‘Even a stopped clock tells the right time twice a day,’ is one of the few quotes from one of my favourite films that doesn’t have to be censored for expletives. It’s proved popular with obscure shoe-gazing indie rock bands and techno acts. In the very same film a hippy drug dealer in the 1960s extols the virtues of long hair, because hair picks up signals from the cosmos. It seems this type of hippy sentiment is reverberating round the Department of Health, which recently rejected calls by MPs to withdraw the funding of homeopathy on the NHS.
It would appear that the Government is happy to continue to fund the prescribing of placebo, even though there appears to be something ethically dubious about prescribing inert sugar pills that may have been in touch with a molecule of something or another at some point, and telling the patient that it will alleviate their symptoms. I suppose one doesn’t consider it to be lying if you believe it yourself.
When the NHS is being asked to make efficiency savings, allowing the choice, and funding, of treatments that are based on fantasy, is irresponsible
There is a part of me that hopes that those that prescribe homeopathy are actually aware of how powerful placebos can be. In the distant past, when I was at medical school, I remember reading about the initial trials for erectile dysfunction treatment. The placebo response in many of the trials was about 50%. Men who believed they were taking an active treatment responded in half the cases. The writers of the article concluded that the cheapest most effective treatment that could be introduced worldwide was placebo. The only slight issue was the ethical one of lying about what you were giving patients. Nowadays we settle for one or more of Vitamin D, topical NSAID gels, peppermint oil or arguably SSRIs.
My other theory is that the NHS has become so obsessed with preventative medicine, which makes up the majority of QOF targets, that perhaps we have taken our eye off the ‘treating of symptoms’ ball. I sometimes feel that I spend so much time ensuring that the patient in front of me has ‘evidence-based’ prevention for fragility fractures, strokes, heart attacks, dementia, kidney impairment, nephropathy, retinopathy, neuropathy, pregnancy and worsening heart failure, that the treatment of patients’ symptoms takes a back seat. Homeopaths, whether they realise it or not, are exploiting the ‘doctor as a drug’ by concentrating on relief of symptoms.
The Department of Health argues that the funding of homeopathy should continue to allow for patient choice. This argument is blatantly ridiculous. At a time when the NHS is being asked to make efficiency savings, allowing the choice and funding of treatments that are based on fantasy, is irresponsible and is further evidence of the Government railroading its own agenda.
Dr Samir Dawlatly is a GP in Birmingham, managing partner and board member of Our Health Partnership and co-clinical director of QCAPS Referral Improvement Programme
