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| Homeopathy: MPs on science and technology committee grill experts The House of Commons Science and Technology Committee has called in homeopaths and scientists to discuss evidence for the alternative therapyThe meeting has now concluded. Read what happened below8.32am: It would be nice to think ministers made policy decisions on the basis of sound scientific evidence, but the government isn't renowned for listening to expert advice it doesn't agree with. Nor does it have a great track record on collecting proper evidence.The Commons Science and Technology Committee has decided to investigate the scientific evidence that underpins the government's existing policies. Today they are looking into homeopathy. They have taken written evidence already, and received the inevitable admission from the Department of Health that the regulation of homeopathy has no scientific basis.Now it's time to hear the oral evidence and this morning's session could be a corker. Between 9.30am and 11.30am the committee will quiz alternative therapists, scientists and doctors to find out what they all make of homeopathy. The government funds several NHS homeopathy hospitals, which have spent around £12m on homeopathic treatments over the past three years.You can watch the webcast session in full here.Below is a list of today's cast of players. Let us know what you make of it all.9.30am Professor Jayne Lawrence, chief scientific adviser, Royal Pharmaceutical Society of Great BritainRobert Wilson, chairman of the British Association of HomeopathicManufacturers, and Nelsons, a homeopathy companyPaul Bennett, professional standards director, Boots the chemistTracey Brown, managing director, Sense About ScienceDr Ben Goldacre, journalist, The Guardian10.30am Dr Peter Fisher, director of research, Royal London Homeopathic HospitalProfessor Edzard Ernst, director, Complementary Medicine Group, Peninsula Medical SchoolDr James Thallon, medical director, NHS West KentDr Robert Mathie, research development adviser, British HomeopathicAssociation9.07am: The session is due to kick off at half past the hour. We should be in for an interesting discussion today. A few of these folks have taken pot shots at each other in the past. We've got Paul Bennett from Boots, the high street chemist, which was slated by Edzard Ernst for pushing homeopathic remedies. Here's a quote from a recent Guardian piece:The population at large trusts Boots more than any other pharmacy, but when you look behind the smokescreen, when it comes to alternative medicines, that trust is not justified. You can buy a lot of rubbish, with covert advertising stating things that are overtly wrong. People are spending their money on stuff that doesn't work ... Boots seems to be fast becoming the biggest seller of quack remedies in UK high streets.9.12am: Ben Goldacre's also giving evidence, at the same time as Robert Wilson, who runs a homeopathic medicines company. I hope the committee finds out how much money is made selling homeopathy. It'd be an interesting figure to have. The NHS has spent £12m in three years on it. That's an awful lot of water.9.14am: James Thallon – who's giving evidence in the second session (from 10.30am) – recently cut his PCT's [primary care trust's] funding for homeopathy, stating that the money was better spent on drugs that, erm, worked a bit better.9.16am: Robert Mathie of the British Homeopathic Association added a plug for the BHA on the NHS homeopathy page. He urged anyone who was likely to buy homeopathic substancecs to go to the BHA for advice first.9.18am: You can watch the evidence session here and here.9.23am: It's fair to say that, by and large, the science committee aren't the greatest fans of homeopathy. They piled into Professor John Beddington, the chief scientist, earlier this year for defending the government's stance on homeopathy.9.28am: Robert Wilson is also on the board of the European Coalition on Homeopathic and Anthroposophic Medicinal Products. Yes, anthroposophic medicinal products. According to the ever-reliable oracle that is Wikipedia, anthroposophical medicine is salutogenetic. Marvellous. I've not seen so many big words since graduating.9.31am: Fingers crossed this won't degrade into mumbo jumbo and name calling. I'll be interested to hear if any of the homeopaths embrace the idea that the value of their service is to optimise the placebo effect.9.35am: It'll be interesting to see how many Tories show up. Usually only one or two arrive for the science and tech committee. Mostly it's Lib Dems and Lab. Looks like a full house.9.35am: Phil Willis is kicking things off. Looking to see "whether there is evidence to support government policy."9.37am: First off – question to Paul Bennett: "You sell them. Do they work?"Paul: "There's consumer demand."I have no evidence to suggest they are efficacious."Great opening."It's about consumer choice and a large number of our consumers think they are efficacious."9.38am: Robert Wilson says it's an old business and popular in France. Phil Willis: "So is prostitution."9.40am: Wilson says he believes homeopathy works beyond the placebo effect.Wilson's comment: "If they didn't work beyond the placebo effect, why do people keep buying them?"Willis: "That wasn't a serious comment was it?!"Willis quizzing Wilson - if you have evidence that it works, why don't you give it to Boots. Boots just admitted they have no evidence that the stuff works.9.40am: Next, Jayne Lawrence: "We've reviewed all the scientific evidence and we don't think there's any evidence for them working."9.41am: "There's no scientific basis for their being effective," says Lawrence9.42am: Next, Ben Goldacre: "Placebo effect is very powerful."I've never seen that man wearing a tie before. Never.9.43am: Goldacre: Thinks homeopathy "culturally" harmful. Undermines credibility of MHRA [Medicines and Healthcare products Regulatory Agency], pharmacists etc.9.43am: Goldacre: "I don't believe sugar pills are physically harmful to people."Tracey Brown is talking about people taking sugar pills and thinking they're getting good treatment when they're not.9.45am: Willis asks "should we sell nothing if it's got no scientific evidence?"Good to see some balance.Brown: "When it has official endorsement, such as a licence, then we have a problem."Our drugs regulator, the MHRA, licenses homeopathic medicines.9.47am: Wilson: The homeopathic community is extremely pro-research.9.52am: Evan Harris, LibDem MP, comes in:"Is the best way to consider the evidence for homeopathy to consider systematic reviews?"Robert Wilson criticises studies in general.Harris gives up on that line. Harris asks Bennett if he has any qualms about selling products that don't have any benefit.Paul Bennett: "At the root of this, is [that] there are regulated products that are safe. It's important we can support our consumers who believe they are efficacious. To deny someone access ... would be wrong to do."9.53am: Harris is pushing Bennett on the ethics of selling treatments that are ineffective beyond placebo.Bennet (Boots): "Our key requirement here is for greater clinical evidence."9.54am: Bennett says homeopathic substances contain the disclaimer: "without approved therapeutic indications"9.56am: Paul Bennett (Boots): "We rely very heavily on the regulatory process to indicate which products are approved and safe for sale."9.59am: Robert Wilson (Nelsons homeopathic products) says the European market for homeopathy is £1.5bn. Iddon: "Why should the MHRA have an interest in supporting the homeopathy industry?"Brown (Sense about Science): EC directive allows nations to bring in their own rules.10.03am: Brian Iddon MP inquiring about the options government could have taken to regulate homeopathy, given the relevant EC directive.To Wilson: National rules scheme for homeopathy developed by MHRA. Iddon asks, has it helped your product list expand?Wilson: it took nearly two years to get one product approved by the national rules scheme.10.06am: Phil Willis to Ben:A lot of homeopathic medicine is prescribed in France and they "aren't dying in their droves". Why should we worry.Ben G: "The MHRA endorsing them is extremely problematic.""This is a £1.5bn industry that is able to influence the regulator.""Sugar pills are being treated ceremonially.""I don't think Wilson could tell the difference between one of his arnica pills and one of his arsenic pills."10.11am: Jayne Lawrence (Royal Pharmaceutical Society): "We'd contest it's better for pharmacists to be present when consumers buy homeopathic substances – and consumers should know there's no evidence that they are effective (beyond placebo)."Q: "How can you ensure that pharmacies are keeping to your ethics code?"Jayne Lawrence: There's an inspectorate that goes out and checks. So far no warnings issued through that route. One complaint mentioned that came in from the public.10.16am: The discussion has turned to whether pharmacists are being trained properly to sell homeopathic treatments. Brown raises the point that homeopathic anti-malarial prophylactic substances are being sold on the high street without scientific evidence.Goldacre: "If you ask a pharmacist, including those at Boots, you'll get a reply that is not in keeping with the evidence."He suggests that pharmacists are recommending homeopathic treatment without making it clear there are no active ingredients.10.25am: Robert Wilson: "There are a great deal of things within orthodox medicine that people don't understand." Just because you don't understand the mechanism doesn't mean you don't use them.Wilson: "Anyone can make an arnica pill. My business for arnica if £5m in this country." Asks, who is going to pay for the research into homeopathy? MP's Q: Can you categorically say it doesn't work?Bennett: "I could not categorically say it does not work."Brown: "The placebo effect is very powerful. People do heal. You would expect to see people benefit from taking a placebo."Goldacre: "There's no evidence homeopathy pills are better than placebo. It's not worth doing more placebo trials, because it would be good money after bad."Jayne Lawrence: It doesn't work beyond placebo. Wilson: One of our best sellers are teething granules for babies. [He's saying babies don't experience the placebo effect.]10.31am: MPs Q: How do you determine between a good homeopath and a bad homeopath?Brown: "Anybody offering medical advice needs to have medical training."MP talking about Niels Bohr and Max Planck [quantum mechanics]. He's asking if [homeopathy] is the same thing - a weird quirk of physics. That's hilarious. Quantum theory came about between 1910 and 1925 and works well enough to make iPhones and so on. Nonsense.10.33am: Robert Wilson: "We just haven't yet understood these highly dilute substances."He's comparing homeopathy to the idea of personalised genetic treatments. Interesting. Flawed, but interesting.10.35am: Evan Harris MP: Asking what Wilson's scientific qualifications are.Wilson: "What interests me are arguments in conventional medicine that resonate with homeopathy. I have none other [qualifications] than an interest.""We need to have more research into homeopathy, research that can stand up to some of the criticisms that it faces."10.47am: Next session up:MP: Is there any evidence that they work?Peter Fisher (Royal London Homeopathic Hospital) "It is quite clear there's evidence." He can't believe some of the things he's heard this morning. Graham Stringer MP: Should treatments offered be based on effectiveness and efficacy?Mathie: "Efficacy is judged in placebo-controlled trials ... it's specific, in terms of drug, dose and schedule. Efficacy is almost a laboratory experiment to see if a drug can have an effect." Peter Fisher (London homeopathic hospital) – yes, treatments should be offered on the basis of efficacy and effectiveness. MP's Question: What is the tolerance for homeopathic medicine?Fisher: We do find a slightly increased level of adverse events in the active arm vs placebo. So he's saying you get more side effects when you give people homeopathic treatments. That's an intriguing one. If homeopathic medicines have nowt in them you wouldn't get side effects. That's why you don't need to test them properly before selling them.Ernst: We looked at all the clinical trials and counted these kinds of side effects. We found no statistical difference. The story of homeopathic aggravations may well be a myth.10.51am: MP: Should the NHS prescribe placebos?James Thallon: If you prescribe a drug that you know has no efficacy, I personally think that's unethical. James Mathie: There are a substantial number of homeopathic medicines that contain some molecules and they're effective beyond placebo. They're not all just sugar pills.Ernst: "If you do it well, an active treament will also trigger a placebo effect."Point being that efficacious medicines have an active component, but also trigger the placebo effect."It is unethical"... the NHS should not be spending money on it.10.53am: Peter Fisher: "I believe I'm the only person called today who practises homeopathy. I practise it because I think it works.""I would not use homeopathy for two minutes if I only thought it was a placebo."10.55am: Peter Fisher argues that basic science is starting to show evidence for homeopathy. Should the money spent on homeopathy be redirected?Fisher thinks you get better results for less money with homeopathy.Ernst: Treatments have to be evidence-based and homeopathy isn't.11.06am: Evan Harris MP: How many substances have been withdrawn on the basis of adverse effects, in 200 years of homeopathy?Peter Fisher: None.Ernst: "I have supplied a list of systematic reviews of homeopathy. There are two dozen. None in that list were positive."James Thallon cut funding of homeopathy in favour of more effective treatments. He's being asked whether other trusts should follow suit. He says he'd be happy to help them do so.11.09am: Evan Harris: "Why do you think the Department of Health is not dealing with this issue?Thallon: "Homeopathy goes beyond the debate about science. There's something that perpetuates the notion that it is important that goes beyond the scientific debate."Harris questioning Peter Fisher on homeopathy.Peter Fisher submitted evidence on how homeopathy works.Why has there been no Nobel prize awarded to the people who've done this work?"Fisher: "It may yet happen.""People say it challenges the laws of physics, it doesn't."I bet everything I will ever own in my life that no one ever receives a Nobel prize for work on homeopathy.11.11am: Peter Fisher: "You use highly purified water and highly purified ethanol. It's not even got sugar in at that stage."He's talking about how homeopathic treatments are made.You shake the water. That helps it "remember" what substance is in it.Harris: "I'd have thought shaking it would make it more likely to forget."Fisher: "You have to vigorously shake it. You can't stir it."This is hilarious. Grown men talking about shaking water to turn it into a medicine.Come on.11.12am: Harris: "Does the MHRA check how much your water's been shaken?"Fisher: You'll have to ask them.This, in the 21st century. Does our medicines regulator check how much water has been shaken before it can be sold as a medicine? How on Earth is this happening. It's Dark Ages stuff.11.20am: James Thallon: Clinical effectiveness should be an "organising principle" for the NHS.Agrees there should be an element of choice about what people spend their money on. Brian Iddon MP: "What if you think you're putting a patient at risk if their condition is serious? Would you refer to a conventional doctor?"Ernst: "There are responsible homeopaths who try their best to look after patients, and others that are less well equipped to do that. There are too many different types of homeopath to generalise."Are homeopaths well enough trained to recognise a serious ailment?Peter Fisher: "We only admit registered physicians and they're well equipped. They are equipped and they would refer on if required."Harris: "You say, you should not give homeopathic antimalarials. Have you asked manufacturers not to make them?"Mathie: "Not explicitly."Harris: "Is there a role of homeopathy in treating AIDS?"Fisher: "I'd never claim to cure it."11.22am: And there we have it.Boots sells homeopathy despite having no evidence that it works, the homeopaths want more research and think Nobel prizes await because it overturns accepted science, and the scientists themselves think there's no evidence of it working whatsoever. A £1.5bn industry nonetheless. Extraordinary.DrugsChemistryMedical researchPseudoscienceHouse of CommonsIan Sampleguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
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