Jun 07 2018

Homeopathy Loses NHS Case

The National Health Service (NHS) in England decided in November 2017 to stop funding homeopathic treatments. That was an excellent decision, made for the right reasons – “lack of robust evidence of clinical effectiveness”. While I think that is an understatement, it is true enough, and is sufficient justification for any modern health care system to abandon homeopathy.

Now a High Court Judge has affirmed that decision by the NHS. Why was a judge even involved? Because the British Homeopathic Association (BHA) sued the NHS over that decision.

Legally, this case was fairly straight forward. The judge was  clear to point out that it was not his job to review the scientific evidence regarding homeopathy. The BHA argued in court that there is “plain evidence that homeopathic treatment does work in particular cases”. That is complete nonsense – homeopathy is nothing but magic potions, with no scientific plausibility, and the scientific evidence clearly shows that it does not work for anything.

But the judge did not have to get into that in court, which is appropriate. It should not be for a judge to make scientific decisions like that. His job was to answer the BHA complaint that the NHS was being unfair in their decision. The judge ruled, however, that the NHS process was “fair and balanced” and that “there was no evidence of ‘bias or predetermination'”.

I do worry when such issues come up before courts or regulatory bodies. It is easy to make the claim of bias against those who are simply following the evidence. It would, for example, be easy to make the case that I am “biased” against homeopathy. After all, I have been regularly trashing the pseudoscience for years. But in reality I am just following logic and evidence. Correctly stating that something is pseudoscience is not a bias when it is the logical conclusion of a fair process.

Any scientist worth their salt should come to the same conclusion. There really isn’t any room for reasonable disagreement here, the case against homeopathy is about as clear-cut as we get in science. So any reasonable scientist properly informed should come to the conclusion that homeopathy is rank pseudoscience. Does that make them biased? That will be the argument against them by proponents, who will then lobby for more “open-minded” people to be on panels or commissions and be involved in decision-making about the fate of something like homeopathy. Of course they have no problem packing such panels with those biased towards homeopathy – that is not bias in their book.

That was the tactic taken in this bogus case against the NHS, they were accused of bias and being unfair. It is reassuring that the judge quickly concluded that their process was fair, there was no bias, and therefore their decision is reasonable.

The NHS’s decision is part of an attempt to save limited funds, £141 million per year to be exact, by eliminating coverage of treatments that probably don’t work. This includes homeopathy and some herbal supplements. Homeopathy itself was responsible for £92,000 per year. This may not seem like a lot, and it isn’t, but there is no reason to waste a farthing on pure medical nonsense.

There is also much more at stake here than just the direct cost of homeopathic potions. There is a very important principle – if we consider health care a basic human right, then it makes sense to provide public funding for health care. But then that means we need some standard to determine what treatments are worthy of public funding. Tax-payers should not be forced to spend public funds on pure pseudoscience, and those who are entrusted with those limited health-care public funds have the responsibility to make sure the resources are used optimally.

Further, when any official health care body pays for pseudoscience, it legitimizes it. This leads to even more wasted expenditure on worthless nonsense, confuses the public over what is science-based and what isn’t, erodes trust in scientific and professional institutions, and potentially leads to greater health-care costs downstream. Any patient that relies on bogus homeopathic potions for any serious illness, delaying science-based treatment, is likely to have a worse (and more expensive) outcome.

With their complaint, the BHA was not just challenging this one decision, but the entire basis of quality control in medicine and the standard of care. That is the long game that proponents of alternative medicine are playing. They are trying to erode the mechanisms that maintain the standard of care, creating an environment in which anything goes, so that they can sell their bogus treatments with false and misleading claims. They often couch their efforts in the guise of patient “freedom” but it is really blatantly anti-consumer.

For example, in response to this decision, the BHA whined:

“That is not good enough, for it is important to remember that the real losers in this case are the patients who are now being refused a treatment on which they have come to depend.”

Wrong. The patients are winners, because they are being protected from scam artists trying to sell them snake oil. The losers are the snake oil salesmen, which is really what the BHA is concerned about, being the snake oil salesmen themselves.

This decision is a solid victory, and I hope it becomes just one more step on the path to the NHS fully purging all homeopathy from their ranks. Homeopathy is 19th century pseudoscience. It has no place in a 21st century modern medical system.

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