No. If people want to spend their own money on it then that's fine by me (provided that they are told what homeopathy actually is). But the NHS should not pay for it.

why not? According to Channel 4, approx £320m was spent on management consultants in a single year in England alone. I take it that you are quite happy for your money to be wasted this way as long as the evil homeopathic people aren't spending less than 1% of that...seriously?

Millions are wasted on drugs which do not work the way they are supposed to (aspirin), drugs to treat the side effects of other drugs or drugs which are downright dangerous (vioxx, etc), so why not spend a paltry (by comparison) sum on helping patients who cannot be helped elsewhere?

Of course the NHS should continue to pay for homeopathy. Why not??? Homeopathy has been established as a discipline in its own right and has been available on the NHS since it's inception in 1948. Therefore, if critics wish to change this position, appropriate evidence would need to be brought forward.

Badsciencemonk, you have mentioned what has to be one of the best/worst examples of "bad science" ever published by the Lancet! This heavily flawed, hugely biased, poor piece of work is frequently used to prop up weak arguments against homeopathy. It is interesting that you refer to this and ignore the 4 earlier large meta-analyses which were positive, and the very substantial qualitative research which has been done which is also highly positive.

Anyone who thinks the NHS should stop paying for homeopathy will need to present much stronger evidence than the Shang report!

Homeopathy has been shown to be safe, effective and inexpensive and hugely popular with patients, who continue to report significant improvements following homeopathic treatment. Why would anyone wish to deprive such patients of this treatment?

Haven't you explored the rest of this site badsciencemonk??? I am disappointed and surprised.

If you click on "Research" at the top of this page, you will be transported to a very informative section of the website for all the "Disciples of Scientism" out there. There you will find a summary of both the quantitative and qualitative trials done to date in homeopathy.

To save you the energy of such exploration at present however, I am happy to confirm the 4 meta-analyses as Kleijnen et al, 1991 BMJ, Linde et al, 1997 Lancet, Linde et al, 1999 J Clin Epidemiol and Cucherat et al, 2000 Eur J Clin Pharmacol. Before you go away to read up on the criticisms of these papers from your favourite writers, how about keeping your mind open and considering the matter intelligently and sensibly?

You refer to Shang as a "heavily flawed, hugely biased, poor piece of work". Please justify this statement.

The Shang et al meta-analysis of 2005 is widely regarded as a poor piece of work with many flaws.

Firstly, Shang et al were working under the direction of Professor Matthias Egger, well-known for his anti-homeopathy standpoint and heavily biased to start with and certainly biased towards ensuring an anti-homeopathy spin to the results. The bottom line was that they found "weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional medicines". Despite this finding, they managed to twist the conclusion that "this finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects" !

They attempted to compare 110 homeopathy trials with 110 allopathy trials. Overall positive treatment effect was found in both groups. The final analysis was limited to the “best” 8 homeopathy and 6 allopathy trials - (it is interesting that they thought they found more better quality homeopathy trials than allopathy trials !) Thier false conclusion was then of course backed up by the deliberately provocative editorial, "The end of homeopathy”! We hear a lot about "bad science" - I would suggest this is a perfect example of such.

Shang et al's analaysis has also been criticised to be prone to selection bias, in selecting the 8 homeopathy trials and 6 allopathy trials to compare. We know very little if anything about the relevance or value of these trials - 8 trials of homeopathy cannot fairly represent the entire research literature ! Neither can 6 allopathy / conventional trials ! Some key papers are omitted while others were wrongly included. When they eventually did their statistical analysis they found a mean odds ratio of 0.88 for homeopathy trials and 0.58 for conventional medicine trials - hardly a spectacular result either way. In summary - the 2005 Lancet trial was inaccurate, biased, methodologically flawed, unreliable and grossly misleading. Sadly it has been taken up as some sort of magic bullet to rid the NHS of homeopathy. I could go into more detail, but don't really have the inclination to do so.

If you explore this site however, you will find further information regarding the Shang study -

http://www.trusthomeopathy.org/media_centre/news/lancet_paper_flawed.html

Also, the results of the Shang study was questioned and effectively debunked by later analyses published in 2008 by Ludtke et al, and Rutten et al. You can read these papers at -

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T84-4TK2PCH-9&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=69e5e53661e1c311fb7da47b11ddd99b

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WXX-4TPWK20-3&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6fc4fe3201e8947e283dd86a7c58af97

Rutten et al concludes: "Re-analysis of Shang's post-publication data did not support the conclusion that homeopathy is a placebo effect. The conclusion that homeopathy is and that conventional is not a placebo effect was not based on comparative analysis and not justified because of heterogeneity and lack of sensitivity analysis. If we confine ourselves to the predefined hypotheses and the part of the analysis that is indeed comparative, the conclusion should be that quality of homeopathic trials is better than of conventional trials, for all trials (p = 0.03) as well as for smaller trials (p = 0.003)".

I hope this is of some help.

Well gsmyth I have only looked at the first study you mention on Pubmed - Kleijnen et al, 1991 BMJ - but on that the authors clearly state "CONCLUSIONS--At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias" I do not find that a convincing argument of the eficacy of homeopathy.

I will have a look at the others though and will come back to you in due course. I can assure you that I am endeavoring to keep my scepticism in check and am doing my best to avoid "my favourite writers".

Two points: NHS homeopathy costs roughly the budget of a 17 - 18,000 patient General Practice per annum (this is excluding the NHS management costs, district nurses, health visitors and community physios that make up primary care). This is clearly not the source of the NHS funding crisis, is it!

Secondly, lack of evidence is not a problem confined to homeopathy in the NHS. So if we are going to get into this discussion we need to apply the same approach equally and fairly across all areas of healthcare. Yet somehow I can't see anyone arguing over the indiscriminately pooled results of every trial of "drugs" ever conducted, which is what is being done with "homeopathy". All very wierd ...

"Also, the results of the Shang study was questioned and effectively debunked by later analyses published in 2008 by Ludtke et al, and Rutten et al."
I beg to differ. I refer you firstly to this: doi:10.1016/j.homp.2008.12.003 - the analysis by Rutten and Stolper contains misconceptions of Shang et al., contains some important errors, and does not show that the Shang et al. study was an invalid analysis.


As for Ludtke and Rutten, their conclusion stated that "Our results do neither prove that homeopathic medicines are superior to placebo nor do they prove the opposite...it occurs that Shang’s conclusions are not so definite as they have been reported and discussed." Their paper may have been titled "The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials", but the conclusions on the effectiveness of homeopathy *do not* highly depend on the set of analyzed trials, if an appropriate test is used.


Frankly, I'm wary of anything published in the journal "Homeopathy", given the 'memory of water' papers and the subsequent papers I've read that were published in that journal. The quality of the published research in "Homeopathy" seems to be very poor indeed.

"According to Channel 4, approx £320m was spent on management consultants in a single year in England alone. I take it that you are quite happy for your money to be wasted"

What makes you think that the money was wasted?

Homeopathic preparations are based on pseudoscience. No real science exists to give any credible mechanism. (See the entries under the heading on mechanism.) There is no doubt about the efficacy of placebo for some conditions, and homeopathic treatment is nothing other than placebo. The learning from this is sadly ignored, because the time and sensitivity of practitioner care is the issue here. However lying to patients about preparations and medicines is clearly unethical, and giving any credibility to the nonsense that is a homeopathic preparation is both dangerous and immoral.
An example of a practitioner - clearly not well trained in the scientific use of evidence-based medicine, (or of much science for that matter) despite having a medical qualification is that of Dr Michelle Langdon, found guilty of serious professional misconduct and banned from practising medicine for three months by the GMC. She treated several patients ineffectively with homeopathy and failed to use available evidence based treatments, to the health detriment of her patients. In common with others who "believe" in homeopathy, she invoked other forms of pseudoscience, and got support from David Tredinnick - the initiator of the early day motion to overturn the government's science committee investigation into this whole question. He is also reported to believe in astrology. If true, that fits. People voted for him! Amazing...
The source of this information: http://news.bbc.co.uk/1/hi/england/2666411.stm
Check it out, and be in no doubt homeopathy has no basis.