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Civil servants suppress evidence on homeopathy on NHS website after lobbying from prince’s charity

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1071 (Published 18 February 2013) Cite this as: BMJ 2013;346:f1071
  1. Ingrid Torjesen
  1. 1London

The way in which lobby groups and powerful people can influence government has come to light after an article on homeopathy on the public information website NHS Choices was stripped of all evidence questioning its effectiveness as a result of intervention by a charity set up by the Prince of Wales.

The Department of Health commissions the NHS Choices website from the private information company Capita to provide “objective and trustworthy information” to help patients make decisions about their health and treatment.

But evidence obtained under the Freedom of Information Act by David Colquhoun, emeritus professor of pharmacology at University College London and a fellow of the Royal Society, indicates that the health department can edit the content if it contradicts its own policies, even if that content is based on evidence.

Emails obtained from NHS Choices by Colquhoun show that even before the article on homeopathy was written the department invited the writer to a meeting with the Prince of Wales’s Foundation for Integrated Health and the Complementary and Natural Healthcare Council to discuss the content “so we could start to piece this particular jigsaw together” (http://bit.ly/12R9Hnq).

The website’s information on homeopathy was being rewritten after complaints from some readers that it was too much in favour of the practice.

After the meeting, a representative of the foundation wrote to the health department saying that the proposed content was “a bit horrifying” and “anti-complementary medicine.” A department official responded on 7 January 2010, saying, “I have been assured by our editorial team that the content being prepared will be very much better.”

The draft article on homeopathy, which was produced in January 2010 but which never appeared on NHS Choices, said that many independent experts would say that “homeopathy does not work” and that “there is no good quality clinical evidence to show that homeopathy is more successful than placebo” (http://bit.ly/XSG3sb).

It continued: “If the principles of homeopathy were true it would violate all the existing theories of science that we make use of today.”

Comments added to the article by the health department said, “This report is really quite contentious and we may well be subject to quite a lot of challenge from the homeopathic community if published” (http://bit.ly/YcSPzH).

The article that finally appeared on the website in November 2012 had all comments referring to the lack of evidence to support homeopathy stripped out (www.nhs.uk/conditions/Homeopathy/Pages/Introduction.aspx). Also deleted were references to a 2010 report from the House of Commons Science and Technology Committee that recommended that the NHS stop prescribing homeopathy, which it branded a placebo treatment.1

NHS Choices said that it repeatedly raised concerns with the department about its handling of the article and complained about the delays it was causing. An email from NHS Choices on 6 November 2012 said, “I am concerned that this is a reputational issue for NHS Choices, as well as a serious gap in the information we provide for the public.”

David Mattin, who was the editor of the homeopathy article and who has now left NHS Choices, said in an email to Colquhoun, “My strong impression was of DH [Department of Health] civil servants who lacked the courage and, frankly, the energy to stand up to the criticism from special interest groups that they anticipated would arise because of the article; and that did indeed arise when a draft of the article and other draft content on complementary and alternative medicines fell into the hands of the Prince’s Foundation and other CAM [complementary and alternative medicines] groups” (http://bit.ly/VkJJUY).

He added, “They [the department] seemed to have no interest in making an appraisal of the evidence on homeopathy themselves to see if what we were saying was actually true or not.

“The whole episode is an insight into the way special interest groups can influence the workings of government and the public sector, simply by making a lot of noise and having a few powerful friends.”

A spokesperson for the health department said, “NHS Choices website is regularly updated to ensure it is neutral, factual, and objective. We are aware of some concerns regarding the content of one page, and we are currently looking into this.”

Notes

Cite this as: BMJ 2013;346:f1071

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