Feb 14 2013

Politics Trumping Science at the NHS

David Colquhoun is a tireless supporter of science-based medicine in the UK. He has used freedom of information requests to great effect in exposing all sorts on nonsense and CAM-based mayhem. Most recently he has exposed a disturbing episode of politics trumping science in the National Health Service (NHS), specifically the website NHS-Choices which is a forum for educating the public about health decisions and empowering their informed consent.

Unfortunately NHS-Choices has recently fallen victim to politically pressuring with respect to their entry on homeopathy. In my experience most academic and government outlets for explaining medical information to the public do a generally good job – except when it comes to CAM, then they fail miserably.  There seems to be three main reasons for this. The first is that most academics and scientists do not understand pseudoscience in general or CAM in particular. They are simply naive about what it actual is and how it operates. Second (and deriving from the first), in such situations they are happy to turn over responsibility for CAM entries to the “experts,” which means proponents. Proponents will even convince the naive academics that “skeptics” are biased and their input should be avoided.

The third factor is the one apparently at work here – political pressure from proponents combined with the desire to avoid controversy. Giving the public accurate information about health care choices seems to get lost in the calculation.

David now brings us a dramatically clear example of the latter. The NHS Choices page on homeopathy used to contain some clear language about the evidence. David goes over the history in more detail, but briefly – the original NHS Choices page on homeopathy looked like it was written by a homeopath. It was soundly criticized and as a result was removed pending revision. David was sent the draft of the revision, which included the following section:

Does it work?
Many independent experts would respond to this question ‘no, homeopathy does not work’

There is no good quality clinical evidence to show that homeopathy is more successful than placebo in the treatment of any type of condition.

A placebo is the unusual but well-documented psychological effect that sometimes occurs when a person is given a ‘dummy’ medication, such as a sugar pill. They feel better after taking the pill because they think that they are being given real medication.

Furthermore, if the principles of homeopath were true it would violate all the existing theories of science that we make use of today; not just our theory of medicine, but also chemistry, biology and physics.

Then the revision went through political review. During this process, according to The Guardian, Prince Charles’ charity for promoting CAM got involved.  

On 29 December, a letter was sent from the foundation to the department expressing strong feelings about a draft document. “It was just a bit horrifying as it was not only anti-complementary medicine and patients who might use it but clearly drawn up by someone who had no knowledge of this field and was largely factually incorrect,” said the letter.

The above criticism of homeopathy disappeared from the final draft. More evidence of meddling reported by David and reproduced by The Guardian:

The documents reveal subsequent changes to Mattin’s draft by DH officials. The draft stated: “A House of Commons science and technology report said that homeopathic remedies perform no better than placebos and that the principles on which homeopathy is based are ‘scientifically implausible’.”

That critique disappeared. A comment in the margin, apparently from somebody in the department, says: “Can we remove this statement? This report is really quite contentious and we may well be subject to quite a lot of challenge from the homeopathic community if published.”

That is smoking gun evidence of politics trumping science and evidence, and the concerns of the public. The NHS was more worried about the homeopathy community than the public they were entrusted to accurately inform.

The current page on homeopathy is a neutral and worthless bag of evasion. It contains many of the typical weasel phrases like, “practitioners believe,” “the central principle,” and “homeopathy is based on a series of ideas.” The word “evidence” is not even used until the very end, and then only to provide links to pro and con external sites. The page itself makes no comment about the evidence or the science of homeopathy.

In other words – it completely fails to honestly and accurately inform the public about the fact that the evidence overwhelming indicates that homeopathy does not work, and that homeopathy violates numerous basic laws of science.

This, of course, is not the first or only case of misguided political correctness trumping science and honesty, but it is, perhaps, the best documented case. Thanks to David Colquhoun for bringing it to light.

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