On Friday 25 August 2006, Michael Baum and I went to visit the rather palatial headquarters of the UCL Hospitals Trust (that is part of the NHS, not of UCL). We went to see David Fish, who was, at that time, in charge of specialist hospitals. That included world-leading hospitals like the National Hospital Queen Square, and Great Ormond Street children’s hospital. It also includes that great national embarrassment, the Royal London Homeopathic Hospital (RLHH).
It came as something of a surprise that the man in charge did not know the barmy postulates of homeopathy and he looked appropriately embarrassed when we told him.
Michael Baum is not only a cancer surgeon. but he has also taken the lead in thinking about palliative and spiritual needs of patients who suffer from cancer. Listen to his Samuel gee lecture: it is awe-inspiring. It is available in video, Concepts of Holism in Orthodox and Alternative Medicine.
The problem for UCLH Trust is that the RLHH has royal patronage One can imagine the frantic green-ink letters that would emanate form the Quacktitioner Royal, if it were to be shut down. Instead, we suggested that the name of the RLHH should be changed. Perhaps something like Hospital for palliative and supportive care? Well, four years later it has been changed, but the outcome is not at all satisfactory. From September it is to be known as the Royal London Hospital for Integrated Medicine.
What’s wrong with that? You have to ask what is to be "integrated" with what?. In practice it usually means integrating things that don’t work with things that do. So not much advance there. In fact the weasel word "integrated" is just the latest in a series of euphemisms for quackery. First it was ‘alternative’ medicine. But that sounds a bit ‘new age’ (it is), so then it was rebranded ‘complementary medicine’. That sounds a bit more respectable. Now it is often "integrated medicine" (in the USA, "integrative"). That makes it sound as though it is already accepted. It is intended to deceive. See, for example, Prince of Wales Foundation for magic medicine: spin on the meaning of ‘integrated’, and What ‘holistic’ really means.
Of course the amount of homeopathy practised at the RLHH has fallen considerably over the last few years. Already by 2007 there were signs of panic among homeopaths, They are beginning to realise that the game is up. Some of the gaps were filled with other sorts of unproven and disproved medicine.
What the hospital is called matters less than what they do, The current activities can be seen on the UCLH web site.
- Allergy Environmental and Nutritional Medicine
- Autogenics Training
- Children’s Clinic
- Complementary Cancer Care Programme
- Education services
- Musculoskeletal Medicine Clinic
- Pharmacy Services
- Skin Services
- Stress and Mood Disorders Clinic
- The Marigold Clinic – Homeopathic Podiatry and Chiropody
- Womens Clinic
It would be tedious to go through all of them, but here are some samples.
The Children’s Clinic
"The mainstay of treatments offered include Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture. We also assess nutritional status, provide dietary advice and supplementation. Psychotherapeutic techniques including Neuro-Linguistic Programming (NLP), and Visualisation are sometimes used where indicated, to gain better understanding of the presenting problems".
So a wide range of woo there. And they claim to be able to treat some potentially serious problems
"What can be treated
A wide variety of clinical conditions are being treated including:
- Recurrent infections
- Skin diseases such as eczema
- Allergic disorders including asthma
- Food intolerances and eating disorders
- Functional developmental and learning problems
- Behavioural disorders including ADHD (hyperactivity) and autism."
There is, of course, no evidence worth mentioning thar any of these conditions can be treated effectively by “Homeopathy, Herbal remedies, Flower essences, Essential oils, Tissue salts and Acupuncture”.
They describe their success rate thus:
An internal audit questionnaire showed that 70% of children responded well to homeopathic treatment
So, no published data, and no control group. This is insulting to any patient with half a brain.
These claims should be referred to the Advertising Standards Authority and/or Trading standards. They are almost certainly illegal under the Consumer Protection Regulations (May 2008). The UCLH Trust should be ashamed of itself.
Education Services offers mainly courses in homeopathy, the medicines that contain no medicine,
Pharmacy Services stock thousands of bottles of pills, most of which are identical sugar pills. It’s hard to imagine a greater waste of money.
The Marigold Clinic – Homeopathic Podiatry and Chiropody
I was rather surprised to find this is still running. In 2006, I wrote about it in Conflicts of interest at the Homeopathic Hospital. It turned out that the prescription costs if the clinic were spent on Marigold paste, made by a company owned by the people who run the clinic. UCLH claimed that they were aware of this conflict of interest, but had no obligation to make it public. That is an odd ethics in itself. Even odder when I discovered that the Trust had been notified of the conflict of interest only after I’d started to ask questions.
The same people are still running the clinic. They may well be good chiropodists, If so why surround the service with woo. There are, almost needless to say, no good trials of the efficacy of marigold paste (and it isn’t homeopathic).
At the moment, it appears that the renaming of the RLHH is empty re-branding. No doubt UCLH Trust see homeopathy as something that brings shame on a modern medical service. But to remove the name while retaining the nonsense is simply dishonest. Let’s hope that the name change will be followed by real changes in the sort of medicine practised, Changes to real medicine, one hopes.
Other blogs on this topic
Gimpyblog was first, with Farewell to the RLHH, hello to the RLHIM
Quackometer posted An Obituary: Royal London Homeopathic Hospital, 1849-2010
Excuse me if I don’t hold my breath!
I find it all quite brilliant.
Homeopathy -> Alternative -> Complementary -> Integrated
A simple change of words and public concerns about the behaviour of these nuts gets alleviated. The Woo certainly seems to be working on their businesses:) Maybe that’s the best evidence that it does work?
Brilliant and depressing.
I had previously be somewhat ambivalent about the Royal Family. Seemed to do no harm, bring in loads of tourists, on balance probably reduces my taxes a bit so why not?
Since, thanks to an interest piqued by the patently disgraceful reaction of the BCA to Simon Singhs criticisms, I have recently found out what many of these pseudo medical practices actually are and I have discovered that the Prince of Wales seems to be promoting these practices strongly and uncritically I am changing my mind.
Vive La Republique!
But we’re all vulnerable to the pedantic-semantic phenomenon. In order to acknowledge that many people say homoeopathy works for them, even those of us who think homoeopathy is self-evidently stupid are forced to distinguish between ‘effectiveness’ and ‘efficacy’.
I am not ‘forced’ in this way.
I know that homœpathy is self-evidently stupid, to an alarming extent, yet I do not find myself getting my knickers in a twist over petty pedantic distinctions.
If anything, I am ‘forced’ to distinguish between reality & fantasy at most.
Or, to be less pedantic: Truth & Fraud.
Essentially “effectiveness” is what you get if you don’t bother with a control group. So the distinction is real enough but “effectiveness” is a very misleading way to describe what may well be placebo effects and regression to the mean.
There is no such thing as “Integrated” medicine. If the various techniques and substances of alternative therapies had any merit, then they would not be seen as a separate entity – just part of “medicine’, and would have been absorbed into the orthodoxy around the world. Even China has failed, despite its best attempts, to integrate traditional folk medicine with its mainstream western medicine. As modern Chinese turn away from old superstitions, traditional treatments remain as a bolt-on palliative to relieve pressure on the growing western-style healthcare sector.
Re-branding the RLHH as a a hospital for “Integrated Medicine” is a cynical marketing ploy to try to suggest that the services offered are part of a consistent system of thinking or rationale. They are not – more like a hodge-podge of different ideas and interventions that have little basis in proven consistent efficacy. The only thing they have in common is that they are all incommensurable with empirical medicine. They are so ontologically diverse that use of the term “integrated” is meaningless.
Meaningless marketing-babble enables consumerism to replace rational and objective decision-making. The post-modern thesis is that many social forces – decline of authority, feminism, the social green movements, crowd-sourcing etc have jointly created a perception that satisfying individual choice is the touchstone of a modern society. In the 60s, the “Mad Men” confined their attentions to capitalist markets. And of course private individuals are free to waste their money on whatever junk they like, – the marketing men don’t care so long as it sells. But in the last two decades, this concept was increasingly applied to the state-sector – first some Conservatives, then New Labour saw consumerism as a way to avoid either a patrician or Orwellian government.
Throughout all arms of government, education, social legislation, NHS, policing, even the BBC, rational approaches aimed at tangible objectives have been eroded. The socially irresponsible approach of our planners and strategists has drifted towards spending money on what people demand, not what society needs. The “bread & circuses” approach is to be seen to be giving individuals a choice, even if their choice has been formed by the vagaries of fashion, groupthink, emotional bias and preconceptions. So every scarce NHS pound spent on a homeopathic pill or tuina massage, is a pound that won’t be available for the latest cancer-fighting drugs, or proper nurse staffing levels. The government copped out in a similar way on PCT and MHRA approaches to homeopathy – even though they agreed it had no evidence base – they still allowed it to be part of state provision because of consumer demand. Strange logic, that, which if taken to its logical conclusion would require every doctor to dish out antibiotics or liposuction on demand, whether the patient would benefit from it or not. The bottom line is, the NHS is not the equivalent of a supermarket or fashion house, where people have a ‘right’ to some sort of medical ‘pick n mix’. It’s for clinicians and health-economists charged with getting the best health outcomes from limited budgets to make those assessments based on proven principles, hard logic, and explicit goals.
[…] Read more here. […]
The Royal London Hospital almost certainly did not go through with this name change without Royal (i.e. Prince Charles’) approval. As crown subjects I’m afraid we’ll just have to put up with it since I suspect the establishment, mindful of honours and awards in the offing, will swallow whatever reservations they may have over this. They’ll probably peddle the line that….. “it all may be a little misleading but it doesn’t do any harm, sugar water don’t you know; in fact old chap it may do some good ……placebo effect and all that”.
Behind the scenes it seems that (Guardian, 13 Sept 2010)
‘Pressure from the royal family led government ministers to enforce a blanket ban on the disclosure of Prince Charles’s lobbying campaigns, it has been claimed.’
Sadly Prof DC FRS vs HRH PC will have only one winner I’m afraid.
The RLHH has a Royal Charter.
Surely it can’t just go and change its name? Surely the Privy Council has to be asked – and give permission?
And surely there should be no confusuion with any other similar institution?
Such as the Royal London Hospital. Is that not also a hospital or medicine and do they not integrate their various departments?
Surely the RLHH is not deliberately trying to confuse and mislead patients?
Are there any lawyers who can answer these constitutional issues?
[…] This post was mentioned on Twitter by David Colquhoun and Alan Henness, Alan Henness. Alan Henness said: RT @david_colquhoun: My thoughts http://bit.ly/ayNCNf RT @bhahomeopathy Roy Lond. Homeop/ Hosp is now Roy Lond. Hosp for Integrated Medicine, what do you think? […]
I have outpatient appointments for my daughter with Great Ormond Street in the RLHH building. It annoys me every time. Always tempted to graffiti the lift floor list and change the name to “Magic Water Hospital”.
We were actually late this time as we were looking for this different Hosp For Integrated Medicine as we had received a letter telling us the location of our appointment had changed, which was all very confusing as the location had not, but the name had.
It just worries me that having a ‘hospital’ for homeopathy makes people assume it works. The fact they are claiming to help some really serious illnesses, such as asthma, especially in childhood, actually makes me get quite angry.
Look on the bright side -a lot of the building is now occupied by real medicine Let’s hope that the homeopath’s space is eventually reduced to zero, like the concentration of their medicaments.
[…] patient came to see me having checked the NHS Choices website and discovered that the Royal London Hospital for Integrated Medicine was on Choose and Book for fertility treatement. She was amazed at the range of options that […]
[…] Last year the Royal London Homeopathic Hospital was rebranded as the Royal London Hospital for Integrated Medicine (RLHIM). The exercise seems to have been entirely cosmetic. Sadly, they still practise the same nonsense, as described in Royal London Homeopathic Hospital rebranded. But how different will things be at the Royal London Ho…. […]
[…] to make those assessments based on proven principles, hard logic, and explicit goals. Read more on Internal Audit Questionnaire Related […]
[…] II de beschermvrouwe van wat nu het Royal London Hospital for Integrated Medicine heet, maar nog niet zo lang geleden de naam Royal London Homeopathic Hospital […]
Unfortunately woo is strong in the NHS. I was in a ward in Halton Hospital when I was offered Reiki. Unfortunately, by having woo in main stream hospitals, it provide authenticity to such quackery and pseudoscience. There are two implications that come immediately from this- one is that it is effectively giving the patient false authentication that it is beneficial and may actually give patients both false “cures” and lead them to privately wasting money on this. Secondly, it pulls effort and resources away from tried and scientifically tested treatment. Some of these services are provided and paid for by MacMillan Cancer Support, a charity I have previously supported. However, I was of the opinion that my donations would be supporting MacMillan nurses, not being wasted on such drivel. Under “energy-based therapies” they even admit they are nothing but a comfort blanket: “There is no medical evidence that energy-based therapies will treat symptoms, but you may still find them relaxing and calming.”. I now no longer support them but support more valid cancer research directly.
It’s a pity we haven’t actually got significantly more scientists and medically trained professionals in government and have a policy of a fully scientific rational approach to treatment, at least within the NHS.
Thanks @Alien Traveller
I couldn’t agree more. I too can’t support Macmillan Cancer, because of their support for magic. They refuse to grasp the obvious problem, and that problem seems to stem largely from box-tickers in HR departments. You can get a certificate in magic medicine, but there is no job description for nice people who hold hands and chat to desperate people.
I found this article and comments following a search on the NHS and homeopathy. Well done: I concur with the arguments expressed. My concern is this: does the NHS – including the Royal London Hosp. for Integrated Medicine – still waste money on Homeopathy and other quack treatments, in the light of current funding concerns (crisis?) at the start of 2018?
I have examined the RLHIM website and there is evidence of “complementary” and “alternative” treatments, but they seem to be shy of using the H word. It’s hard to tell how much they are still providing alternative “medicine”, or whether “the homeopath’s space (has) reduced to zero, like the concentration of the medicaments” as you put it. I for one object to paying additioanal taxes for the NHS while it still wastes money on things like this.
I note that this thread is 7 years old, but hope you see it and can share your thoughts now!
Thanks for your comment. Seven years on, homeopathy has almost vanished from the NHS. Prescribing had fallen by 95% and the recent consultation about poor-value treatments will see it vanish altogether.
It’s interesting that this result is largely a success for bloggers and skeptical activists. Successive governments have refused to do anything about it. Official regulators have been equally useless. The BMA and GMC have been no help. Chemists continue to sell the useless pills, while the General Pharmaceutical Council looks on lamely.
The government prevented NICE from looking at the problem of quackery. The only official organisation that did a pretty good job was NHS Choices, That was done despite attempts by the Department of Health to stop them from giving accurate information about homeopathy.