Homeopathy in UK Health Service Under Siege from Big Pharma
Sun Sep 30, 2007 at 01:03:16 PM PDT
Contrary to the simplistic view, the UK National Health Service is not a true single payer. Spending decisions and budgets are devolved to a local "Primary Care Trust" (PCT). These are based on geographical areas and can be thought of as a bit like an HMO for everyone in, say a county or borough of a city.
For this reason what range of treatments you can get on the NHS depend on where you live and the priorities of your local PCT. While most treatments recommended by the National Institute for Health and Clinical Excellence are automatically available, new and expensive drugs and alternative treatments are decided by the PCT. Patients have had access to homeopathic treatments since a commitment given at the very foundation of the NHS. Now a concerted campaign by doctors wedded to conventional medicine together with an organization funded by big pharma are pressurizing PCTs to withdraw funding for homeopathy and a specialist hospital unit is under threat of closure. That organization is also highly involved in promoting GM foods which are dependent on chemicals produced by the very same companies making pharmaceutical drugs.
This week the West Kent PCT decided to cease funding homeopathic treatment. This puts at risk the Tunbridge Wells Homeopathic Hospital which has been treating patients for over 100 years. The unit shares the building with community paediatrics and a child and adolescent mental health service. The homeopathic services are run by consultants Dr David Ratsey and Dr Helmut Roniger, supported by five other doctors. All are skilled in not just complementary techniques but also in conventional medical practice. The hospital is run by the Maidstone and Tunbridge Wells NHS Trust, which will have to consider the future of the hospital after the loss of funding. The Hospital performs an important teaching function in addition to providing treatments and has a support group fighting to save it.
For the last two years letters have appeared from a group of mostly retired doctors and medical scientists calling for such funding to be withdrawn. These come out in May when the process of consultation on spending for the following (April-March) financial year are being proposed. The 2006 letter (.pdf) came out in the name of Professor Michael Baum, Emeritus Professor of Surgery at University College, London "and others". A very similar letter was sent to PCT Directors of Commissioning in May this year, this time under the name of Professor Gustav Born FRS Emeritus Professor of Pharmacology, Kings College London "and others" including Professor Baum.
The Times online reproduces this letter. Born was a signatory to the 2006 letter. The letters have similar arguments that the express their concern
about the continued provision to patients of ‘alternative’ medicine including homeopathy, in the absence of evidence of efficacy, across the NHS. This reflected our broader concern with the need to promote evidence-based medicine in the provision of all medical services, which we are sure that you share.
"Evidence based medicine" are of course convention drugs. The problem for homeopathy (and acupuncture) is that the explanations of the way they work is counter-intuitive. The principle in homeopathy for example is that the greater the dilution, the more effective the treatment. Both are often dismissed as only effective because of the placebo effect - a patient believes it will work so feels better. Unfortunately that does not explain how both can be used to treat animals effectively unless we are to believe that the subjects have faith that the pills being given to them will work. However to promote their cause they provide some background briefing:
If you have not already reviewed your own trust’s provision, you might find it useful to consider, in conjunction with your Director of Public Health, the paper that we have enclosed which, while not a full review of the scientific position, has been used by other trusts to promote evidence based commissioning.
That paper was a document (.pdf) produced by an organization called Sense About Science. Who describe themselves on their web site:
Sense About Science is an independent charitable trust promoting good science and evidence in public debates. We do this by promoting respect for evidence and by urging scientists to engage actively with a wide range of groups, particularly when debates are controversial or difficult.
Your suspicions may start to be raised when you lood at the list of donors to Sense About Science These include the rather coyly abbreviated Association of British Pharmaceutical Industries (ABPI), GE Healthcare, and pharma companies GlaxoSmithKline, Oxford GlycoSciences plc, Pfizer plc, and Unilever plc.
In January this year Sense About Science started a campaign to attack various celebrities and their views on genetically modified foodstuffs and their preference for organic food. A response was published in the Daily Mail written by the environmentalist Zac Goldsmith. Goldsmith has advised the Conservative Party in the UK on the "green" policies and is on their list of prospective candidates they would like to stand at the next election, the so-called "A List". This is part of what he wrote.
The pamphlet is full of what it regards to be false, but nevertheless anodyne assertions by celebrities about the benefits of homeopathy and so on, and ends with an offer by the organisation to act as a fact-checking service. However it is the pamphlet's repeated objection to any hint that chemicals might not be good for our health that suggests an altogether less helpful agenda.
and
SAS is often described as an aggressively pro-GM lobby group. But it's much, much more than that. It is born of a bizarre political network that began life as the ultra-left Revolutionary Communist Party and switched over to extreme corporate libertarianism when it launched Living Marxism magazine in the late eighties. LM advocated lifting restrictions on child pornography, it opposed banning tobacco advertising, supported human cloning and so on. In as much as it has a central philosophy, it is a fierce opposition to the state attempting to protect citizens from the excesses of big business. But its real goal, and the reason for its political zigzagging, may stem from a long-held hatred of any kind of positive reform that might risk prolonging the system they hate. They call it "revolutionary defeatism". By helping to accelerate the contradictions of capitalism they believe they are hastening the move to the 'next stage' of human development.
During the nineties, Living Marxism was successful at influencing the British media coverage of science and environment issues, particularly relating to GM food. But in 2000, it was sued for claiming that ITN had falsified evidence of Serb atrocities against Bosnian Muslims, and was forced to close. It soon reinvented itself as the Institute of ideas, and the on-line magazine Spiked.
At each step in its evolution, it has been largely the same people who have given life to this strange movement and painstaking research by Jonathan Matthews of www.gmwatch.org shows it is many of the same people who now put themselves forward as the faces of respectable, and trustworthy science.
Article by Zac Goldsmith about SAS
The activities of SAS in promoting GM foods and details of the personalities involved in it can be found here on the GMWatch site
[UPDATE:]
- Several posters seem to suggest that I am proposing homeopathy become available. That is not the case. Homeopathic treatment was available from 1948 under the Health Service. The diary is therefore not about introducing it to the NHS, it is concerned with whether patients already being treated should continue to do so as well as whether future patients should have access. I should also reiterate this is a complementary therapy, not a replacement for all medication.
- The original description of how both homeopathy and acupuncture work are not in accord with current scientific thinking however there is no question that patients report improvements or there would be no demand for it.
- Because facilities are limited, NHS homeopathy treatments tend to be available after conventional medicines have found to be wanting either because they are ineffective or have side effects unacceptable to the patient. The usual "scientific" explanation is that supposed cures are a placebo effect and I did not wish to enter into a debate over the matter other than to point out that there is cost saving if conventional drugs are not used or less used. Many patients wish this type of treatment because of the side effects from conventional drugs and another route for the improvement may be the withdrawal of them!
- Homeopathic treatments are accepted as legitimate by the Royal College of Veterinary Surgeons who list vets trained in and providing it as a separate index so that they can be found easily.
Under the terms of the (UK) Veterinary Surgeons Act 1966, it is illegal for anyone other than a RCVS-registered Veterinary Surgeon to prescribe homeopathy for animals or to diagnose or give advice based upon a diagnosis. This includes but is not limited to homeopathy, acupuncture, herbal medicine and aromatherapy.
see: http://www.bahvs.com
Animal owners would not pay good money if they did not see a benefit from using homeopathy.
All of that suggests that homeopathic treatment is recognized as effective in animals. Critics may well wish to explain how animals develop a belief in their treatment so that a placebo effect is generated.
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