Sugar pills that cost too much

Fifty years ago the worried well were given coloured water. Today they are offered homeopathy

http://www.observer.co.uk/comment/story/0,6903,664840,00.html
Robin McKie
Sunday March 10, 2002
The Observer


Over the next few weeks, an impressive, carefully prepared package outlining the benefits of homeopathy will drop through the letterboxes of GPs round the country. 'You might never have been taught anything about homeopathy,' the guide warns doctors, 'yet patients are looking to you for authoritative advice.'

The maildrop is, essentially, a simple bid by the Faculty of Homeopathy to drum up business, and a rather unnecessary one at that - for more than 500,000 Britons now take their remedies and a quarter of GPs provide access to them. We even have five NHS-funded homeopathic hospitals, with the largest, London's Royal Homeopathic, having just received a £20 million upgrade out of our taxes.

In short, things look pretty chipper for homeopaths, with more and more patients seeking their medicines and practitioners obtaining more and more NHS funds to promote their wares (though neither health department officials nor the Faculty of Homeopathy will say precisely how much). Great news for alternative medicine, but worrying for sceptics who doubt the worth of giving fantastically dilute solutions of dubious substances to the sick.

Such fears will not have been assuaged by last week's revelation that two homeopath doctors had triggered a measles epidemic in Bavaria that affected 700 children (and hospitalised 30) after campaigning against MMR vaccines. That certainly doesn't strike me as value for money. Worthy of imprisonment, more like.

So why should we pay out millions to fund homeopathy? What 'authoritative advice' should our GPs give patients? After all, most homeopaths admit their stuff is inappropriate for treating cancer, helping the mentally ill or preventing major ailments, instead reserving claims for their effectiveness as aids for eczema, arthritis, and asthma sufferers, and for patients who have to cope with chemotherapy.

Such goals are perfectly reasonable, of course. But does homeopathy actually fulfil them? After all, it seems incredible to claim efficacy for solutions that are so dilute you would need to build a vat the size of the solar system to be sure you could house a single molecule of active ingredient. As physicist Robert Park states in Voodoo Science (OUP), when you consider homeopathy in this light, you have reached 'the point at which everyone is supposed to realise how ridiculous this is, and share a good laugh.'

But homeopaths don't laugh. Their infinitely dilute, but nevertheless incredibly potent, remedies really work, they insist, and in the faculty guide claim that a total of '89 double-blind, randomised, placebo-controlled trials' of their medicines support their effectiveness.

It sounds impressive. But it isn't. Two weeks ago, the results of an analysis of these trials - in which homeopathic remedies were compared with placebos - was released by the NHS's own Centre for Reviews and Dissemination at York University. It came to a startlingly different conclusion. Methodological inadequacies were discovered in many trials that had had initially seemed to support homeopathy, so that when a total comparison was carried out, all signs of its efficacy disappeared into a statistical void. 'There is insufficient evidence of effectiveness to recommend homeopathy as a treatment,' said the report.

Homeopaths disagree, but they would, wouldn't they? They have been in business for 200 years, and have staked careers on the practice. They can scarcely now admit it's utter hokum.

Where it leaves the National Health Service - whose York statisticians have completely undermined the case for the public funding of homeopathy - is a different matter. As a taxpayer, I resent cash being paid out to support this sort of quackery, the 'extremely dilute opiate of the mystically inclined masses', as one pharmacologist describes it.

On the other hand, I note the views of other sceptics who doubt homeopathy's effectiveness but point to its soothing influence on troubled patients. Fifty years ago, doctors gave such unsettled individuals coloured tonic water to keep them quiet. Today, they are offered the useless pills and solutions of the homeopath. It's harmless and keeps people happy, runs the argument.

But it's not. It's wrong, and it supports mumbo-jumbo and sloppy thinking which don't deserve succour. For homeopathy to work, water must somehow retain a memory of the medicine once dissolved in it but which has been removed by excessive dilution. Such an effect would represent a new force in physics, as Richard Dawkins points out, yet homeopaths make no effort to uncover this glittering scientific crown. 'Can it be they don't really believe their theory after all?' he asks.

It's a damning point. So when patients come inquiring about homeopathy, I suggest this 'authoritative advice': Let them drink water.