Though the response has weak points, the UK Government stands up for the use of homeopathy in the NHS and demonstrates serious flaws in claims made by the Science and Technology Committee.
In a decision that reaffirms the individual's right to choose, the United Kingdom's Department of Health has slapped down the Science and Technology Committee's demand to abandon homeopathy. Rather than report on it honestly, news media are simply allowing anti-homeopathy forces free rein to give their opinions.
After reviewing "Evidence Check 2: Homeopathy", which denounced homeopathy and demanded that it be erased from the formulary, the UK Government's response for the Department of Health (DOH) took the Science and Techology Committee's points on one by one—and demonstrated why they were unreasonable and counter to the people's needs.
Rebutted Points
"Evidence Check 2: Homeopathy" makes many claims against homeopathy. Each one was taken on by the Government. Herein is a sampling:
The Demand that the NHS Spend Money to Identify How Much Has Been Spent Over the Last 10 Years
On the demand that the total amount spent on homeopathy over the last ten years be researched and calculated, the response noted that it is "important to keep spending in perspective". They point out that:
...scrutinising individual trusts’ finances to the level of detail that would be needed to answer this question fully, or similar questions in other areas, could well require a disproportionate amount of resource.
The Claim that Homeopathy Is Only a Placebo Effect
The Science and Technology Committee (STC) made many points claiming that homeopathy is merely a placebo effect. They make the claim—without substantiation—that homeopathy is ineffective and that, therefore, it is unethical to prescribe homeopathic remedies. The demand ran several paragraphs and covered tired old territory about randomized controlled trials, meta analyses, and even dipped into sarcasm with, "We would expect the Government to have a proper understanding of the power and complexities of the placebo effect and the ethical issues surrounding its use in a clinical setting." The Government's response was to the point, and belied the claims made:
The Government agrees that, when looking at the evidence base for efficacy, it is important to focus on the most scientifically robust studies and evidence. We note, however, that a "proper understanding of the power and complexities of the placebo effect" is difficult to achieve, since we are not aware of any scientific consensus at present on the mechanisms by which placebos have an effect. We note also that it is not for the Department of Health to comment on the ethics of the use of a particular treatment in a particular setting.
The Claim that Homeopathy Harms Patients' Trust
Based on the claim that the only effect of homeopathy is through the placebo effect, the STC claimed that patients don't have genuine free choice because they don't understand that the benefits they've gotten aren't real. The demand further claims that patient choice is somehow limited by the existence of homeopathy on the NHS. The response pointed out that it already requires that patients be given the best possible information, based on the individual and his or her wishes. The Government stated:
Quality information is fundamental to making informed decisions and choices. Without information, there can be no choice. We share the Committee’s view that patients should be fully informed. This information should cover the potential benefits of treatment options, as well as risks and possible side effects.
The Claim that Homeopathy Should Not Be Tested
The STC claims that evidence shows that homeopathy is ineffective, and that therefore it should not be tested anymore—and that it's unethical to enroll patients in homeopathy trials. Unfortunately, the response to this wild and inaccurate claim was weak. However, even here, the Government refuses to be cowed by the STC:
Each application for public research funding, whether to the National Institute for Health Research, or to the research councils, should be considered on its own merits. This is the longstanding principle upon which the UK public funding for scientific research is based.
In other words,
no assumptions are made to preclude research. If a proposal has merit, it should not be excluded simply because of preconceived notions.
The Claim that Like Cures Like Is Theoretically Weak
The STC claims that the basis of homeopathy, that like cures like, is theoretically weak. They make this claim in the face of modern medicine's routine use of injecting substances that cause allergic reactions to desensitize patients to them. Unfortunately, this point, probably the weakest point of the STC, was not appropriately countered by the Government. They do report that, "there are peer-reviewed reports that therefore have the support of some scientists, that suggest there may be limited evidence of efficacy of homeopathy in certain circumstances." Unfortunately, the Government did not have the fortitude to follow through and, essentially, capitulated to the STC.
The Suggestion that Patient Care Trusts with Homeopathic Hospitals Urgently Review the Cost Effectiveness
To the suggestion that Patient Care Trusts "urgently" review them to determine that, presumably, they aren't cost effect, and that a specific document be used to that effect, the Government pointed out that the document is already available. Sadly, they didn't also point out that the Northern Ireland Complementary and Alternative Medicines Pilot Project, which was funded by the NHS, documented that homeopathy, along with other alternative therapies, is not only cost effective, but also saves money and results in better health for patients.
The Conclusion
Several other points are made by the STC, most of which are shown to be either wrong or petty. The STC concludes that, "To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy." The Government responded:
The regulation of homeopathic products enables the MHRA to protect the public from unsafe products and unwarranted claims to treat serious illness. The requirement for regulation of homeopathic products is laid down in a European Directive and is a treaty obligation of the UK.
Respect for the Individual
The Government has expressed significantly more respect for the individual than did the STC, which clearly believes that it has The Truth, and further, that it has The Right to Enforce The Truth Down Everyone's Throats.
Though I am not pleased with the Government's weak response to the STC, it has made clear that its claims are not The Truth and that the people still have the right to determine what methods will be used in their medical treatment.
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