Personal budgets to allow patients to buy homeopathy and acupuncture

Can someone please explain why tax payers should be subsidising people to indulge in pseudomedical flim flam?

Trust Andy Lewis to be in first with his predictable insults to the thousands of patients, GPs and practitioners who find these approaches useful in a whole range of conditions for which conventional medicine has very little to offer. Tim Robinson made a very good case for using homeopathy in his practice earlier this week in Pulse. The evidence base for CAM is improving all the time and already matches that for many conventional interventions. May the voice of reason and experience triumph over these knee-jerk negative interjections. (No doubt Lewis's sceptic colleague David Colquhoun will follow very soon!)

'The evidence base for CAM is improving all the time and already matches that for many conventional interventions.' And the world is getting flatter and flatter...

That's it Stephen, attack Andy rather than answer the question: why should the taxpayer be paying for unproven or disproven pseudo scientific quackery? If and when the evidence base for CAM (whether that's homeopathy, crystal healing, ear candling or other patent nonsense) shows its efficacy in quality, unbiased clinical trials, it can be 'integrated' into the NHS. Homeopathy in particular doesn't even make it to the first hurdle.

Stephen Gordon says that CAM is 'useful in a whole range of conditions for which conventional medicine has very little to offer'. Is Stephen Gordon really arguing that all those diseases that are not curable or treatable by conventional medicine can be cured or treated by CAM? By extension this would imply that Stephen Gordon believes CAM is effectively a miracle cure. Is there really a place for zealots like this in healthcare?

Would it not be even simpler to abolish all science, reason, logic, evidence etc in one big bang, rather than returning to the dark ages in agonisingly painful steps?

Hi Stephen Gordon. Are you still General Secretary for the European Council for Classical Homeopathy, whose members would undoubtedly benefit if such a misguided move were to become reality? You are quite right to say that 'the evidence base for CAM is improving all the time and already matches that for many conventional interventions' - yes, those conventional interventions that we find do not work. Personnaly, for those conditions that real medicine cannot offer anything for, I would prefer a weekend spa break in the Pyrenees paid for from my 'personal budget'. Who will deny my right to choose?

'And the world is getting flatter and flatter...' Again another typical knee-jerk sceptic response. Are NICE flat-earthers? No, they took a pragmatic approach when they recommended acupuncture and manipulation for low-back pain, ie there is not much conventional medicine can do and there is a range of evidence for these CAM interventions. http://www.evidence.nhs.uk/Search.aspx?t=low+back+pain Roll on pragmatism in the face of prejudice!

The vast majority of people who support that NICE recommendation are CAM practitioners who are now on to a nice little earner. Beyond their fold you will find plenty of clinicians and other healthcare workers who do not regard their conclusions as particularly 'pragmatic'. Have a play on Google.

Oh dear! What would the founders of the NHS have to say to this latest bout of madness by our executives? Quackery and humbuggery had almost disappeared in this country as a result of the NHS and the availability to everyone of the best medical care that modern medicine could provide. It is now back with a vengeance, encouraged by politicians and princelings who believe that faith rather than fact is important in deciding whether a treatment works or not. All humbuggery is not equal however and when undertaken by properly qualified and knowledgeable practioners of modern, evidence-based medicine is a useful addition to specific pathology-directed therapy. If GPs had the time to spend with their patients that they currently have to waste on meeting bureaucratic demands on their time they might be able to give them the debonafide treatment (1) they seek from alternative sources - sometimes with unfortunate results. Ref.(1) Basmajian J.V Debondafide effects vs placebo effects. Proc R Coll Physicians Edinb 1999;29:243-244

Speaking as one of the people who posted replies to GP TIm Robinson's 'case for homeopathy', I didn't find his arguments at all convincing. Stephen Gordon did, I see - but since he is a homeopath, the phrase that springs to mind is 'Well, he would say that, wouldn't he'. Though I do not approve of it, I can just about live with medical practitioners offering not-terribly-evidence-based-but-non-harmful CAM therapies. This is because doctors are charged to have the patient's BEST INTERESTS at heart, within a system which stresses evidence and testing, and also because dangerous incompetence - such as recommending CAM when a 'mainstream' therapy is indicated - will lead to professional sanctions and perhaps to being struck off. None of the above applies to lay CAM therapists, whose attitude to evidence is elastic (at best) and blind-eyed (more typically). Offering people a budget to take their NHS (or at least tax-funded) business to such lay practitioners, who will have a direct financial interest in keeping the punter on the hook. is a suggestion of the utmost ludicrousness. I am happy to regard unproven (and frequently disproven) CAM therapies as a kind of tax on the well-heeled and gullible. However, the idea of spending public money on them - money that could go on proven therapies whose availablity is currently limited by cost or scarcity of provision - is one of the silliest ideas I have ever heard. For some examples of both the more extreme dangers of CAM therapies and therapists, and the attitiude of the advocates to criticism, try either http://bit.ly/24eUTV (a UK example) or http://bit.ly/4wI6nL (a much-publicized recent case in Australia),

Spot on, JamesM. A good place to read about the NICE fiasco is: http://www.dcscience.net/?p=1593.

So much for evidence based medicine. It's back to magic again. Bring on the leeches, bleeding and cupping. And all on the good old NHS!

Andy Lewis should keep his data-base up-to-date - I am General Secretary of the European Central Council of Homeopaths. And what are your job positions and declared interests Andy?

I am a great believer in science, reason and logic and indeed prefer it by far to the unreasoning kneejerk criticisms of homeopathy from the likes of Professor Ernst and his friends. A recent Pulse featured an article by a GP who reported patient satisfaction at the homoeopathic treatments he gave his patients. Why is it that a person who has undertaken medical training like other physicians suddenly becomes an agent of the dark ages merely by registering for further medical training with the Faculty of Homoeopaths? Patients generally report satisfaction with homoeopathic treatment, as the recent Ulster CAM report demostrates. Needless to say, Professor Ernst and his pals didn't have much positive to say about those findings.

First, there IS a body of clinical research that confirms the efficacy of homeopathy. Second, when one reviews the 'high quality' studies, they show that homeopathic medicines were more effective than placebo. Only when one evaluated the 8 large studies (6 of which did not individualize treatment!) were the results negative. But if we want to not fund health services for which there are no double-blind trials, let's STOP funding the vast majority of surgery. Aha...here's where a double-standard rises.

Dana Ullman, who he?

Dana Ullman is an American homeopath, author, and tireless online booster for homeopathy. He has his own Wikipedia entry (sic), but for an introduction to him, and a good intro to 'magical medical thinking' in general, I recommend this excellent short article in the FASEB Journal by Professor of Medicine and Rheumatology Gerald Weissman MD: http://www.fasebj.org/cgi/reprint/20/11/1755

How many scandals of false research, burying of negative medical studies, deaths by medicine need to occur before denialists such as Ernst, Gordon, etc wake up to the fallacies of their thinking and argument. Dana Ullman is quite respected in many countries for the quality of information that he has collected and presents. Once again writers on this blog wear blinders and refuse to hear anything that doesn't support their narrow-minded prejudices. Homeopathy does not kill, my allopathic drugs do. Many thousands annually die from legally prescribed allopathic drugs. And these numbers come from hospital records. They do not count the deaths ascribed to diseases that could have been cured except for drugs. They do not include the numbers of deaths from prescribed drugs not reported by private practice physicians.But show me the numbers of people who die from homeopathy. The number is zero! Remove your blindfolds. As for financial benefit, will all of you stand up to reveal your financial and professional benefit from promoting the malarky that you do.

Would all those sceptics who posted on here like to take a day out at farm and see what's happening in the animal kingdom with regard to homoeopathic treatment of illness? This would afford them the opportunity to understand how homoeopathy is dealt with on a case-by-case basis, and why it is unlikely to ever suit their methods of undertaking research. I hope it wouldn't be an uncomfortable experience for them. I'm sure we can arrange to have professional vets in attendance, who are trained in both conventional and homoeopathic veterinary medicine. If they want help in fixing this up, then why not get in touch with me? oliver.dowding@sheptonfarms.com