Homeopathy Funding: Something Stupid Afoot in the UK
July 27th, 2010
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For a good while it looked like funding of homeopathy through NHS, the national government-sponsored health-care system in the UK was going to finally end. An MP report on the subject was predictably very strongly against continued funding, nearly every member of the medical establishment who commented on the issue was firmly against homeopathy and various British skeptic and pro-science groups seized the moment to show how worthless homeopathy is. The British Medical Association firmly backed the removal of funding for homeopathy by government programs.
The big blow to homeopathy came earlier this year when a select committee of the British Parliament published their findings, concluding that homeopathy is no more useful than placebo and does not deserve continued funding. (Well, yeah, thanks Captain Obvious.)
Yes, it looked like the tax payers of the UK would finally be able to avoid paying for expensive water in perfume bottles. Or so it seemed…
DH commits to continue NHS funding of homeopathy
NHS funding for homeopathic treatments will continue, despite a highly critical report published by MPs earlier this year.MPs on the parliamentary science and technology select committee published a report on homeopathy in February, which urged the government to withdraw NHS funding for such treatments and for the medicines regulator to stop licensing homeopathic products.
Both proposals were rejected this week by the Department of Health as it published its official response to the report.
Homeopathy has been funded on the NHS since the service began in 1948 and there are four homeopathic hospitals in the UK, in London, Bristol, Liverpool and Glasgow.
It is estimated that the NHS spends around £4 million a year on homeopathy.
The select committee’s report said there was no conclusive evidence that homeopathic drugs were any more effective than a placebo and given that existing scientific literature showed no good evidence of efficacy, further clinical trials of homeopathy could not be justified.
The committee said it believed homeopathy was a placebo treatment.
To prescribe these treatments was damaging the integrity of the doctor-patient relationship and because the effect of homeopathy was unreliable and unpredictable, it should not form the sole basis of any treatment on the NHS.
The MPs also wanted the Medicines and Healthcare products Regulatory Agency (MHRA) to stop licensing homeopathic products because they were allowing these products to make medical claims without evidence of efficacy.
The BMA at its annual conference in June voted overwhelmingly for a motion that said homeopathic remedies should be banned on the NHS and taken off pharmacy shelves where they are sold as medicines.
Yes, you read right. The UK has four hospitals dedicated to a pretend magic potion that doesn’t actually help anything. Four medical establishments where sick people go, money is paid and absolutely nothing of use or benefit happens. Here, homeopaths are employed, they get a paycheck and do nothing that contributes meaningfully to health or society. Not only is NHS okay with continuing to license and approve this, but they’ll continue to pay for it!
Not only is this a complete waste, but it gives this ridiculous concept legitimacy. The British Homeopathy Association even uses the fact that NHS funds homeopathy as an argument for its legitimacy.
But here’s the part that gets me:
The Department, however, in its response, said the use of homeopathy on the NHS did not amount to a “risk to patient trust, choice or safety”.
In addition, it did not believe the risk was significant enough for the Department to take the unusual step of removing PCTs’ flexibility to make their own decisions.
Public health minister, Anne Milton said: “We believe in patients being able to make informed choices about their treatment, and in a clinician being able to prescribe the treatment they feel most appropriate in particular circumstances, which includes complementary or alternative treatments such as homeopathy.
“It is the responsibility of clinicians to discuss the risks and benefits of specific treatment options with individual patients; and to take into account safety, clinical and cost-effectiveness and the availability of suitably qualified/regulated practitioners.”
So here we go again, “patients rights” becomes the issue. It’s one thing to allow people the liberty to pay for something useless with their own money, but this is not about people choosing to be stupid – it’s about the government funding their stupidity!
Healthcare is expensive, and like many other countries the UK has found its healthcare program suffering from chronic budgetary issues. Of course, not all medical procedures can be covered by such programs. Elective procedures are not and often procedures which are considered unnecessary, unorthodox and unlikely to be successful are not. There has to be some limit to what is covered. So here’s an idea: only fund medicine that actually works. Save money by not paying for fake stuff.
Clinicians should certainly be able to prescribe what they feel is best for a patient, but homeopaths are not doctors! Homeopathy is never “appropriate.” Any doctor who prescribes homeopathy is in the wrong profession. There’s no such thing as a “qualified homeopath” because that’s an oxymoron and the cost/benefit ratio of homeopathy is division by zero because it has no benefits. Anyone who thinks it works is not “informed” because it doesn’t work.
While some may argue that it does occasionally have some benefits as a placebo or to calm a patient (or get them to shut up,) this is a violation of all medicine is supposed to be. It undermines the very notion of informed consent and makes it impossible to trust doctors to give it straight. It offers a government stamp of approval to fraud and makes the government party to an act of deception against those it is supposed to be helping.
Why this is continuing to happen may simply be an example of a fundamental law of politics: it is extremely difficult, sometimes impossible to repeal funding or subsidies which allow a group to make huge amounts of money for free. Even if the group is small, they will fight tooth and nail and use every form of lobbying, advertising and legal maneuvering they can to avoid losing the gravy train. Simply put, people like free money and don’t want to give it up.
There have been demonstrations for continued funding of homeopathy. It’s hard to say what proportion of the demonstrators have money on the line and what proportion are genuinely ignorant or delusional and have been suckered into this scam.
Finally, some might think it in poor taste to criticize a government which I do not live under. This may be valid in some circumstances, but COME ON! Funding homeopathy?!?!?!?! Is there any way NOT to see this as idiotic?
This entry was posted on Tuesday, July 27th, 2010 at 8:07 pm and is filed under Bad Science, Culture, Not Even Wrong, Politics, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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July 27th, 2010 at 9:36 pm
How does it take away freedom to not fund something but allow people to still use it if they pay?
He who pays the piper calls the tunes or so it is said.
Health coverage, whether it’s government or otherwise has the responsibility to provide for treatment that is necessary and effective. It has no obligation to pay for treatments that are fake. They aren’t even “treatments” they’re no “medicine” they’re lies, scams, bull****!
That’s four million pounds that could actually go to helping someone for christ sake!
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July 27th, 2010 at 9:46 pm
Given that Americans and the American government have been the whipping boys of the world for the last sixty years, I don’t think you need to apologise for giving a little back, especially when it’s so richly deserved.
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July 27th, 2010 at 11:22 pm
Yeah, its sickening. Remember the big point is that every useless treatment means less money to help someone actually get well. “No monopoly in medicine?” What the hell is that? It’s not like there is one single drug company or hospital that controls everything, unless you’re one of those nuts who thinks it’s all one giant unified conspiracy.
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July 27th, 2010 at 11:25 pm
Did you read yesterday that the British government wishes to overhaul the NHS and give the money directly to the doctors to decide who gets what treatment. They are talking about 125 billion pounds. This is for medicine, hospital time and surgical procedures. this makes 2000 pounds for every man woman and child in the Uk this sounds like a pretty good insurance policy for everyone although I don’t believe that insurance schemes should be run by private companies as profits come before insurance.
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July 28th, 2010 at 12:18 am
Imagine if all insurance worked this way (allowing coverage of non-working stuff with no penalty)
You get in a minor car accideount that leaves a big dent in the fender.
You take the car to a body shop, they say it’s $400 to fix it. You say “No thanks, I’m going to a homeopathic auto repair shop”
You go somewhere and a guy sprinkles magic water on the car and charges you $50. The insurance company pays the$50.
A week later, the dent is still there, the homeopath tells you that the car needs more treatment. You take it back. He sprinkles magic water on it and insurance pays $50.
After a few months, the dent is still there, despite insurance paying hundreds for homeopathic “dent healing” sessions.
You take the car back to the body shop. Now they tell you that because you didn’t get the dent repaired properly, water and road salt got into the fender and there’s rust damage and the fasteners are all shot. They will need to replace the whole quarter panel for $1500
The insurance company pays the $1500 without complaint
That’s basically how health insurance that covers homeopathy works.
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July 28th, 2010 at 1:58 am
As a UK citizen I wholy endorse this blog post.
On topic:
The word “hospital” is somewhat misleading, we’re talking about four relatively small establishments with the capacity to keep patients in overnight – hence qualifying for the name “hospital” instead of “big clinic”.
And as Dionigi says, the overall NHS budget is somewhere in the region of £100 billion, so £4 million spent on homeopathy in total is not a terrifying amount. (N.B.: To my knowledge the figure of £100 billion is taken as £100 x 10^12, as opposed to 10^9, the American billion; but I’m trying to confirm this, I’ll get back to you all).
Of course, if you’re one of the many NHS staff liable to get made redundant in the next 12 months under the “efficiency cuts” coming in you may be less sympathetic for even the tiny percentage of NHS funding represented by homeopathy.
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July 28th, 2010 at 3:43 am
“.. through NHS, the national government-sponsored health-care system in the UK “.
A small point, but an important one – the NHS is a national govenment *provided* health-care system. The central state owns and directs it, lock,stock, and scalpel.
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July 28th, 2010 at 3:52 am
Having lived in this “stone-age” country (UK) for a few years with only a limited grasp of the internal politics, I am fairly convinced the main culprit in this instance is spelled “Charles” (the idiot who is next in line for the throne). This absolute &^%£-wit is one of the reasons I am seriously considering leaving this place, he is a strong proponent of complementary quackery (among other things) and he has strong influence in policymaking even though he shouldn’t (he recently managed to stop a major development because the design was contemporary).
I am sure the only reason why the queen is still hanging on is because she knows he will be a disaster as a/the king…
Ciropractitioners around where I live, openly claim to be able to cure cholic in infants, nicotine dependancy (through spinal manipulation I assume), migranes and others, though told not to do so by their national organisation (if I see a claim for curing cancer I will gather evidence and report the buggers). If any of them tries to give me a “freebie”, I will kill the “protractor” and claim self defence, enough people have died from that infamous neck-twist to keep my concious clear, not sure the law would look at it that way though.
I have to admit I am not suprised, though I am appalled, enough of my tax money has been wasted recently on other useless stuff; members of parliment expenses, the EU, MoD procurement…the list goes on.
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July 28th, 2010 at 5:10 am
Personally I think the weight of Charles’s influence is over-stated and that the political issue is a bit more… PR-based. The issue that the UK government has with NHS service is the government buzzword of the minute: “Choice”.
I, having more brain cells that fingers, am not so enamoured with choice. I don’t want to choose, I don’t want to have to put that much thought in. I don’t want to have to make big decisions about which hospital to go to, which school to send my children to. I want to simply have a high quality service wherever I go with public services. But the logic is that it’s basically about providing competition and thus efficiency, the supposed advantage of privatised industries.
In reality, “Choice” is a weak way of pandering to all the groups. Very few people are going to think twice about their vote because the party they favour is going to continue homeopathy funding. By contrast, the homeopathy faithful will vote against a party who intends to cut all their funding. And thus the standard tactic becomes to fund a bit of everything and blame the shortfall on the dubious financial planning of the previous government.
View from the Solent said:
A point well made… and given I was raised in Southampton I’m glad to have some company.
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July 28th, 2010 at 6:18 am
No, it is 100 x 10^9. See e.g. http://en.wikipedia.org/wiki/UK_budget
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July 28th, 2010 at 6:24 am
This http shows public spending for 2009-2010 http://www.marketoracle.co.uk/Article18562.html
It shows 120 billion pounds for the NHS. I was wrong with the figure for the doctors it was 80 Million as the article was in US dollars.
Note it also gives a figure of 120 Billion for pensions as there are 9.1 million pensioners it works out to 200+ per week for each pensioner, I know there are admin costs but just how much admin cost is there in putting the money in to bank accounts. I think this is where all the money in the Uk goes to.
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July 28th, 2010 at 6:29 am
Chem Geek Gregor said:
Great analogy. And it shows why even if homeopathy doesn’t cause direct harm, it wastes money and can lead to ultimately more expensive treatment being needed.
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July 28th, 2010 at 7:05 am
That’s hysterical. Beautifully put. I’ll have to remember to steal it.
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July 28th, 2010 at 7:10 am
prase said:
Thank you kindly young [pronoun of your choice].
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July 28th, 2010 at 8:21 am
I’mnotreallyhere said:
I understand that it’s not a huge amount in the greater context, but it is still four million too much. Also, I’d suspect that it may actually be a bit more if the indirect costs are considered. By indirect costs, I mean things like how homeopathy might displace other treatments or the various incidental costs of referrals and such. Still, I’m sure the total cost is not all that huge.
Part of it is the principle of the thing. It legitimizes homeopathy in a way that elevates it to the level of real medicine. It’s also government participation in an outright scam against patients. That’s not acceptable, IMHO
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July 28th, 2010 at 9:53 am
Shafe said:
Agreed. It’s going in my quotefile for sure.
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July 28th, 2010 at 10:02 am
I’mnotreallyhere said:
What the Brits call a “billion”, Americans call a “trillion”. The US budget for 2009 was about three and a half trillion (short scale) which works out to 3,500,000,000,000.
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July 28th, 2010 at 10:46 am
Of course Chem Geek Gregor, when it comes to homeopathic autobody repairs, you are forgetting that your car has to really WANT to get better.
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July 28th, 2010 at 5:18 pm
Calli Arcale said:
Yeah, this causes a great deal of confusion especially when there are reports in the international press.
If the budget of NHS is 100 billion pounds, then that would have to be short scale billion (as in milliard, one thousand million pounds)
It could not be the short scaled trillion or that would be more money than the combined budgets of all the world’s national governments. It would be more than the US spends in a decade,
But whatever the case. I’m not saying four million pounds is a huge portion of the budget. See comment 15. It’s four million more than should be spent on a scam and it’s four million reasons every British tax payer should be angry about the situation.
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July 28th, 2010 at 7:36 pm
I’mnotreallyhere said:
That whole caveat about “high quality service wherever I go” is the big kicker. I can’t speak for the UK, but in the US it’s impossible to rely on the gov’t to provide that.
Our public schools offer the prime example of that. I will in no way suggest that the gov’t fund a charter school that believes in using knowledge potions to educate children, but I do hate being told which substandard school my children must attend based on which side of a political boundary my house rests. Unfortunately, it requires a lot of sacrifice to scrape up the funds to choose a better school or to eke by as a 1-income family for the sake of homeschooling, but the lack of choice that is imposed by our education system necessitates it.
I’m fearful that as our Fed gov’t gets more involved in our healthcare, that they will gain more and more control over where we get treatment. My chances of beating cancer are much better if I travel 30 mi to the MD Anderson Cancer Center in Houston than if I settle for treatment at a suburban hospital (even though both hospitals are high quality real medicine, the volume of cases and the level of expertise at the former is unparalleled), and my insurance will cover either one. If I get told where to go, then I am much worse for it. I’m not in favor of political boundaries or whims dictating where I get treatment
So for me, yes, “Choice” is quite an issue.
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July 29th, 2010 at 5:41 am
Shafe said:
EDIT: Okay, this got really long. Bear with me.
Absolutely, the situation is much the same in the UK – it’s often referred to as “the postcode lottery” : the impact your address has on your quality of life, of treatment, of education, etc, etc. There’s a certain bitter irony to the fact that irrespective of postcode, Starbucks looks the same and the coffee tastes identical in different countries, let alone different cities.
And it’s intrinsic to the nature of the medical profession and the way people work. Doctors in a given field will want to work at the best workplaces for that field of medicine even if it means a commute. Patients will always choose to travel for the best treatment, “staying alive” being near the top of most people’s priority lists.
But long-term, the impacts of this aren’t necessarily positive. If the vast majority of the cancer patients in a region commute to a specialist cancer centre, they will receive expert care. Those who can’t make the commute, or can’t wait on lists for space in the over-booked cancer centre go to their local hospital, where they are given less capable care by staff with less experience with cancer and less investment in specialist equipment to fight it.
When the stats come out, the cancer centre will show excellent mortality rates, enhancing an already excellent reputation (note as well that those able to make the commute will probably be slightly younger, richer and healthier than those who cannot) and the district hospitals will not score as highly. Patients will respond by increasing their demand to go to the cancer centre, potentially commuting from even further out.
The district hospitals see less cases of cancer (and possibly make less money from the ones they do get) and at the next finance review perhaps start thinking “Maybe we should be investing money in other areas, since our chemotherapy and radiotherapy units aren’t being overworked”.
And the cycle repeats.
________________
For the record, I don’t know where they stand on cancer, but surgeons will often reject possible surgery patients on the grounds that they’re too likely to die on the table which would make their statistics look bad. Surgery is not always the best option for a patient, but even critical patients are sometimes simply not put in for surgery because the hospital / department / surgeon doesn’t want their percentages slipping.
________________
Let’s take a look at a quick run of some VERY hypothetical stats:
Imagine you are a patient. You can go to:
A) A specialist cancer centre, capacity: 1000 patients per year, survival chance: 90%
B) Your local hospital, capacity: 300 (cancer) patients per year, survival chance: 70%
You choose A. Well done, because you are a hypothetical representation of a statistical average, 90% of you has survived. The other 10% will go black and probably fall off over the coming weeks.
However if we assume that the specialist cancer centre draws from the areas covered by 10 such hospitals, we should get 3000 survivals per year (against 4000 cases admitted by the 11 hospitals in total).
Now, imagine you are a senior public health official. You have it in your power to redistribute some cash, some doctors and to try to stop people commuting in so far to the cancer centre unless they’re the worst cases. And imagine that according to your studies, you’ll end up slashing survival rates at the cancer centre to 80% (-10%) whilst boosting them elsewhere to 75% (+5%).
Do you do it?
If you answered “Yes”, you are an opponent of free choice and just saved 50 people’s lives.
If you answered “No”, you are in favour of free choice and 50 people will die for it.
____________________
MASSIVE Disclaimer: Clearly the above stats do not come from any actual case study or scientific statistical analysis. They exist purely as hypotheticals to back up a point which is possibly valid. By reading any of this post at all you agree not to sue me when you choose to “further the expertise of your local hospital” and therefore die of cancer.
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July 29th, 2010 at 7:00 am
Yes, well, understand that my suburban hospital may see 300 cancer patients a year, they may see a thousand. I don’t know. But the MD Anderson Cancer Center will see 90,000 patients in a year. They come not only from across the country but from around the world. And so do the doctors. There is a critical mass of talent and expertise whose collaboration allows for a terrific throughput with an astounding success rate. It is also a teaching hospital and so an incubator for more health professionals who will carry that expertise, the expectation of success, and valuable contacts with them as they move on to other hospitals or open private practices.
I would rather this system serve as a rising tide for the oncology field rather than raid its funding and talent pool to artificially pump up the other hospitals.
The current system is a product of the med students and residents choosing where to train, the hospital choosing whom to hire, and the patients choosing where to get treatment. I hope never to see the day when a public health bureaucrat has the power to take it upon himself to “fix” it.
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July 29th, 2010 at 9:02 am
drbuzz0 said:
Word.
Frankly, I think 1p is too much to spend on homeopathy.
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July 30th, 2010 at 2:42 am
Shafe said:
Valid. I have a tendency to get a bit too grumpy about the word “choice” being bounced around, it’s a buzzword allowing politicians to be weak-willed and do things like funding homeopathy.
(See what I did there? Clever, no?)
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July 30th, 2010 at 10:05 am
I’mnotreallyhere said:
Okay, this has got me bothered. I read your post several times. Then I went after work and had a liter and a half of beer. Then I came home and read it again, had some pistachios, and read it again. I’m not clever enough to see it. I’m afraid you’ll have to explain it.
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July 30th, 2010 at 11:28 pm
This blog article:
Supreme arrogance masquarading as knowledge.
Abysmmal ignorance presenting as wise insight.
Inexperience and crass stupidity producing fodder fit only for fellow one-eyed c**p merchants like the writer.
Has it ever occurred to you that waxing forth on a subject you know absolutely nothing about and have never experienced and
parading your ignorant prejudices before the world makes you look nothing more than a silly, one-eyed, bigoted dick?
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July 30th, 2010 at 11:32 pm
Wellwellwell said:
Has it ever occured to you that putting water in a vial and selling it as medicine is fraud?
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July 30th, 2010 at 11:52 pm
Wellwellwell said:
As it was once put to me (and I’m sorry I don’t remember who said this) “If you can make it past second grade and not see that the idea of homeopathy is complete bull****, our educational system has failed abysmally.”
For the past few years I’ve been heavily involved in the pro-science skeptic movement, and I’ve come to learn a great deal about things like bias errors commonly made and also medical fraud. It’s a huge problem, in fact, our medical schools, for all their great teaching of medicine have done a lousy job in teaching doctors how to deal with all the healthfraud they encounter out practicing medicine.
Fraud in medicine takes many forms and has evolved to keep pace with the culture. It’s weathered the demise of patent cure-alls and the great medical advances of the 20th century. Still, some things don’t change. Today’s medical “infomercials” are not much different than the traveling medicine shows of the past. Homeopathy has staying power, I’ll give it that. It’s always been useless yet the fact that so much money is to be made for nothing is powerful incentive to continue to fight for its acceptance, ridiculous as that may be.
I know much about it.
As for ” have never experienced” it. Well, for one thing, there’s nothing to experience. But that’s besides the point. We don’t evaluate medicine based on trying it out to see if each of us like it. That’s not an acceptable way because it’s too subjective and introduces enormous bias.
Effectiveness is determined by placebo-controlled clinical studies. Homeopathy fails this in all cases..
Also, it’s completely idiotic.
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January 7th, 2011 at 1:33 am
Your malicious propaganda against homeopathy is set to die soon.
http://timesofindia.indiatimes.com/city/mumbai/IIT-B-team-shows-how-homeopathy-works/articleshow/7108579.cms
with technology becoming better, soon even idiots like you will be able to understand How Homeopathy Works.
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