Is it the end for NHS homeopathy?21st November 2007
NHS funding will be reduced or stopped at some of the UK's homoeopathic hospitals.
Udani Samarasekera asks in The Lancet if this signals the "beginning of the end" for homeopathy within the health service.
Homoeopaths working in the UK may have cause to feel anxious. A campaign against their profession, along with a questioning of its benefits to patients, has been particularly active in recent years. Many critics - including doctors, scientists and journalists - have been increasingly vocal in speaking out against homeopathy and its practitioners.
However, homoeopathy is still popular with people in the UK. About 13,000 patients are seen at five homoeopathic hospitals each year. 14.5% of the population say they "trust homeopathy" and it is a multi-million pound market which is expected to grow over the next 5 years.
A conference which deals with the use of homeopathic treatment in HIV/AIDS patients is due to take place in London in December. It is organised by the Society of Homeopaths - the largest group of its kind in Europe.
The organisers have said: â€śThe symposium will be looking at different methods and approaches that appear to be having some success in helping with the symptoms of HIV/AIDS.â€?
Michael Baum, Professor Emeritus of surgery at University College London is critical of the conference. â€śPeople say homoeopathy cannot do any harm but when it is being promoted for HIV then there is a serious problem,â€? he said.
In 2006, the charity Sense About Science found that ten homoeopathic clinics and pharmacies picked from an internet search said they could offer remedies to guard against malaria and other serious illnesses.
David Colquhoun, professor of pharmacology at University College London said: â€śMaking false claims about treating colds is one thing but it is quite another thing to make false claims about malaria.â€?
Last year, a group of physicians and scientists sent out a letter to Primary Care Trusts which made their thoughts about the use of homeopathy clear. In particular, they criticised its lack of "convincing evidence of effectiveness."
This letter appears to have had some success. In September this year, West Kent Primary Care Trust stopped NHS funds for the Tunbridge Wells Homeopathic Hospital. The Trust's Medical Director James Thallon said that there was a lack of clinical evidence which meant they would not carry on using homeopathy as a treatment.
In addition, a number of Primary Care Trusts have decided to reduce or stop paying for treatment at the Royal London Homeopathic Hospital. The hospital's clinical director said that referrals were reduced by 20% last month in comparison to the same month in 2006.
Homeopathic remedies are made by massively diluting ingredients, unlike herbal medicines. Although herbal medicine is often untested, it has a better chance, scientifically, of providing some benefit to a patient. In some homeopathic treatments, the main ingredient is so diluted "not even a single molecule" of its active form remains.
According to data from The Lancet, published in 2005, the tested benefits of homeopathy are no better than a placebo. Some scientists have argued that this placebo effect could be used to help patients. Professor Baum calls the prescription of placebos "unethical and patronising."
The Society of Homeopaths and the Faculty of Homoeopaths disagreed with the evidence published in The Lancet.
A spokesperson for the Faculty stated: â€śThere are many scientists around the world who have found evidence that water may retain information about homoeopathically prepared solutes.â€?
Earlier this year, the journal Nature published information which showed that six universities in the country now provide Bachelor of Science degrees in homoeopathy.
In the Nature article which published information about degree courses available in homeopathy, David Colquhoun said the subject had "barely changed" for 200 years and said: "it is much more like a religion than science.â€?
He said that students of the subject faced a confusing degree course, as they had to study the subject at the same time as traditional subjects, such as physiology. He argued that they would be taught one form of scientific ideology in one subject and another in the next.
However, homeopathy has received some positive news recently. In September last year the Medicines and Health Regulatory Agency issued new regulations which gave its support to some remedies available as over-the-counter preparations.
The regulations allow homeopathic remedies to list what they can be used to treat. Makers of these remedies need only offer "safety evidence and information about what their remedies are traditionally used for to gain a licence."
Professor Baum argues that the National Institute for Health and Clinical Excellence (NICE) needs to look at how cost-effective homeopathy is as a treatment. In order for this to happen, the DoH would need to refer the issue to NICE.
The DoH said to The Lancet that it currently takes into consideration: "complementary therapies alongside conventional treatments when developing clinical guidelinesâ€?. NICE's current guidelines do not list homeopathic treatments in any of their recommendations.
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