says that anti-homeopathy groups have targeted Boots because they believe its status as a registered pharmacist gives the public false confidence in such products.

"It legitimises homeopathy, and sends out a really confused message," says Robbins. "People need to be able to trust their pharmacist to give them medicines that work." Like opponents of other alternative medicines, he objects to the notion that whether or not it does good, it does no harm.

The anti-homeopathy lobby believes that by diverting people with genuine complaints away from conventional medicine, lives can even be put at risk. They cite cases of seriously ill patients who have been advised by practitioners to swap over-the-counter medicines that treat serious diseases such as malaria with homeopathic preparations, to stop taking cardiac medicine, and even to refuse vaccinations.

David Colquhoun, professor of pharmacology at University College London, has long been concerned about the rising popularity of homeopathy. When he passes a chemist, he likes to carry out an experiment, asking the pharmacist what natural remedy they would recommend for his sickly grandchild, who has suffered from "terrible diarrhoea for days". Just one in 10 chemists advises him to send the child to a doctor immediately, or choose a conventional rehydration treatment – the course of action recommended by the medical profession.
"It's terrifying," says Prof Colquhoun. "Any sensible parent would be searching out Dioralyte, but nine out of 10 times the pharmacists will start rummaging through the homepathic shelves."

The British Homeopathic Association (BHA) says the very idea that anyone could overdose on homeopathic products betrays a misunderstanding of the model. Chief executive Cristal Sumner says that while science still has a lot to explain, the evidence base in favour of homeopathy is gradually increasing.

"There are well over 100 double-blind trials in homeopathy, and more are positive than negative," she says, adding that the association would not support any practitioner who discouraged a client with a serious illness from seeking conventional and effective care.

Paul Bennett, professional standards director for Boots, treads just as carefully. "We know that many people believe in the benefits of complementary medicines, and we aim to offer the products we know our customers want," he says.

Boots' pharmacists, Bennett adds, are trained health-care professionals and are on hand to offer advice on the safe use of complementary medicines.

Bennett is quick to describe homeopathy as "recognised by the NHS" – a major concern for those who oppose its use. Latest figures show 54,000 patients treated annually at four NHS homeopathic hospitals in London, Glasgow, Bristol and Liverpool.

Next week, the Commons select committee is expected to back calls by the British Medical Association for better research on homeopathy – especially if the NHS is going to spend money on it.

Prof Sir Ken Calman, a former chief medical officer for England, now chairman of the BMA's board of science, said its members want the NHS rationing body, the National Institute for Health and Clinical Excellence (NICE), to evaluate the current evidence, and make a definitive ruling on whether such treatments should be paid for by the state.

Advocates for homeopathy want something different – they say better trials are needed, in order that homeopathy can prove its worth.

As many as 400 GPs practise alternative medicine, says the BHA. Dr Michael Dixon is one of them. The Devon GP is medical director of the Prince's Foundation for Integrated Health, a charity set up in 1993 by the Prince of Wales to promote complementary medicine.

Dr Dixon says a dogmatic opposition to homeopathy ignores the simple fact that many patients say it helps them – and that a belief in treatment itself makes it more likely to work.

"Even if it is just placebo effect," he says, "homeopathy often gives great help to people for whom conventional medicine can do nothing – or can do no more."

Homeopathy 'works'- but it is the talking, not the tinctures that helps patients

By Laura Donnelly, Health Correspondent, November 4, 2010

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