Homeopathy 'should be available on the NHS', says minister

It's true that there is no evidence about effectiveness of homeopathy but it is a patient's right to choose the system of medicine for his treatment. Many patients having no significant problems will be satisfied with homeopathy and many with significant problems will discover over the passage of time that homeopathy is not effective and then will not only turn back to the scientific way of treatment but also convince their family members and friends that homeopathy is not effective.

First we have stories that the NHS will be in a 20billion deficit in a year or two, then they come out with this! Well, I suppose on the basis that first 'I should do no harm' then using homeopathy will fulfill that role nicely. Of course doing some good with it will be a little trickier, especially as we won't have an hour long appointment to weave some magic and get out the smoke and mirrors.

Science and Technology meeting discussing homoeopathy - hmm... By the way, when did the word mutate into 'homeopathy' which is plain wrong?

Homeopathic consultations involve more than prescribing of placebos. 1) The patient gets the opportunity to say what is bothering them, how it is affecting them, what they think contributed to their illness and what seems to make it better or worse. Emotional factors are often discussed in depth. 2) A conventional diagnosis is reached and a discussion of what the best approach to treatment is. This always includes discussion of 'obstacles to cure'. This means eliminating things that are contributing to the illness or preventing it getting better. Responsibilty for changing these can rest with the patient or may involve the doctor changing what they do eg stopping unhelpful medications or stopping medications that have side effects. 3) The treatment plan often includes other non-drug therapies including stress reduction, nutritional advice, environmental changes, acupuncture or other techniques depending on the skils of the doctor. Homeopathic remedies may or may not be simple placebos. Still, they don't appear to cause harm, and they are cheaper and safer than a lot of medications doctors issue 'to please the patient'.

It is indeed the patient's right to choose the system of medicine for his treatment. However, he should not expect other taxpayers to fund that choice where the treatment has repeatedly been shown to be ineffective. Without evidence, we face a slippery slope with no clear boundary between treatments we should fund and treatments we should not. Does this right extend to someone brought up in the tradition of Voudoun, Scientology, or Christian Science? Can we be expected to fund sacrifice, auditing or prayer on the NHS? Evidence for treatment is, in my view, a necessary requirement for a publicly funded health system.

As an eminent Professor of Medicine I know likes to joke, 'Homeopaths give good narrative'. BUT: why does patient experience as narrative (a concept that features widely in medical training right down to undergrad level) have to be bundled up with all the incredible nonsense homeopaths profess to believe in - beliefs which they presumably pass along 'undigested' to their patients? Surely the doctor and the patient should be able to discuss the patient's life and problems without what Jonathan Harte aptly terms 'smoke and mirrors'?

If you tell a lie often enough it seems to become 'truth'. Everyone, including government ministers apparently, just state that 'there is no evidence for homeopathy' and leave it at that. Presumably, they have never looked. Well, for anyone who is really interested, and sufficiently open minded to look for it, the evidence in favour of homeopathy is now available, and in fact, has been mentioned in the evidence submitted to the Science and Technology Committee by the Alliance of Registered Homeopathy, the Homeopathy Research Institute, and others. Just saying 'there is no evidence' and leaving it at that is just no longer honest.

Yes Sean, I want my choice. And I don't want to be stopped in exercising that choice by people who can make a comment that homeopathy 'has repeatedly been shown to be ineffective'. TELL ME WHERE! I have no difficulty in people wallowing in ignorance about homeopathy - just as long as they don't attempt to impose it on me.

How entirely predictable that homeopath Steve Scrutton should be repeating the line about there being 'evidence for homeopathy'. What was actually said at the hearing was to do with 'totality of evidence' and 'evidence that stands up'. The totality of evidence is that there is nothing more to homeopathy than placebo effect and 'stealth psychotherapy'. The question then becomes whether that is enough to make it acceptable ethically, and acceptable value, for the NHS and the taxpayers. As to the people Scrutton cites as 'sources of evidence', their vested interest is rather obvious.

RCGP motto: 'scientia CUM CARITAS' = COMPASSION WITH science. Nuff said? Nice to be able to cure through narrative - whether Autogenic Training, Acupuncture, Amoxicillin, Homeopathy, X-ray, referal or doing nothing ie listening. All these interventions rely on narrative to discover the patient's history and narrative to formulate a patient centered management pathway which can be complied with. Narrative is also required to formulate scientific null hypotheses which once assessed in a research setting deliver sound evidence based medicine. Meta-analyses often look at studies with widely divergent null hypotheses - how scientific!! We are born divergent as individuals hence attempting to apply group findings to suffering individuals might be seen to be bound to fail. Similarly birth can be viewed as a death sentence and our choices lie in how we spend the intervening gap.

This is wonderful news, not only for homeopathy, for medicine and for the NHS but for liberty and democracy (which doesn't allow minority views to be bullied out of existence). As the sensible man said: 'We take the view that it is not our job to stop clinicians prescribing these medications if they feel they are appropriate.' Yes, minister and thank you for finally making it clear to all and sundry that homeopathic doctors are trained doctors, fully accountable for all interventions they make, whatever journalists such as Ben Goldacre, Simon Singh and others may think.

As a pharmacist, with a science based background, I too have difficulty understanding the concept of homeopathy, which is based on the actvity of infinitesimally diluted molecules in solution having a therapeutic effect. How can this be rationalized? Then I think about the shark in a vast ocean picking up the presence of blood miles away and heading straight for the source, or a moth that can pick up the scent of pheromones in the air from a female moth miles away. These observations are fact, and the only limitation is our ability to comprehend these phenomena.

As the homeopath who instigated the Northern Ireland Integrated Medicine Programme, I have been following the debate about homeopathy for quite a few years. Actually, the word 'debate' is inappropriate here, because that would mean a discussion involving the consideration of opposing arguments, when what we really have is sustained homeopathy bashing. However, looking beyond all the slagging, three recurring themes emerge: The first is that those opposed to homeopathy maintain that there is NO scientific evidence for homeopathy. This is simply untrue, and yet is repeated endlessly - yet again at the Commons Select Committee hearings last week - as though it were incontrovertible fact. There have been at least 130 high quality trials published in the peer-reviewed literature, the majority of which are positive. What this means is that there IS scientific evidence for homeopathy, but that some people who call themselves scientists are in denial of it. This is not science, it is prejudice. The second theme is that the more rabid anti-homeopathy postings are generally from people who are not actually involved in treating the sick, while those in favour tend to be more moderate contributions such as the article describing the clinical experience of practitioners such as Dr Tim Robinson (Pulse 23 Oct). The third theme is the refusal even to consider the very large and ever-growing mountain of clinical outcomes evidence from observational studies of homeopathic treatments in the real world. This is dismissed outright by the critics as of no evidential value. I am reminded of Galileo's clerical friends who refused even to look through his telescope at Jupiter's moons because 'the Church tells us what you are saying can't be true'. Surely the practical experience, quiet wisdom and moderately-stated views of homeopaths such as Dr Robinson, integrated with that of tens of thousands of homeopaths around the world, treating hundreds of millions of patients, has greater authority than the bombast of non-practitioners with academic or journalistic reputations to protect.

Government minister quoted as saying 'it's not our job to stop clinicians prescribing medicines they feel are appropriate' ... my goodness what a turnabout! No more consultants/patients having to apply to faceless pen-pushers for the latest biological chemotherapy only to be turned down because 'not cost effective' then... brilliant news for patients... F ONLY IT WERE BLOODY TRUE YOU WEASEL.

NHS provision for allergy investigation in UK is almost totally inadequate, with almost total dependence on expensive drugs for control of asthma and other allergies. Drugs suppress symptoms but can never cure. Many patients want to know the cause or causes of their problem, hoping that it is avoidable. If NHS will now pay for all sorts of CAM, why not pay for evidence based allergy investigations?

Working in a medical school and being both the partner of a doctor and a long-time trainer of medical students, I know quite a lot of GPs and hospital doctors. With very rare exceptions their 'quiet wisdom and moderately stated view' (in Ken Mayne's phrase) on homeopathy, when it comes up in discussion, could be summarised as *rolls eyes and sighs exasperatedly*. One doctor of my acquaintance told me his considered opinion on homeopathy was that imaginary remedies worked wonders for people with imaginary illnesses, while another used the blunter word "codswallop". Most of these people, I suggest, think homeopathy is complete hocus-pocus, but have no vested interest in it and thus are 'shruggees' - people who just ignore the fuss, shrug, and get on with their work. In contrast, we hear endlessly from homeopaths, who have a living to defend, and from the vocal pro-homeopathy lobby led by Prince Charles and his various acolytes both inside and outside medicine. If we are now seeing a backlash (Quacklash?) from sceptics, including many scientists and not a few sceptical physicians, this is largely a response to the inroads made by the campaign for 'sectarian therapies' over the last two decades. Under its various language-neutral code words like 'complementary' or 'holistic', what has really been happening is an ongoing campaign to 'integrate' stuff that probably does work with a whole bunch of stuff that fairly clearly doesn't. Up until recently it has seemingly been considered too non-PC to point this out. Finally, I have no interest in banning complementary therapies, even unproven ones - but they should not be taxpayer subsidised.

My rehabilitation unit, which provides care for nearly 300 patients with severe neurological disability, is currently threatened by monetary shortages, so it sticks in my throat that millions of pounds may continue to be spent on worthless 'treatments' that have no evidence of efficacy and no sensible rationale. Need I say more?

Those who claim that homeopathy should be funded on the NHS because it meets the choices of patients, should really be honest and say what boundaries they would draw around such choices and why homeopathy should be included. Is any choice valid? The critics of state funded homeopathy are quite clear - choice is good, but choice should be restricted to options that meet clinical need and not extended to fantastical pseudomedical poppycock. Homeopaths - where do you draw the line?

How about a middle ground. Give the benefit of doubt to the homeopaths - provided they are willing to accept that the NHS will only fund homeopathic treatments for areas where there is sufficient proof of efficacy. Submit evidence about for individual disease areas to the same process that NICE uses for conventional treatments and you then have an even playing field. Conflict of interest: I have just sat on a guideline development group for NICE which considered 'alternative' treatments together with 'conventional'. They were considered in exactly the same way, using the same criteria for quality of evidence etc. In our case there was no studies for homeopathic treatment but we would have looked at them had they been available.

Crumbs, this one gets people worked up, doesn't it? It's not often you get that many comments on a topic on this site.

@ Ken Mayne: Thank you for an excellent contribution to the discussion here with your last sentence putting everything into an authentic perspective. Your comment is an excellent synopsis of this affair, worthy of a full article in this publication. @Andy Jones: What you are discussing is a different issue whose context is a financial one. The claim that money is wasted on NHS homeopathy does not stand up to scrutiny. NHS GPs such as David Spence have published award-winning studies showing how much money is saved by incorporating homeopathy into their practices. http://www.dcscience.net/spence-jacm-05.pdf In addition, homeopathy costs the NHS one hundredth of one percent of overall NHS costs. A patient of mine did some research on the costs and cost-effectiveness of homeopathy: http://drkaplan.co.uk/wp-content/uploads/homeopathyinperspective.pdf And remember, dear colleagues, a lot of the satisfied patients going to NHS homeopathic hospitals were considered 'difficult cases' not responding satisfactorily to conventional medicine - which is why their GPs decided or agreed to send them for homeopathy.

If the minister feels that the NHS should pay for placebos in a homeopathic guise why disallow them in a pharmaceutical one? The main reason why homeopathy is an issue in the first place is that it smacks of extreme double standards - and the minister seems to support them! The mind boggles.

Fantastic news from the Rt Hon Health minister Mike O'Brien not only for the homeopathic community but also for the public who will exercise their right to choose treatment which they believe is working for them and make informed decisions, as in the Government's pledge for patient centered care

Yes.. good news for common sense. Homeopathy should continue to be available on the NHS. It has been very effective for me, my family and many thousands of people. It is safe effective and good value for money. I pay taxes and I prefer homeopathy to other NHS treatments which are less effective and expensive. In fact only 13% of NHS treatments have been shown to be truly effective. In the light of personalised health Care budgets, patients will choose the treatment they find most helpful to them.

I'm deeply sorry to bang on- a patient has cancelled their appointment and I'm driven to surmise from Ernst's title he might be using irony and expect pharmacists to be trustworthy. Chatting with my pharmacist colleagues they tell me they do care about our patients, but are primarily businessmen making money from shifting product as well as dispensing medicines- hence the breadth of goods stocked in e.g. Boots. The falacious argument with expressed surprise at Boots selling items their customers want to purchase indicates how far from reality some individuals' perspectives have moved. It's as if we should be surprised bankers try to squeeze maximal bonuses for themselves - as if this was alien rather than human nature! Perhaps more people would be helped to see the wood made from trees were old classics like Animal Farm made compulsory reading again. As it is the current administration have been considered to have taken Animal Farm on as their covert manifesto.

@Julian Spinks: It's one day too late for 'middle ground' suggestions. Sorry but the minister went with liberty and democracy. I particularly liked his choice of the word 'illiberal' to describe the government's take on this campaign to restrict the choices of medically qualified doctors. @ Edzard Ernst I'm almost amazed to see you use the phrase 'extreme double standards' in relation to homeopathy. You have used EBM, not as a gold standard for all interventions, but as blunt instrument to attack homeopathy. I've consistently tried to draw Pulse readers to the BMJ graph that shows that only 12% of COMMONLY USED (note the BMJ's words - Les Rose) treatments are fully backed by solid evidence.http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp It is those who, in the face of these statistics, use EBM to attack homeopathy and CAM who are guilty of 'extreme double standards' and certainly not the health minister who in a landmark decision yesterday, protected freedom of choice for patients and doctors as well as liberty and democracy in Britain.

The technique of the sceptic collective of Edzard Ernst, Andy Lewis, Ben Goldacre, Evan Harris MP etc. is to constantly repeat their mantras and their stock phrases. So, just a little repetition from the other side for a change. Conventional medicine does not have all the answers. Agree or not? Many GPs who are ready to admit this fact refer patients who they think may benefit to the outpatient clinics of homeopathic hospitals. (So the patients that get referred are already classified as difficult cases - non-responders to conventional care). Yet outcome studies of NHS-delivered homeopathy care (such as those referred to by others above e.g. the Bristol Homeopathic Hospital and Northern Ireland project) show both high levels of treatment success and patient satisfaction. (Sorry guys, no control group I know!) If the sceptic collective and the House of Commons S&T Committee were really concerned about saving money in the NHS they should be enquiring into the patient safety events that annually cost the NHS 1.5 billion a year through the constant 10% of hospital beds filled with patients suffering adverse events and the compensation payments that have to be made to many of them. If many of those patients were treated with homeopathy instead of GPs persisting in prescribing inappropriate drugs that cause adverse effects, these costs may very well be significantly reduced. 10 milion a year on homeopathy, and I doubt it is even that much, palls into significance besides these figures.

Years ago , when doctors were less clever , but a little wiser and more tolerant than we are today, our profession was thought of as a 'Broad Church'. It was accepted that there may be more than one route to a summit, and more than one way to help a sick person. Some climbers, physicians and some sick persons might be more suited to one route than another. To condemn someone on another route, without knowing why they chose it, was unseemly. After all, '...we are not wholly bad or good , who live our lives under Milk Wood', remarked the Reverend Eli Jenkins, vicar of Llareggub, as the foibles and eccentricities of his parishioners were revealed through the lines of Under Milk Wood, a play for voices by Dylan Thomas. Nowadays, no such niceties prevail. Colleagues who have no personal knowledge nor experience of a subject compete with each other in demonstrations of their critical powers. Until the urgent need for accreditation of non medical homeopaths is met, unthinking critics of homeopathy have their lives made easy by the presence of an unregulated homeopathic fringe. Thinking critics habitually neglect the beams in our own professional eyes. Readers of The New York Review of Books, January 15, 2009, will have been concerned to discover the opinion of Marcia Angell. 'It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgement of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.' A dozen senior colleagues in the UK wrote to Health Authorities last year suggesting that those Authorities reconsider the funding of NHS homeopathy. They chose to use an NHS letter heading. Many months passed before officialdom agreed that they should not have done so. It was no more than a 'senior moment' of course, deserving tolerance rather than censure. Junior colleagues who are as forgetful on their application forms may be less fortunate. The most recent stain on our shared professional garment is from the mud thrown at medical homeopaths by our colleagues. That stain may spread unless we understand its origins. Isaac Newton changed the way that people understood the observable world. His world, and ours, seem to be ruled in large part, by the laws of particle physics of which he knew nothing. He was aware that his discoveries were a beginning, that much more would be revealed. Today, some learned colleagues, almost Newtonian in their estimation of themselves, though less humble, are confident that all has been revealed. They are alarmed by phenomena that are outside their understanding, and react as if personally threatened. Sensible people, when challenged intellectually, know to pause, listen, and reconsider. Sensible people spend lifetimes understanding and eradicating anger, from within. Years ago doctors with anger problems would shout at juniors, nurses and even patients. Some threw tantrums in Theatre. Now that those outlets are rightly frowned upon, what is the angry doctor to do? Attack homeopaths of course. Homeopaths are bored at being likened to liars. We console ourselves that the verbal and written abuse thrown our way may be a useful catharsis for our critics. Something their partners and friends might like to thank us for. Medical homeopaths are a good humoured and open minded bunch, happy to discuss our interests in a non judgemental forum. I suggest we set aside a day or two, for a convivial workshop with our critics, in Llareggub. The Reverend Eli Jenkins will be in the chair, reminding us that 'we are not wholly bad or good, who live our lives under Milk Wood'. Nor anywhere else for that matter. (Noel Thomas, NHS GP for nearly 40 years. Jobbing, unpaid homeopath for more than half that time)

Scotland already has a very successful homoeopathic service within the NHS provided by the Glasgow Homoeopathic Hospital (Centre for Integrative Care). As far as evidence, I remember that there was an RCT which was peer-reviewed and published in the Lancet a few years ago showing without any doubt that homoeopathy is effective in the treatment of rhinitis. It was published by Dr David Reilly and his team at the Glasgow Homoeopathic Hospital. The editorial went something along the lines that, either homoeopathy works or we will have to re-evaluate every piece of research ever done I saw one of Dr Jacques Benveniste's experiments myself when he used a 'potentised' homoeopathic remedy (adrenaline?) to increase the pulse rate of an animal's heart. Then he placed the remedy inside a strong magnetic field which 'erased' the active properties of the remedy. When he applied this 'erased' liquid to the heart again, it had no effect i.e. the liquid was just water and not a homeopathic remedy any longer. His theory was that water has a memory which is related to electromagnetic forces. In later years non-medical authors (mainly physicists I think) have shown that water molecules do change their characteristics and clusters reacting to exogenous energies.

Do not grant homeopathy credence by giving time to discuss this professionally. This is flim flam of the worst order, with no rational basis. Snake oil for our times. This demonstrates quite clearly the politicians' inability to make rational decisions regarding healthcare. They much prefer to be cool and trendy - right on. For a short and sweet hatchet job on homeopathy, if you should need one, read Bad Science by Ben Goldacre.

A huge blow has been struck for freedom of choice here. Many who have not been helped by standard treatments can continue to have another option. Autism is a case in point. This condition costs the Government an estimated 40 billion per year and homeopathic treatment has shown real promise in this area. As a homeopath I have personally seen remarkable ameliorations of autistic symptoms in children and this experience is shared by colleagues around the world. Impartial research is needed to back up the anecdotes and parental testimonies seen here. http://www.savingalostgeneration.com/ and http://blinddogfilms.com/within_without.html. It is vitally important that families dealing with autism have access to homeopathic doctors on the NHS if there is a chance that their children can be helped and thus have less reliance on already overstretched services. If Edzard Ernst's opinions were taken on board this would not be a possibility. He stated to the Common's select committee that he did not feel that the public should have the right to influence health policy. Thankfully this elitist view fell on deaf ears and common sense has prevailed. Ernst also suggests a place for medical placebo on the NHS. So the 'little white lie' is OK while homeopaths are accused of deceiving their patients. Placebo is possible in many unwitting circumstances but the difference here is that homeopaths believe that they are prescribing an active substance in the form of a substance-specific electromagnetic charge and are not knowingly deceiving their patients.

I'd like to have a week's winter break in Spain to eliminate the incipient onset of illness (seasonal affective disorder). It is likely to be cheaper and far more pleasant than obtaining a referral to a homeopath to treat me for the same condition. Since my personal 'choice' seems to be the overidding and all-important factor here, can someone prescribe this for me on the NHS please?

I am constantly amazed that people who claim to be scientists, and presumably therefore reasonably open-minded to new discovery, are so closed-minded about something that they simply don't understand. Austin Elliott criticises homoeopath Steve Scrutton for suggesting that there is evidence to support homoeopathy. He refers to the need for 'evidence that stands up', because he considers that the evidence available suggests it is no more than a 'placebo effect' and 'stealth psychotherapy'. He chimes with repeated similar calls by Edzard Ernst who refers to homoeopathy as 'worthless treatments'. I'm sorry to upset everybody who wants to dismiss homoeopathy as worthless, but maybe they'd care to 'ask' the millions of animals treated successfully with homoeopathy? I did so for 15 years, with over 500 dairy cattle, and to my knowledge none of them had a hangup about homoeopathy, none of them had preconceptions, none of them had a medical training, and none of them were liars, and lastly none of them had a vested interest in getting better. I think this could be considered to be the 'inconvenient truth' of homoeopathy, which all those who cynically dismiss it like to forget or ignore. Shame on you all. I too thoroughly enjoyed the last sentence in Ken Mayne's contribution. I note that it drew no further comment, presumably forming an uncomfortable riposte. I also noted the well-understood, but often ignored comments about the numbers of patients harmed by the apparently 'safe' and thoroughly tested conventional medicines administered by thoroughly conventional medics.

Olivier Dowding, Perhaps you can produce a single placebo-controlled trial of homeopathy in animals that shows it to be more effective than placebo. If you can find one, then perhaps you might like to find more than one and then perhaps a meaningful meta-analysis to put the single studies into a 'holistic' context. I'm afraid homeopathy simply provides a rationalisation for doing nothing which is particularly despicable when it is done to an animal that cannot consciously choose to be subjected to that treatment. Merely observing the natural history of trivial conditions may be acceptable in certain sections of the human medical patient population, but passive observation is not acceptable when done to animals in place of useful treatment for serious diseases.

Surely the practical experience, quiet wisdom and moderately-stated views of AZTEC PRIESTS, integrated with that of tens of thousands of AZTEC PEOPLE around the world, SACRIFICING THOUSANDS OF PEOPLE TO KEEP THE SUN RISING, has greater authority than the bombast of non-practitioners with academic or journalistic reputations to protect. Yet the slaughter stopped. And the Sun still rose. Argumentum ad populum is no argument. Is that good enough, Oliver Dowding?