Ministers in the United Kingdom recently announced that the National Health Service could ban doctors from prescribing homeopathic remedies. The announcement is a culmination of several years of campaigning by members of parliament who say that the health claims of homeopathy are unproven, their use is a waste of taxpayer money and these remedies should not be supported by the nation’s publicly funded healthcare system.
The NHS could be spending around £5 million ($7.45 million) each year on homeopathic remedies, according to a report by Good Thinking Society, a charity that campaigns against NHS funding for homeopathy. Samuel Osborne of the Independent writes that the money the NHS currently spends on homeopathy “could fund 239 fully qualified nurses a year," noting that homeopathy “has been extensively studied and conclusively debunked."
"Given the finite resources of the NHS, any spending on homeopathy is utterly unjustifiable,” said GTS founder Simon Singh. "The money spent on these disproven remedies can be far better spent on treatments that offer real benefits to patients." Prescriptions issued by general practitioners account for about £110,000 ($164,000) each year, according to the BBC.
The proposed ban is sure to have a good number of detractors: Each year, nearly six million Britons see practitioners of “complementary and alternative medicine” (CAM) — which includes homeopathy — with one in four wanting access to be universally available through the NHS.
Prince Charles certainly can’t be pleased. Like many royal family members, he is a devoted homeopath who credited the practice with helping him heal abroken arm.
Conceived of in 1796 by German physician Samuel Christian Hahnemann, homeopathy is an alternative practice of medicine based on the concept of “likes cure likes” (Hahnemann called it the "law of similars"). Homeopaths believe an extremely diluted version of an illness-causing substance can cure that illness. A homeopath may treat hay fever, for example, by administering a dilution of grass or pollen.
(graphic: BBC)
Homeopathy is a thriving industry not just in the U.K., but around the globe. The European market has grown 60 percent over a decade. According to the latest estimates from the Centers for Disease Control, about 3.3 million Americans spent $2.9 billion on homeopathic remedies in 2007.
The practice enjoys its biggest popularity in India, where it is officially recognized by the government as one of its national systems of medicine, and regulated by the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health & Family Welfare. India is home to the largest number of homeopathic practitioners in the world and has the most colleges in homeopathic education.
While India remains a homeopathy stronghold, other national governments have come out strongly against it. In addition to the recent moves by the U.K. Parliament, Australia’s top body for medical research, the National Health and Medical Research Council, came out against homeopathy with a report issued earlier this year. “Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective,” the council wrote. It added a stern warning: “People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”
”We need governments around the world to recognize the dangers of promoting homeopathy for life-threatening illnesses,” said Robert Hagan, a biomolecular scientist at the University of St. Andrews in Scotland. Hagan is a member of the Voice of Young Science Network, a group of young researchers concerned that the use and promotion of homeopathy in the developing world is putting lives at risk. The group is part of Sense About Science, a charity that educates the public about evidence-based science. In 2009, VYSN sent a letter to the World Health Organization urging the body to issue a statement condeming the promotion of homeopathy for the treatment of serious diseases. The letter states:
We are calling on the WHO to condemn the promotion of homeopathy for treating TB, infant diarrhea, influenza, malaria and HIV. Homeopathy does not protect people from, or treat, these diseases. Those of us working with the most rural and impoverished people of the world already struggle to deliver the medical help that is needed. When homeopathy stands in place of effective treatment, lives are lost.
WHO responded with a warning that people with serious conditions such as HIV, tuberculosis and malaria should not rely on homeopathic treatments.
Paula Ross, chief executive of the Society of Homeopaths, agreed with the concerns about promoting homeopathy remedies for TB, malaria or HIV and AIDS. But she said, "This is just another poorly wrapped attempt to discredit homeopathy by Sense About Science."
"The irony is that in their efforts to promote evidence in medicine, they have failed to do their own homework,” said Ross. "There is a strong and growing evidence base for homeopathy and most notably, this also includes childhood diarrhea."
Sara Eames, president of the U.K.’s Faculty of Homeopathy, said it “seems reasonable to consider what beneficial role homeopathy could play” as possible treatments for serious disease. “What is needed is further research and investment into homeopathy."
The British government disagrees with Eames’ assessment. The U.K.’s announcement of the possible national ban, made in November, comes nearly six years after the House of Commons Science and Technology Committee published a damning 2010 report that said homeopathic remedies performed no better than placebos, adding that the practice was based on principles that are "scientifically implausible."
The report concludes:
The Government's position on homeopathy is confused. On the one hand, it accepts that homeopathy is a placebo treatment. This is an evidence-based view. On the other hand, it funds homeopathy on the NHS without taking a view on the ethics of providing placebo treatments. We argue that this undermines the relationship between NHS doctors and their patients, reduces real patient choice and puts patients' health at risk. The Government should stop allowing the funding of homeopathy on the NHS.
We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals — hospitals that specialise in the administration of placebos — should not continue, and NHS doctors should not refer patients to homeopaths.
The report came on the heels of an editorial published in the Journal of Medical Ethics by David Martin Shaw of the Faculty of Medicine at the University of Glasgow. In it, he outlined five potential unethical effects of homeopathy:
- Patients may seek homeopathic remedies instead of, rather than as well as, traditional medicine
- It is ethically dubious to spend NHS funds on treatment that has no evidence base
- Homeopathy can involve deceiving the patient; indeed, if the only effect is placebo, it is probable that deception is essential to the practice of homeopathy
- Support for homeopathy could weaken patient confidence in the NHS, and in science and medicine more generally
- Funding homeopathy distracts attention from the fact that there are other complementary therapies that are efficacious
There is another ethical issue: In the U.K., there is no legal regulation of homeopathic practitioners. “This means that anyone can practice as a homeopath, even if they have no qualifications or experience,” notes the NHS.
The NHS website lists several common conditions that are commonly treated with homeopathy, including asthma, high blood pressure, ear infections, hay fever, allergies, dermatitis, arthritis and mental health conditions, such as depression, stress and anxiety.
“There is no good quality evidence that homeopathy is an effective treatment for these or any other health conditions,” says the NHS. “Some practitioners also claim that homeopathy can prevent malaria or other diseases. There is no evidence to support this and no scientifically plausible way that homeopathy can prevent diseases.”
Sense About Science has been monitoring public perceptions of homeopathy. In its written submission to the parliamentary report, it said homeopathic remedies are "often confused with herbal medicine (and, related to this, that people were often unaware of the mystical belief in water memoryand in 'like cures like' on which it is based).”
Importantly, they said people assumed that because a homeopathic remedy is supplied by the NHS, it “must be effective” and “there must be something in it.”
But there’s another, more pressing issue that has brought this possible ban to the foreground: the national budget. In an interview last year, U.K. health secretary Jeremy Hunt, responding to a question about spending on homeopathy, said, "When resources are tight, we have to follow the scientific evidence and spend the NHS's money on what works."
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