[back] Lord Dick Taverne
The short answer from the Minister of State was that “decisions on the commissioning of complementary and alternative therapies, including homeopathy, on the NHS, are matters for primary care trusts. The Government consider that clinical decisions on the use of complementary or alternative treatments should be left to clinicians. However, there is further scope for the National Institute for Clinical and Health Excellence to include assessment of complementary therapies in its guideline work.”
In the ensuing discussion it became apparent that some of the noble Lords who spoke were confused about the difference between evidence as to whether or not a treatment works, and knowledge of its mode of action. We were treated to the statement from one noble Lady that her consultant admitted that he does not know how paracetamol works, but he still prescribes it.
Leaving aside the problem of a consultant physician who has apparently
forgotten the pharmacology he was presumably taught at medical school, ignorance
of the mechanism of action of a drug or other treatement should not prevent its
use - as long as it has been demonstrated to be effective.
Aspirin was used very effectively for almost 100 years before Sir John Vane elucidated its mechanism of action as an anti-inflammatory drug. Penicillin was used for two decades before its mechanism of antibacterial action was explained. We still do not really know how the antidepressant drugs act. If they simply increase the availability of neurotransmitters in the brain, why is there a 2 - 3 week lag before benefits are seen? Chemical depletion of neurotransmitters leads to a deep depression within hours.
It is not acceptable to dismiss a proven treatment on the grounds that we do not know how it acts, but equally it is unacceptable to say that a treatment that has not been proven to work (or, as in the case of homeopathy, has been demonstrated not to work) should be used because we do not know its mechanism of action.
The full exchange can be read in Hansard at: http://www. publications.parliament.uk/pa/ld199697/ldhansrd/pdvn/lds06/ text/60123-02.htm