‘His position’ in the title would be that of the Government’s Chief Scientific Adviser. But, as we know, the scientific illiteracy that prevails in the House of Commons is legendary. And, regardless of their Chief Scientific Adviser’s position, the UK Government have published their response [pdf file] to the Commons Science and Technology Committee’s Report, Evidence Check on Homeopathy.
Here are the main paragraphs
4. The Department sets out policy guidance and recommendations, and asks that the local NHS implements that policy in the way that is most appropriate for their local communities. Primary Care Trusts are responsible for commissioning high quality services, within allocated resources, to meet local patient needs.
5. Given the geographical, socioeconomic and cultural diversity in England, that involves a whole range of considerations including, but not limited to, efficacy. Given the pressure on the NHS in the current economic climate, we are currently looking, as part of the Quality, Innovation, Productivity and Prevention agenda, at what more we could do in terms of providing information that would help support commissioning decisions.
6. The Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department of Health, is responsible for the regulation of medicines (including homeopathic products) and medical devices. The medicines regulatory framework is largely set at a European level. European Union legislation includes specific provisions and definitions concerning the regulation of homeopathic products. The UK, like any other EU Member State, must comply with requirements set out in European Directives.
7. Most importantly perhaps, the relationship between a clinician and a patient is one that is built on trust and understanding. Clinicians are bound by a strong moral code but also by the guidance from the General Medical Council – rather than by instructions from the Department. We believe in patients being able to make informed choices about their treatments, and in a clinician being able to prescribe the treatment they feel most appropriate in particular circumstances, within the regulatory and guidance frameworks by which they are bound.
8. We agree with many of the Committee’s conclusions and recommendations. However, our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians, rather than Whitehall, are best placed to make decisions on what treatment is appropriate for their patients – including complementary or alternative treatments such as homeopathy – and provide accordingly for those treatments.
9. The Government Chief Scientific Adviser has discussed the Department of Health policy on homeopathy with lead officials, and understands the reasons for the policy decision. However, he still has concerns about how this policy is communicated to the public. There naturally will be an assumption that if the NHS is offering homeopathic treatments then they will be efficacious, whereas the overriding reason for NHS provision is that homeopathy is available to provide patient choice.
10. In order for the public to make informed choices, it is therefore vitally important that the scientific evidence base for homeopathy is clearly explained and available. He will therefore engage further with the Department of Health to ensure communication to the public is addressed. His position remains that the evidence of efficacy and the scientific basis of homeopathy is highly questionable. [added emphasis]
As Martin Robbins points out in the Guardian
The report accepts that there’s no evidence that homeopathy works, but apparently this shouldn’t be a barrier to it being distributed via the NHS because not handing out medicines that don’t work might infringe the freedom of patients to choose things that don’t work. What makes this even more absurd is that they concede that:
“In order for the public to make informed choices, it is therefore vitally important that the scientific evidence base for homeopathy is clearly explained and available. He [the government’s chief scientific adviser] will therefore engage further with the Department of Health to ensure communication to the public is addressed.”
So the government is planning to launch a public information campaign against homeopathic treatments at the same time as it continues to fund those treatments through the NHS. In this glorious mess of a policy the government has come up with something so brain-meltingly stupid that even the satirical brain of Armando Iannucci (The Thick of It, In the Loop) would struggle to match it.
And as Martin Robbins also goes on to point out, both the Conservatives and the Liberal Democrats had declared their positions on the provision of non-evidence-based medicine on the NHS prior to the General Election.
Before the election I put questions on science policy to all the main parties on behalf of the Guardian. The Conservatives told me that it would be “wholly irresponsible to spend public money on treatments that have no evidence to support their claims”. The Liberal Democrats stated that they would actively seek a full review of complementary and alternative therapies and that, “[if] Nice’s advice was that the treatment did not perform better than placebo, then of course it should not be supported by the NHS.”
Both parties made a commitment to evidence-based medicine on the NHS. Both parties have performed screeching U-turns on the subject at the first hurdle, ignoring pledges made in writing only three months ago.
What should they do now? As a near namesake of mine once said, I’d make a suggestion, but they wouldn’t listen. No one ever does. It’s all very depressing.