Time to turn away from a very modern snake-oil...

A fine chap, Simon Singh. To my mind one of our most important science communicators. And now it seems that he and his excellent Good Thinking Society have forced the hand of the NHS to seriously consider blacklisting homeopathy.

They have been campaigning for homeopathy to be added to the list of drugs that cannot be prescribed by GPs. And, after a threat to take their plight to court, Department of Health legal advisers have said that ministers will conduct a consultation in 2016.

Frankly I am amazed that the £4m a year (spent on both prescription and, even more amazingly, homeopathic hospitals) currently granted to homeopathy has gone on this long without more outrage. So why has it been tolerated and funded?

Well, it certainly seems true that some patients have experienced benefit from receiving homeopathic remedies, but no rational person should be under the misapprehension that this is anything more than placebo. There is absolutely no evidence for the mechanism of action that a homeopathic remedy would have. None, absolutely zip.

The British Homeopathic Association helpfully suggest a couple of contenders to fill this theoretical void. Maybe, they say on their website, it’s the way we shake the preparations as we dilute them; or perhaps it’s something to do with the memory of water (particularly troubling this one, given the history of this particular claim.)

This once again highlights the difficulty, especially in biology, of proving a link between an effect and its alleged cause. But – however difficult this is – it is a link that must be proven before the public pay money through the NHS for a medicine. Now, should we dismiss it purely because we don’t understand it? Of course not. Quantum mechanics is a perfect example of why we shouldn’t dismiss things which appear counter intuitive. But what we do need is evidence – and lots of it. Something sorely lacking for homeopathy.

Can you imagine if a drug company attempted to build a case for one of its products to be adopted by the NHS based on the kind of approach currently foisted on us by homeopaths? They wouldn’t even be dignified with so much as a polite letter telling them in which orifice, and with how much force, to shove their hokum. And rightly so. What’s more, I’d suggest that it is incumbent on homeopathic apologists to supply more evidence than even the reams required for ‘regular’ drugs.

Extraordinary claims require extraordinary evidence. And the claim that homeopathy makes – that their ‘medicines’ become especially effective when diluted to the point where there are no molecules of original substance left in the solution – really is extraordinary. There are a vanishingly small number of NHS funded drugs whose mechanisms are a complete scientific mystery. And fewer still which break scientific convention so egregiously.

In essence homeopaths seem to be saying that ‘whatever it is, it doesn’t matter, it works’. Except that the problem is it doesn’t. The British Medical Association, the Chief Medical Officer, the House of Commons’ Science and Technology Select Committee and the Government’s Chief Scientific Advisor have all come out against spending public money on homeopathy. Incredibly, even the NHS – the very people who have decided to thus far spend money on it – readily admit there is no good-quality evidence that homeopathy is effective as a treatment for any health condition.

And the frustrating thing is that we don’t need to pretend there is medicine where there is none. There are so many surprising and amazing potential sources of therapeutics (insect venom being a fine example, and we delve into this here) we would be better served doing away with this wishthinking and concentrating on funding new drugs, with actual evidence to support their use.

The question the NHS commissioners and ministers face is in the end quite simple: Do we pay for medicine that is based on strong scientific evidence, or do we accept the pseudo-scientific approach of hear-say and poor evidence. And if, after the consultation in 2016, it’s the latter, one will have to ask: Where do we draw the line? Medieval blood-letting? Trepanning? Phrenology?

And so I say this: Astronomy not astrology. Chemistry not alchemy. Medicine not snake-oil.

Author: Phil Prime