What follows is mostly from the press release for the report of the Science and Technology Select Committee’s report on homeopathy.
Comments on their hearings can be found in Comedy gold in parliament and tragedy from Prince of Wales: editorial in British Medical Journal (Although published before Christmas, the comments on this editorial are still going strong in the BMJ).
It seems that the attempts of the British Homeopathic Association to misrepresent the evidence (as documented by Martin Robbins in the Guardian) were not sufficient to fool the MPs.
Committee chairman. Phil; Willis, said
"We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not."
The NHS As well as recommending, as expected, that NHS funding of homeopathy should end. the report also recommends that no more money should be spent on clinical trials of homeoapthy. The evidence is in and it doesn’t work
The MHRA The Medicines and Health Regulatory Authority (the MHRA) came in for strong criticism when it allowed registering of homeopathic products, and allowed highly misleading labelling of them (see for example, The MHRA breaks its founding principle: it is an intellectual disgrace, and The MHRA loses the plot, and Learned Societies speak out against CAM, and the MHRA). During the committee’s hearings, the CEO of the MHRA, Kent Woods, seemed to say that the labelling of Arnica 30C had been tested to ensure that it did not mislead the public. However evidence subsequently submitted by the MHRA showed that this was not the case. This, rightly. elicited strong criticism in the report
"The MHRA’s user-testing of the label for Arnica Montana 30C—the only product currently licensed under the NRS—was poorly designed, with some parts of the test little more than a superficial comprehension test of the label and other parts actively misleading participants to believe that the product contains an active ingredient.”
With scientific papers it is not acceptable to cut and paste the press release, but for a report of this sort, it summarises the main points succinctly.
The summary of the report
In a report published today, the Science and Technology Committee concludes that the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.
The Committee carried out an evidence check to test if the Government’s policies on homeopathy were based on sound evidence. The Committee found a mismatch between the evidence and policy. While the Government acknowledges there is no evidence that homeopathy works beyond the placebo effect (where a patient gets better because of their belief in the treatment), it does not intend to change or review its policies on NHS funding of homeopathy.
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.
The Committee concluded—given that the existing scientific literature showed no good evidence of efficacy—that further clinical trials of homeopathy could not be justified.
In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice—which the Government claims is very important—as it means patients do not have all the information needed to make choice meaningful.
Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.
The report also examines the MHRA licensing regime for homeopathic products. The Committee is particularly concerned over the introduction of the National Rules Scheme (NRS) in 2006, as it allows medical indications on the basis of study reports, literature and homeopathic provings and not on the basis of randomised controlled trials (RCTs) – the normal requirement for medicines that make medical claims.
The MHRA’s user-testing of the label for Arnica Montana 30C—the only product currently licensed under the NRS—was poorly designed, with some parts of the test little more than a superficial comprehension test of the label and other parts actively misleading participants to believe that the product contains an active ingredient.
The product labelling for homeopathic products under all current licensing schemes fails to inform the public that homeopathic products are sugar pills containing no active ingredients. The licensing regimes and deficient labelling lend a spurious medical legitimacy to homeopathic products.
The Chairman of the Committee, Phil Willis MP, said:
“This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not.
“It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is ‘evidence’ enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government’s response to our report with interest.”
A lot of people gave written about the SciTech report. The report of the Parliamentary Select Committee appeared. Evidence check homeopathy damned the policy of both the Department of Health and of the MHRA. The main job, apart from a few talk shows, was a visit to the BBC News Channel for an interview about it. Here it is. The comment about Chanel Number 5 seemed to go down well on Twitter.
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