Re: Good medicine: homeopathy
Recent highly pejorative remarks made about homeopathy by Sir Mark Walport  and Dame Sally Davies  (the UK Government’s Chief Scientific and Chief Medical Officers – CSO and CMO, respectively) are inaccurate, misleading, and fall far short of the objectivity and gravitas required of those charged with such high-profile advisory roles. This is why.
According to many (Walport and Davies included), homeopathy has no scientific basis. Yet according to the BMJ , over 50% of conventional medical procedures funded by the National Health Service (NHS) also have little or no basis in science. Funding these procedures therefore must be even more nonsensical than funding homeopathy, as they are much more expensive!
But it gets worse. Much is made of the millions spent on homeopathy by the NHS. This too is utterly misleading. Both the CSO and CMO will be well aware that in 2010, the NHS’s drug bill was a staggering £10.2 billion, £2 billion of which was spent dealing with these drugs’ side effects. NHS spending on homeopathy (including infrastructure) was just £12 million – a mere 0.011% of the total £110 billion NHS budget – of which only a miniscule amount, £152,000, was spent on side-effect-free homeopathic medicines [4-6]. Given this vast disparity, why should the NHS stop funding an incredibly cheap therapeutic modality used and trusted by millions of people throughout the United Kingdom, and half a billion people around the world? Oh yes: it’s all about the science, isn’t it. Well, let’s examine that.
It is disappointing the CSO and CMO repeat the spurious claim there is no scientific basis for homeopathy. One wonders whether these two eminent scientists have ever bothered to seriously investigate this for themselves. If they had, then they would know that, by end of 2010, 156 Randomised Controlled Trials (RCTs) of homeopathy (on 75 different medical conditions) had been published in peer-reviewed journals. Of these, 41% had a balance of positive evidence, 7% had a balance of negative evidence, and for 52% no conclusions could be drawn either way .
A cursory glance at these statistics might cause supporters of homeopathy to rejoice because the ratio of positive to negative trials is clearly in homeopathy’s favour. However, the really interesting statistic here is the number of trials for which no conclusions can be drawn either way; greater than 50%. Because when one then looks at similar statistics for RCTs of conventional medicine, something odd appears.
So, data obtained from an analysis of 1016 systematic reviews of RCTs of conventional medicine, indicate that 44% of the reviews concluded the interventions studied were likely to be beneficial (positive), 7% concluded that the interventions were likely to be harmful (negative), and 49% reported that the evidence did not support either benefit or harm (non-conclusive) .
Walport and Davies should take careful note of this, because obtaining such a similar spread of statistics regardless of the therapeutic modality would suggest:
• Homeopathy fairs no better or worse in RCTs than conventional medicine. So rejecting homeopathy on RCT data is false and biased as many conventional drugs/procedures should on that basis be similarly rejected but are not.
• There is something fundamentally wrong with the RCT (and those who claim it to be a ‘gold standard’), when around 50% of all RCTs fail to deliver a clear result . So all that the available scientific evidence suggests is that, there is disagreement over the effects of homeopathic medicines and how ultra-high dilutions work.
Thus, a more objective, less emotive CSO and CMO would no doubt have concluded, not that homeopathy “is nonsense” or “rubbish” but just as with many conventional medical procedures, the scientific evidence so far can only indicate homeopathy is of uncertain efficacy. And even if homeopaths were just ‘peddlers’ of placebos (a thoroughly unprofessional remark made recently by the CMO to the House of Commons Select Committee on Science and Technology: neither the first, nor unfortunately the last to make such a scurrilous, unfounded accusation), homeopathy would still be far cheaper than Prozac, currently favoured by the NHS and, as the CSO and CMO are no doubt aware, shown recently to be no better than placebo !
Add this to the by-now, well-known systemic, systematic fraud perpetrated by the pharmaceutical industry (e.g., the real peddling of unlicensed anti-depressants to minors by GSK last year ), and the long-term abuse of science that has been going on in medical and pharmacological research [11-13]), perhaps the CSO and CMO might have been better advised to take a more measured attitude towards a subject on which they clearly have no expertise. Instead, how disappointing and intellectually moribund they are now among the ranks of those subjective ‘cheerleaders’, so-called sceptics, who doth protest too much over homeopathy.
Thus, referring to homeopathy as ‘nonsense’ and ‘rubbish’, and (perhaps libelously) accusing homeopaths of being ‘peddlers of placebos’, not only impugns the professionalism of the approximately 400 dedicated NHS doctors and other qualified health professionals who by practicing homeopathy, dedicate themselves to the welfare of their patients, it also insults the health choices of millions. How unprofessional is it when private opinions are paraded as if they are matters of public fact? They are not and if the CSO and CMO bothered to take the time to study the subject, they would realize that .
Scientists, probably with good reason, worry that the government ignores them. In his recent Dimbleby Lecture, Sir Paul Nurse enjoined scientists to speak truth to power, and engage more with the public . As a scientist, I have to agree with him, but with the proviso that it is truth we speak, not the tired shibboleths of well-funded campaigning organisations, or the ersatz invective of facile media commentators who use homeopathy as a whipping boy . In the eyes of the public, that simply demeans science and scientists.
For history shows time and again that the truths of science are relative not absolute, but when believed absolutely (aka scientism, especially when over-enthusiastically applied in medicine [17-23]), science descends into bullying quasi-religious dogma , ably assisted by lucrative commercial considerations. In a liberal democracy beset by the growing demands of globalized capital, that should worry all of us , particularly the CSO and the CMO.
Dr Lionel R Milgrom BSc, MSc, PhD, CChem, FRSC, LCH, MARH, RHom.
Competing interests: I am a scientist and a homeopath. Go figure….
1 See http://www.telegraph.co.uk/health/healthnews/10003680/Homeopathy-is-nons.... Accessed 22nd April 2013
2 See http://www.telegraph.co.uk/health/healthnews/9822744/Homeopathy-is-rubbi.... Accessed 22nd April 2013
3 See the BMJ site http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp. Accessed 22nd April 2013
4 Call to curb the rising NHS drug bill, 3.04.2008 http://news.bbc.co.uk/2/hi/health/7190267.stm.
5 Boseley S: Adverse drug reactions cost NHS £2 billion. The Guardian, 03.04.2008. www.guardian.co.uk/society/2008/apr/03/nhs.drugsandalcohol.
6 Mr O’Brien, response to Q244, House of Commons Science and Technology Committee, Evidence Check 2: Homeopathy (London: The Stationery Office Limited 2010) p Ev73.
7 The Evidence for Homeopathy. British Homeopathic Association. www.britishhomeopathic.org.
8 El Dib RP, Atallah AN, Andriolo RB: Mapping the Cochrane evidence for decision making in health care. J Eval Clin Pract 2007;13:689–692. Cartwright N, and Munro E. The limitations of randomized controlled trials in predicting effectiveness J Eval Clin Pract 2010;16:260-266.
9 Kirsch I, et al.: Initial severity and anti-depressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5:e45.
10 GlaxoSmithKline to pay $3bn in US drug fraud scandal. BBC News On-line, 2nd July 2012,
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14 see, http://www.telegraph.co.uk/health/9993347/Doctors-Diary-Homoeopathy-play... accessed 22nd April 2013
16 Liddle R: Homeopathy? Let’s save £4 million and hire a witch doctor instead. London, Sunday Times, 25.03.2012. Aaronovitch D. Enough placebo politics. Vote for the geeks. The Times, http://www.thetimes.co.uk/tto/opinion/columnists/davidaaronovitch/articl...
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Competing interests: I am a scientist and a homeopath