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Giving homoeopathy on the NHS is unethical and unreliable, MPs are told

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b5080 (Published 27 November 2009) Cite this as: BMJ 2009;339:b5080
  1. Adrian O’Dowd
  1. 1London

    Experts have described the practice of prescribing homoeopathic medicines on the NHS as unethical, unreliable, and pointless.

    Several witnesses giving evidence to MPs on the parliamentary science and technology committee on 25 November questioned the wisdom of giving such remedies to patients in an NHS setting.

    The committee was holding a one-off evidence session on homoeopathy as part of an investigation of the scientific evidence that underpins the government’s existing policies.

    MPs asked about the ethical dimension and James Thallon, medical director of NHS West Kent, giving evidence, said: “I’m not saying that it does not happen, but in principle if you prescribe with that which you know to have no clinical efficacy on a basis which is essentially dishonest with the patient, I personally feel that is unethical behaviour.”

    Fellow witness Edzard Ernst, director of the Complementary Medicine Group at the Peninsula Medical School in Exeter, said: “I would argue that it is unnecessary, unreliable, and unethical to prescribe placebos through the NHS.

    “If the NHS commitment to evidence-based medicine is more than a lip service, then money has to be spent on treatments that are evidence based, and homoeopathy isn’t.”

    Expert opinion about the effectiveness and worth of homoeopathy is sharply divided it emerged after evidence from various witnesses.

    Committee chair Phil Willis, Liberal Democrat MP for Harrogate and Knaresborough, asked the witnesses whether or not homoeopathic medicines worked beyond the placebo effect.

    Jayne Lawrence, chief scientific adviser for the Royal Pharmaceutical Society of Great Britain, giving evidence, replied: “No we don’t believe there is any scientific or clinical evidence supporting their use.

    “A lot of patients claim to have benefits if they are asked afterwards from these therapies, but there is no evidence that we can see that supports their use or to show they are effective.”

    Fellow witness Robert Wilson, chairman of the British Association of Homeopathic Manufacturers, said: “It definitely does work. We have many trials that show a strong efficaciousness for homoeopathic medicine. People continue to buy products because they work for them.”

    He said the homoeopathic market was worth £1.5bn (€1.6bn; $2.5bn)across Europe, but that the market in the United Kingdom was comparatively small and was worth about £30m. In 2005, NHS prescriptions for homoeopathic remedies cost £500 000 and in 2007, it was £320 000, he said.

    Peter Fisher, director of research at the Royal London Homeopathic Hospital, giving evidence said: “I am shocked by the statements that have been made repeatedly this morning that there is no evidence. There have been five comprehensive global systematic reviews or meta-analyses of homoeopathy, which looked at the whole thing—four of which were positive.

    “I practise homoeopathy because I think it works and I believe the evidence supports me in that. I would not practise it for two minutes if I thought I was conning the patients.”

    MPs asked whether money that is spent on homoeopathic consultations should be redirected elsewhere in the NHS.

    Dr Thallon of NHS West Kent was involved in the decision in 2007 to reduce funding to Tunbridge Wells Homeopathic Hospital after deciding that priority should be given to proved medications.

    “If the business of primary care trusts is about prioritisation, then a treatment about which the balance of scientific opinion says is of either virtually no efficacy, effectiveness or none, then we would prioritise that at a far lower level than other treatments we wish to commission,” he said.

    Notes

    Cite this as: BMJ 2009;339:b5080

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