Evidence Check – can anyone do maths?

Well it’s another week after the second meeting of the Evidence Check and the sound bites continue, they’ve now reached  online regional newspapers wringing every last drop out of yesterday’s news.

I wonder though, can someone not put the record straight – how much DOES the NHS spend on homeopathic medicines?  The Telegraph went for “£4 million a year on dispensing homeopathy to patients.”  But is that the cost of the medicines, or the cost of dispensing them, or both?  Because The Guardian reported that the NHS spent “£12 million on homeopathic remedies between 2005 and 2008”.  £4 million a year again, but suggests it’s only for the medicines.  Sounds like a small point I know, but it wouldn’t be if you were footing the bill.  The Minister of State, Mike O’Brien, told us that the NHS bill for homeopathic medicines was around £150,000 a year, a bit of a difference, although he went on to add that the cost of providing homeopathy, including running 4 homeopathic hospitals, paying for GP homeopathic services and referrals etc was around £12 million a year – a figure he said he got from The Guardian !  Mike O’B did remind everyone that the drug budget of the NHS (that’s not the NHS budget, just the part for drugs) is around £11billion a year, and that since homeopathy is already funded by the NHS and there is a group of clinicians who believe it works, they should continue to have the right to prescribe it.

So just to be clear, that’s £11billion for drugs compared to £150,000 for homeopathic remedies.
All right then.  Sorted.

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Redefining the Quack

When I was sick as a child in working class industrial Manchester, I would be taken to see The Quack, aka the family GP.  He was a stern man but kind, and always looked for the simple solution before reaching for his prescription pad.  He was a dying breed back then and such a doctor nowadays is, sadly, a rare and precious thing.

Having heard my parents use the term all my life, it came with some irony that all these years later I find myself described as a Quack and it’s meant to be an insult.   I’ve been called a wide range of other descriptives as well of course, from a number of less imaginative four letter words, all the way to the whimsical “woo artist”.
The only emotion any of these words elicit in me is one of sadness. If we look to the homeopathic material medica, all the characters are in there. If only they had some good constitutional treatment they would open their minds and debate rather than debunk. Discuss rather than go for the jugular. Exchange ideas rather than employ character assassination.

Homeopathy = Placebo? Politics, politics, politics

Brits are very, very fearful of ridicule – most humans are, but the Brits are especially sensitive to it. For a Brit it ranks right up there at the top of things to avoid at all cost, and much of the population runs its life accordingly. And so we see everyone taking sides and hedging their bets on this issue. Homeopaths are by and large, thank goodness for humanity, immune to it. 200 years of swimming against the tide of closed minds has toughened them up.

The placebo effect is a hot topic in science.  Right now it allows a paternalistic Dr Goldacre to pronounce homeopaths well meaning but delusional – which is somehow nicer than homeopaths deliberately peddling sugar pills and ripping off the public.  It’s the hour long consultation with a caring attentive homeopath that’s responsible for the good effect – the people who see homeopaths are not really ill, and would have got better anyway.  Either way, the result is the same – however nicely it’s couched, it’s a misrepresentation of homeopathy.

The thing is, Dr G may be able to wax lyrical about the placebo effect – which given the cultural power vested in a man, (and occasionally) a woman, in a white coat with a stethoscope hanging round their neck, should be much more powerful in conventional medicine – but at the end of the day it’s all a distraction.

A typical Q and A session about homeopathy = the placebo effect goes something like this:

Evidence check – the committee meets the big wigs – clarifications all round

Monday saw the second round of oral submissions – though the name is a little misleading – it’s actually a question and answer session – no submissions that I could see.  It took the same format as the previous session (see blog on Nov 26th) with Rt Hon Mike O’Brien QC MP, Minister of State, Professor David Harper CBE, Chief Scientist, Department of Health, and Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency in the hot seat.

Before opening the meeting, The Chair, felt the need to clarify what this committee’s remit actually is. I for one was glad to hear it, because in all the media furor since the last meeting, something had been lost in translation.
The Chair announced, “ I want to put it on record as there seems to be a little confusion about the nature of the work we’re doing.  This is not an enquiry into whether homeopathy works or not.  It’s an enquiry that follows a series of evidence checks across a number of government departments as to say whether in fact there was any evidence to support the government’s policy towards homeopathy.”

Evidence Check – honourable members do the honourable thing

I’ve read many more of the submissions now (see previous post) and here’s the thing….

The Neutrals identify the need for more research – the YESes welcome more research.

The NOs state that more research is a waste of time and money because “homeopathy doesn’t work” Q.E.D.

I’m reminded of a quote by Einstein: “Concepts, which have proved useful for ordering things, easily assume so great an authority over us, that we forget their terrestrial origin and accept them as unalterable facts. They then become labeled as ‘conceptual necessities,’ etc. The road of scientific progress is frequently blocked for long periods by such errors.”   That block in the road is where we are right now.

We should be very grateful that researchers in history didn’t give up when their important advances in science were met with derision and ridicule and worse. 

Evidence check – Well done you homeopaths!

Let’s hope the Science and Technology Committee read the written submissions sent in for the Evidence Check on Homeopathy.  I am busy ploughing through them and interesting reading they make.

Is homeopathy effective?  Does the Evidence support that?

Score: YES – 28            NO – 11            Neutral – 7

To be fair, 3 of the YES group are satisfied patients making a plea for keeping homeopathy within the NHS, and – as we are reminded daily by the NOs – anecdotal evidence, however much there is, whether new born babies, herds of cattle, comatose patients or people with intractable conditions not helped by 30 years of conventional medicine (no placebo effect there then)  – does not count.

The remaining 25 in the YES group are well constructed, many of them one might say are academic, papers, fully referenced and carefully laying out the reasons for their conclusions.

What’s the difference between Sara and Sarah? Evidence Check fallout

I am stunned by the two interviews I just watched on the BBC. One with the polite Dr Sara Eames from the Royal London Homeopathic Hospital and the very confused journalist, Celia Walden.   And the other with Professor Lewith and the bulldozer Dr Sarah Jarvis, a GP.

Here we have homeopathy taking another major beating in the media following Boots’ gift of a sound bite from the parliamentary Evidence Check – which I feel compelled to mention again, IS NOT YET OVER.

A mild mannered and polite Dr. Sara Eames waited for her questions and answered them, albeit repetitively.  But WHY oh WHY did she not set the seriously confused Celia Walden straight?