Thursday, 4 March 2010

Letter to Celia re: EDM 908

David Tredinnick MP, he of the appeal to fund research into Medical Astrology (I shit you not) has created Early Day Motion 908 in which he calls on MPs to offer their support for homeopathy against the recent parliamentary select committee report that called for its withdrawal.
My MP signed it, so I wrote her a little letter. I encourage you to do similar if your MP's name should appear on the list.

Dear Ms Barlow MP,
I am writing to express my disappointment that you have signed this early day motion in support of homeopathy.

I believe a quick dissection of the EDM is in order.

EDM: That this House expresses concern at the conclusions of the Science and Technology Committee's Report, Evidence Check on Homeopathy; notes that the Committee took only oral evidence from a limited number of witnesses, including known critics of homeopathy Tracy Brown, the Managing Director of Sense About Science, and journalist Dr Ben Goldacre, who have no expertise in the subject;

Response: This is untrue. Ben Goldacre is a medical doctor who works for the NHS and is fully conversant with what is required for medicines to be considered effective, and Tracy Brown heads the Sense About Science organisation and has considerable knowledge of the legislation in this area and the science surrounding the issue. It should be noted that one does not need to be an expert in the behaviour of fairies to know that fairies do not exist; the absence of evidence for fairies should be enough. Additionally, evidence was heard from many other parties including representatives of pro-homeopathy groups such as the head of the Royal Homeopathic Hospital, and a representative from the association of homeopathic manufacturers, all of  whom failed to offer any credible evidence. The Society of Homeopaths were not asked to give verbal evidence because the written report they submitted did not contain any written evidence, merely an appeal that homeopathy should not be subject to the same evidential criteria as conventional medicine. Additionally professor Edzard Ernst, formerly a practitioner of homeopathic "medicine" and a current professor of complementary medicine, presented his evidence that demonstrates conclusively that homeopathy has no effect beyond the placebo.

EDM: believes that evidence should have been heard from primary care trusts that commission homeopathy, doctors who use it in a primary care setting, and other relevant organisations, such as the Society of Homeopaths, to provide balance;

Response: Evidence was taken from the only PCT to have investigated this area. West Kent determined that there was little or no evidence to support its funding and has therefore withdrawn it. Additionally, anecdotal evidence from anyone, including doctors, is no substitute for properly controlled trials which the homeopaths have completely failed to produce. Even ten-thousand people claiming to have cured people with it would be insufficient. "The plural of anecdote is not data."

EDM: observes that the Committee did not consider evidence from abroad from countries such as France and Germany, where provision of homeopathy is far more widespread than in the UK, or from India, where it is part of the health service;

Response: that France, Germany and India have failed to adequately investigate the evidence for homeopathy, or failed to act appropriately on said evidence is neither here nor there. If genuine evidence was available from any country, the homeopaths surely would have provided it in their written submissions?

EDM: regrets that the Committee ignored the 74 randomised controlled trials comparing homeopathy with placebo, of which 63 showed homeopathic treatments were effective, and that the Committee recommends no further research;

Response: This is quite simply untrue. Meta analysis and systematic review of ALL of the studies available were considered. The data shows that studies that are methodologically flawed (improperly blinded or randomised etc.) do tend to show some effect for homeopathy, but those that are properly controlled show none beyond the placebo. There is a clear correlation between properly methodologically conducted trials and the inefficacy of homeopathy. Given the extent of the evidence against it, further research in this area would be a waste of public money.

EDM: further notes that 206 hon. Members signed Early Day Motion No. 1240 in support of NHS homeopathic hospitals in Session 2006-07;

Response: That 206 MPs were hoodwinked 4 years ago, before the evidence was presented, should have no bearing here.

EDM: and calls on the Government to maintain its policy of allowing decision-making on individual clinical interventions, including homeopathy, to remain in the hands of local NHS service providers and practitioners who are best placed to know their community's needs.

Response: The evidence is in; homeopathy does not work, it's continued provision must be viewed as either ignorance or deception. Local NHS services should not need to conduct these investigations themselves at further cost to the nation. It is high time this quackery was removed from the NHS list of services, if not banned altogether. Much is made of patient "Choice" on the NHS, however an uninformed choice is no choice at all. In order to provide adequate choice, patients must be informed of the inefficacy of homeopathy before they are offered it. Since homeopathy "works" by placebo only, this would negate any point providing such a service. Either homeopathy works (it doesn't) or it can be knowingly provided as a placebo, thus lying to patients, or it should be removed. Homeopaths are steeped in pseudo-science and unproven principles (like-cures-like, dilution and succussion increases potency, etc.) and are therefore inadequately equipped to deliver evidence-based medical care. If placebo treatments must be offered on the NHS for certain conditions that do not respond well to conventional treatments, and in opposition to the principle of informed choice, they should at least be done so knowingly by persons medically trained. This would at least ensure that conditions requiring genuine medical care do not go untreated. It would also allow the placebos to be prescribed in a way that does not give undue credibility to unsatisfactorily regulated quacks who discourage patients from seeking genuine medical care when it is required, as many homeopaths have been shown to do. Of course most persons medically trained would view it as a violation of their ethics to practice the deception required prescribe placebos to their patients. Some doctors it seems, while unable to prescribe placebo themselves, are happy to refer patients to homeopaths who will unwittingly do their dirty work for them. In my opinion this should not be allowed to continue.

It should also be noted that the proposer of the EDM, David Tredinnick, recently expressed his opinion in the house that funding should be given to "medical astrology". If that wasn't enough to ring alarm-bells about his ability to form cogent opinions on the topic of medicine, I don't know what is. In my opinion it ought to be enough to have him removed from his position on grounds of insanity.

I call on you to withdraw your support for this motion. If the brief summary I have given here is insufficient to convince you, I am happy elaborate further. I would recommend reading "Trick or Treatment" by professor Edzard Ernst and Simon Singh. Dr Singh will be speaking in Brighton on July 11th at a meeting of the local "Skeptics in the Pub" group on the topic of alternative medicine. This event is sold out, but if you wish to attend please let me know and I will arrange it.

Yours Sincerely,
Mr T. McGregor BSc (hons) CEng MBCS CITP

P.S. on previous occasions I have written asking you to give your support to early day motions and you have indicated that were unable to do so due to your role in government. I assume this situation has now changed?